NR507 ADVANCED PATHOPHYSIOLOGY FINAL
EXAMINATION PRACTICE QUESTIONS WITH
SOLUTIONS 2026/2027
Instructions: This exam contains multiple-choice questions covering the core content domains
tested on the NR507 Final Examination. Topics include cellular adaptation, genetics, fluid and
electrolytes, acid-base balance, immunology, hematology, cardiovascular, respiratory, renal,
and gastrointestinal pathophysiology.
1. A 65-year-old male with a long history of smoking presents with
chronic bronchitis. His bronchial epithelium has replaced the normal
ciliated columnar cells with stratified squamous epithelium. Which
cellular adaptation is this?
A. Hyperplasia
B. Metaplasia
C. Dysplasia
D. Anaplasia
Correct Answer: B — Metaplasia
Rationale: Metaplasia is a reversible replacement of one differentiated
cell type with another more resilient type in response to chronic stress,
,such as squamous cells replacing ciliated columnar cells in smokers.
Hyperplasia involves increased cell number, dysplasia involves
disordered growth with atypia, and anaplasia refers to lack of
differentiation in malignant cells .
2. Following a myocardial infarction, the ischemic cardiac muscle cells
undergo cell death characterized by cellular swelling, loss of membrane
integrity, and an acute inflammatory response. What type of cell death
is this?
A. Apoptosis
B. Necrosis
C. Pyroptosis
D. Autophagy
Correct Answer: B — Necrosis
Rationale: Necrosis is an uncontrolled, pathological cell death
characterized by cellular swelling, loss of membrane integrity, and
inflammation, unlike the neat, programmed, and non-inflammatory
,process of apoptosis. Pyroptosis is a programmed inflammatory cell
death, and autophagy is a survival mechanism .
3. A 45-year-old female undergoes an endometrial biopsy that reveals
abnormal, disorderly proliferative changes with loss of polarity and
nuclear atypia. Which cellular adaptation best describes this finding?
A. Hyperplasia
B. Metaplasia
C. Dysplasia
D. Neoplasia
Correct Answer: C — Dysplasia
Rationale: Dysplasia refers to abnormal, disorganized cellular
development with loss of polarity and nuclear atypia, which is often a
precursor to neoplasia but not neoplastic itself. Hyperplasia is increased
cell number, metaplasia is cell type replacement, and neoplasia refers
to new growth .
, 4. A couple is referred for genetic counseling after having a child with
cystic fibrosis. They are asymptomatic carriers. What is the inheritance
pattern for this disorder?
A. Autosomal dominant
B. Autosomal recessive
C. X-linked dominant
D. X-linked recessive
Correct Answer: B — Autosomal recessive
Rationale: Cystic fibrosis is a classic autosomal recessive disorder
requiring two mutated alleles for the disease to manifest, meaning
carriers with one allele are asymptomatic. Autosomal dominant
disorders manifest with one mutated allele, and X-linked recessive
disorders typically affect males .
5. A researcher is studying a gene that is normally silenced but becomes
transcriptionally active after exposure to a specific environmental toxin,
EXAMINATION PRACTICE QUESTIONS WITH
SOLUTIONS 2026/2027
Instructions: This exam contains multiple-choice questions covering the core content domains
tested on the NR507 Final Examination. Topics include cellular adaptation, genetics, fluid and
electrolytes, acid-base balance, immunology, hematology, cardiovascular, respiratory, renal,
and gastrointestinal pathophysiology.
1. A 65-year-old male with a long history of smoking presents with
chronic bronchitis. His bronchial epithelium has replaced the normal
ciliated columnar cells with stratified squamous epithelium. Which
cellular adaptation is this?
A. Hyperplasia
B. Metaplasia
C. Dysplasia
D. Anaplasia
Correct Answer: B — Metaplasia
Rationale: Metaplasia is a reversible replacement of one differentiated
cell type with another more resilient type in response to chronic stress,
,such as squamous cells replacing ciliated columnar cells in smokers.
Hyperplasia involves increased cell number, dysplasia involves
disordered growth with atypia, and anaplasia refers to lack of
differentiation in malignant cells .
2. Following a myocardial infarction, the ischemic cardiac muscle cells
undergo cell death characterized by cellular swelling, loss of membrane
integrity, and an acute inflammatory response. What type of cell death
is this?
A. Apoptosis
B. Necrosis
C. Pyroptosis
D. Autophagy
Correct Answer: B — Necrosis
Rationale: Necrosis is an uncontrolled, pathological cell death
characterized by cellular swelling, loss of membrane integrity, and
inflammation, unlike the neat, programmed, and non-inflammatory
,process of apoptosis. Pyroptosis is a programmed inflammatory cell
death, and autophagy is a survival mechanism .
3. A 45-year-old female undergoes an endometrial biopsy that reveals
abnormal, disorderly proliferative changes with loss of polarity and
nuclear atypia. Which cellular adaptation best describes this finding?
A. Hyperplasia
B. Metaplasia
C. Dysplasia
D. Neoplasia
Correct Answer: C — Dysplasia
Rationale: Dysplasia refers to abnormal, disorganized cellular
development with loss of polarity and nuclear atypia, which is often a
precursor to neoplasia but not neoplastic itself. Hyperplasia is increased
cell number, metaplasia is cell type replacement, and neoplasia refers
to new growth .
, 4. A couple is referred for genetic counseling after having a child with
cystic fibrosis. They are asymptomatic carriers. What is the inheritance
pattern for this disorder?
A. Autosomal dominant
B. Autosomal recessive
C. X-linked dominant
D. X-linked recessive
Correct Answer: B — Autosomal recessive
Rationale: Cystic fibrosis is a classic autosomal recessive disorder
requiring two mutated alleles for the disease to manifest, meaning
carriers with one allele are asymptomatic. Autosomal dominant
disorders manifest with one mutated allele, and X-linked recessive
disorders typically affect males .
5. A researcher is studying a gene that is normally silenced but becomes
transcriptionally active after exposure to a specific environmental toxin,
