NSG 520 PATHOPHYSIOLOGY AND
PHARMACOLOGY EXAM QUESTIONS AND
CORRECT ANSWERS LATEST GUIDE 2026/2027
NSG 520 Pathophysiology & Pharmacology – Practice
Examination
Section 1: Cellular Adaptation, Injury, & Inflammation
(Q1–Q10)
1. A patient with chronic hypertension develops left ventricular thickening. This
cellular adaptation is best described as:
• A. Hyperplasia
• B. Hypertrophy
• C. Metaplasia
• D. Dysplasia
Answer: B. Hypertrophy
Rationale: Hypertrophy is an increase in cell size in response to increased
workload, as seen in cardiac muscle which has limited regenerative capacity.
Hyperplasia is an increase in cell number, metaplasia is replacement with another
cell type, and dysplasia is disordered cellular growth.
2. A patient with tuberculosis develops a lung lesion containing cheesy, white-
gray material. This type of necrosis is:
• A. Coagulative necrosis
• B. Liquefactive necrosis
, • C. Caseous necrosis
• D. Fat necrosis
Answer: C. Caseous necrosis
Rationale: Caseous necrosis is特有的to tuberculosis and fungal infections,
creating a soft, "cheese-like" appearance. Coagulative necrosis is typical of
ischemia (e.g., myocardial infarction). Liquefactive necrosis occurs in the brain. Fat
necrosis is seen in pancreatitis.
3. Which statement best describes apoptosis?
• A. Uncontrolled cell death causing inflammation
• B. Programmed cell death without inflammation
• C. Cell death due to acute ischemia
• D. Rapid cell swelling and lysis
Answer: B. Programmed cell death without inflammation
Rationale: Apoptosis is a regulated, energy-dependent process that eliminates
damaged or unwanted cells without triggering inflammation. Necrosis is
uncontrolled and inflammatory.
4. A patient develops tissue damage after blood flow is restored to an ischemic
area of the heart. This phenomenon is called:
• A. Hypoxic injury
• B. Reperfusion injury
• C. Coagulative necrosis
• D. Infarction
Answer: B. Reperfusion injury
Rationale: Reperfusion injury occurs when oxygen is suddenly restored to ischemic
tissue, generating reactive oxygen species (free radicals) that cause additional
cellular damage beyond the initial ischemic insult.
,5. A biopsy of a chronic smoker's bronchus shows replacement of normal ciliated
columnar epithelium with stratified squamous epithelium. This change is called:
• A. Dysplasia
• B. Hyperplasia
• C. Metaplasia
• D. Anaplasia
Answer: C. Metaplasia
Rationale: Metaplasia is the reversible replacement of one differentiated cell type
with another, often due to chronic irritation (e.g., smoking). Dysplasia and
anaplasia are associated with cancer risk.
6. The four cardinal signs of inflammation are:
• A. Fever, chills, headache, malaise
• B. Redness, swelling, heat, pain
• C. Nausea, vomiting, diarrhea, fatigue
• D. Edema, hypotension, bradycardia, pallor
Answer: B. Redness, swelling, heat, pain
Rationale: These classic signs (rubor, tumor, calor, dolor) result from vasodilation
(redness/heat), increased vascular permeability (swelling), and chemical
mediators like bradykinin and prostaglandins (pain).
7. Which cell type is the first to arrive at the site of an acute bacterial infection?
• A. Macrophage
• B. Lymphocyte
• C. Neutrophil
• D. Eosinophil
Answer: C. Neutrophil
Rationale: Neutrophils are the first responders to bacterial infection, arriving
, within hours to phagocytose pathogens. Macrophages arrive later, lymphocytes
are involved in adaptive immunity, and eosinophils respond to parasites/allergies.
8. A patient with systemic lupus erythematosus (SLE) has antibodies against self-
DNA and nuclear proteins. This is an example of which type of hypersensitivity?
• A. Type I
• B. Type II
• C. Type III
• D. Type IV
Answer: C. Type III
Rationale: SLE involves immune complex deposition (Type III hypersensitivity).
Autoantibodies bind nuclear antigens, forming complexes that deposit in blood
vessels, kidneys, and joints, activating complement and causing tissue damage.
9. A child develops hives and wheezing within minutes of eating peanuts. This
reaction is mediated by:
• A. Cytotoxic T cells
• B. IgE and mast cell degranulation
• C. Immune complex deposition
• D. Delayed-type hypersensitivity
Answer: B. IgE and mast cell degranulation
Rationale: Peanut allergy is Type I hypersensitivity: IgE cross-links on mast cells,
causing immediate release of histamine, leukotrienes, and other mediators that
produce vasodilation, bronchoconstriction, and increased vascular permeability.
10. Anaphylactic shock is a medical emergency. First-line pharmacologic
treatment is:
• A. Diphenhydramine (Benadryl)
• B. Albuterol nebulizer
PHARMACOLOGY EXAM QUESTIONS AND
CORRECT ANSWERS LATEST GUIDE 2026/2027
NSG 520 Pathophysiology & Pharmacology – Practice
Examination
Section 1: Cellular Adaptation, Injury, & Inflammation
(Q1–Q10)
1. A patient with chronic hypertension develops left ventricular thickening. This
cellular adaptation is best described as:
• A. Hyperplasia
• B. Hypertrophy
• C. Metaplasia
• D. Dysplasia
Answer: B. Hypertrophy
Rationale: Hypertrophy is an increase in cell size in response to increased
workload, as seen in cardiac muscle which has limited regenerative capacity.
Hyperplasia is an increase in cell number, metaplasia is replacement with another
cell type, and dysplasia is disordered cellular growth.
2. A patient with tuberculosis develops a lung lesion containing cheesy, white-
gray material. This type of necrosis is:
• A. Coagulative necrosis
• B. Liquefactive necrosis
, • C. Caseous necrosis
• D. Fat necrosis
Answer: C. Caseous necrosis
Rationale: Caseous necrosis is特有的to tuberculosis and fungal infections,
creating a soft, "cheese-like" appearance. Coagulative necrosis is typical of
ischemia (e.g., myocardial infarction). Liquefactive necrosis occurs in the brain. Fat
necrosis is seen in pancreatitis.
3. Which statement best describes apoptosis?
• A. Uncontrolled cell death causing inflammation
• B. Programmed cell death without inflammation
• C. Cell death due to acute ischemia
• D. Rapid cell swelling and lysis
Answer: B. Programmed cell death without inflammation
Rationale: Apoptosis is a regulated, energy-dependent process that eliminates
damaged or unwanted cells without triggering inflammation. Necrosis is
uncontrolled and inflammatory.
4. A patient develops tissue damage after blood flow is restored to an ischemic
area of the heart. This phenomenon is called:
• A. Hypoxic injury
• B. Reperfusion injury
• C. Coagulative necrosis
• D. Infarction
Answer: B. Reperfusion injury
Rationale: Reperfusion injury occurs when oxygen is suddenly restored to ischemic
tissue, generating reactive oxygen species (free radicals) that cause additional
cellular damage beyond the initial ischemic insult.
,5. A biopsy of a chronic smoker's bronchus shows replacement of normal ciliated
columnar epithelium with stratified squamous epithelium. This change is called:
• A. Dysplasia
• B. Hyperplasia
• C. Metaplasia
• D. Anaplasia
Answer: C. Metaplasia
Rationale: Metaplasia is the reversible replacement of one differentiated cell type
with another, often due to chronic irritation (e.g., smoking). Dysplasia and
anaplasia are associated with cancer risk.
6. The four cardinal signs of inflammation are:
• A. Fever, chills, headache, malaise
• B. Redness, swelling, heat, pain
• C. Nausea, vomiting, diarrhea, fatigue
• D. Edema, hypotension, bradycardia, pallor
Answer: B. Redness, swelling, heat, pain
Rationale: These classic signs (rubor, tumor, calor, dolor) result from vasodilation
(redness/heat), increased vascular permeability (swelling), and chemical
mediators like bradykinin and prostaglandins (pain).
7. Which cell type is the first to arrive at the site of an acute bacterial infection?
• A. Macrophage
• B. Lymphocyte
• C. Neutrophil
• D. Eosinophil
Answer: C. Neutrophil
Rationale: Neutrophils are the first responders to bacterial infection, arriving
, within hours to phagocytose pathogens. Macrophages arrive later, lymphocytes
are involved in adaptive immunity, and eosinophils respond to parasites/allergies.
8. A patient with systemic lupus erythematosus (SLE) has antibodies against self-
DNA and nuclear proteins. This is an example of which type of hypersensitivity?
• A. Type I
• B. Type II
• C. Type III
• D. Type IV
Answer: C. Type III
Rationale: SLE involves immune complex deposition (Type III hypersensitivity).
Autoantibodies bind nuclear antigens, forming complexes that deposit in blood
vessels, kidneys, and joints, activating complement and causing tissue damage.
9. A child develops hives and wheezing within minutes of eating peanuts. This
reaction is mediated by:
• A. Cytotoxic T cells
• B. IgE and mast cell degranulation
• C. Immune complex deposition
• D. Delayed-type hypersensitivity
Answer: B. IgE and mast cell degranulation
Rationale: Peanut allergy is Type I hypersensitivity: IgE cross-links on mast cells,
causing immediate release of histamine, leukotrienes, and other mediators that
produce vasodilation, bronchoconstriction, and increased vascular permeability.
10. Anaphylactic shock is a medical emergency. First-line pharmacologic
treatment is:
• A. Diphenhydramine (Benadryl)
• B. Albuterol nebulizer
