NUR 631 FINAL EXAM REVIEW (GCU) NEWEST
2026/ 2027 TEST BANK| NP CERTIFICATION
EXAM PREP
1. A patient with a known BRCA1 mutation is at significantly increased risk for
breast and ovarian cancer. The BRCA1 gene is best classified as which of the
following?
A) Proto-oncogene
B) Oncogene
C) Tumor suppressor gene
D) Apoptotic gene
Answer: C. Tumor suppressor genes (like BRCA1, p53, RB) normally regulate cell
growth and repair DNA. When mutated, they lose their "brake" function, allowing
uncontrolled growth. Proto-oncogenes (A/B) become oncogenes when mutated
(gain of function, "gas pedal"). Apoptotic genes (D) regulate programmed cell
death.
2. A pathologist notes that a tissue sample has cells that vary greatly in size and
shape, with hyperchromatic (dark) nuclei and loss of normal tissue architecture.
This finding is most characteristic of:
A) Metaplasia
B) Dysplasia
C) Hypertrophy
D) Atrophy
Answer: B. Dysplasia is disordered cellular growth with pleomorphism (variation
in size/shape) and hyperchromatic nuclei; it is considered a pre-neoplastic lesion.
Metaplasia (A) is a reversible change from one mature cell type to another (e.g.,
Barrett's esophagus). Hypertrophy (C) is an increase in cell size. Atrophy (D) is a
decrease in cell size.
3. A child is diagnosed with Angelman syndrome characterized by severe
intellectual disability, ataxic gait, and inappropriate laughter. This condition is
,most often caused by a deletion on which chromosome inherited from which
parent?
A) Chromosome 15; paternal deletion
B) Chromosome 15; maternal deletion
C) Chromosome 5; paternal deletion
D) Chromosome 5; maternal deletion
Answer: B. Angelman syndrome is due to a deletion on the maternal chromosome
15. Prader-Willi syndrome is due to a deletion on the paternal chromosome 15
(A). Chromosome 5 is associated with Cri-du-chat syndrome.
4. A patient with chronic gastroesophageal reflux disease develops replacement
of the normal stratified squamous epithelium of the lower esophagus with
simple columnar epithelium. This adaptive change is known as:
A) Anaplasia
B) Dysplasia
C) Hyperplasia
D) Metaplasia
Answer: D. This is the classic description of Barrett's esophagus—a metaplastic
change. It is reversible but increases the risk of adenocarcinoma. Anaplasia (A) is a
loss of differentiation seen in malignant cancers. Dysplasia (B) is disordered
growth. Hyperplasia (C) is an increase in the number of cells.
5. Which cellular process is characterized by cell shrinkage, chromatin
condensation, and formation of apoptotic bodies without triggering an
inflammatory response?
A) Necrosis
B) Pyroptosis
C) Apoptosis
D) Autophagy
Answer: C. Apoptosis is programmed, energy-dependent (ATP-requiring) cell
death that is clean and does not elicit inflammation. Necrosis (A) is unplanned,
causes cell swelling, rupture, and triggers a robust inflammatory response.
Pyroptosis (B) is inflammatory programmed cell death. Autophagy (D) is the cell's
recycling mechanism.
,6. A patient with a rare genetic disorder has a mutation in the gene encoding the
CFTR protein, leading to defective chloride transport. The resulting thick mucus
production in the lungs and pancreas is a classic feature of:
A) Huntington's disease
B) Cystic fibrosis
C) Marfan syndrome
D) Duchenne muscular dystrophy
Answer: B. Cystic fibrosis is an autosomal recessive disorder caused by a mutation
in the CFTR gene on chromosome 7. Huntington's (A) is a trinucleotide repeat
disorder. Marfan (C) affects fibrillin. Duchenne (D) affects dystrophin.
7. A tumor biopsy reveals cells that are poorly differentiated and have invaded
the basement membrane into surrounding tissue. This tumor is best described
as:
A) Benign and in situ
B) Malignant and in situ
C) Benign and invasive
D) Malignant and invasive
Answer: D. Poorly differentiated (anaplasia) + invasion through the basement
membrane = malignant (cancerous) and invasive. "In situ" (A/B) means it has NOT
invaded the basement membrane. Benign tumors (C) are well-differentiated and
do not invade.
8. The "Hayflick limit" refers to:
A) The maximum number of times a normal cell can divide before senescence
B) The minimum number of oncogenes required for malignant transformation
C) The duration of the S-phase of the cell cycle
D) The threshold for apoptosis activation
Answer: A. The Hayflick limit describes the finite number of cell divisions (around
40–60) that normal human somatic cells can undergo before entering replicative
senescence, largely due to telomere shortening.
9. A newborn presents with hypotonia, feeding difficulties, and hypogonadism.
A DNA test reveals a deletion on the paternal chromosome 15. This infant most
, likely has:
A) Angelman syndrome
B) Prader-Willi syndrome
C) Down syndrome
D) Fragile X syndrome
Answer: B. Prader-Willi syndrome is caused by a deletion on
the paternal chromosome 15. Angelman (A) is the maternal deletion. Down (C) is
trisomy 21. Fragile X (D) is a trinucleotide repeat on the X chromosome.
10. Which of the following is a classic example of a gain-of-function mutation
that acts as a dominant oncogene?
A) p53 mutation
B) BRCA1 mutation
C) RAS mutation
D) RB mutation
Answer: C. RAS is a proto-oncogene; when mutated, it becomes an oncogene via a
gain-of-function (it is stuck in the "on" position, continuously signaling cell
division). p53 (A), BRCA1 (B), and RB (D) are tumor suppressors that lose function
(loss-of-function) via a "two-hit" hypothesis.
Immunity & Inflammation (Questions 11–20)
11. A patient develops hives, bronchospasm, and hypotension within minutes of
receiving intravenous penicillin. This reaction is mediated by which
immunoglobulin and cell type?
A) IgG; Macrophages
B) IgA; Neutrophils
C) IgE; Mast cells
D) IgM; Natural Killer cells
Answer: C. This is a classic Type I hypersensitivity (anaphylactic) reaction. It is
mediated by IgE binding to Fc receptors on mast cells and basophils, causing
degranulation and release of histamine and other vasoactive amines.
2026/ 2027 TEST BANK| NP CERTIFICATION
EXAM PREP
1. A patient with a known BRCA1 mutation is at significantly increased risk for
breast and ovarian cancer. The BRCA1 gene is best classified as which of the
following?
A) Proto-oncogene
B) Oncogene
C) Tumor suppressor gene
D) Apoptotic gene
Answer: C. Tumor suppressor genes (like BRCA1, p53, RB) normally regulate cell
growth and repair DNA. When mutated, they lose their "brake" function, allowing
uncontrolled growth. Proto-oncogenes (A/B) become oncogenes when mutated
(gain of function, "gas pedal"). Apoptotic genes (D) regulate programmed cell
death.
2. A pathologist notes that a tissue sample has cells that vary greatly in size and
shape, with hyperchromatic (dark) nuclei and loss of normal tissue architecture.
This finding is most characteristic of:
A) Metaplasia
B) Dysplasia
C) Hypertrophy
D) Atrophy
Answer: B. Dysplasia is disordered cellular growth with pleomorphism (variation
in size/shape) and hyperchromatic nuclei; it is considered a pre-neoplastic lesion.
Metaplasia (A) is a reversible change from one mature cell type to another (e.g.,
Barrett's esophagus). Hypertrophy (C) is an increase in cell size. Atrophy (D) is a
decrease in cell size.
3. A child is diagnosed with Angelman syndrome characterized by severe
intellectual disability, ataxic gait, and inappropriate laughter. This condition is
,most often caused by a deletion on which chromosome inherited from which
parent?
A) Chromosome 15; paternal deletion
B) Chromosome 15; maternal deletion
C) Chromosome 5; paternal deletion
D) Chromosome 5; maternal deletion
Answer: B. Angelman syndrome is due to a deletion on the maternal chromosome
15. Prader-Willi syndrome is due to a deletion on the paternal chromosome 15
(A). Chromosome 5 is associated with Cri-du-chat syndrome.
4. A patient with chronic gastroesophageal reflux disease develops replacement
of the normal stratified squamous epithelium of the lower esophagus with
simple columnar epithelium. This adaptive change is known as:
A) Anaplasia
B) Dysplasia
C) Hyperplasia
D) Metaplasia
Answer: D. This is the classic description of Barrett's esophagus—a metaplastic
change. It is reversible but increases the risk of adenocarcinoma. Anaplasia (A) is a
loss of differentiation seen in malignant cancers. Dysplasia (B) is disordered
growth. Hyperplasia (C) is an increase in the number of cells.
5. Which cellular process is characterized by cell shrinkage, chromatin
condensation, and formation of apoptotic bodies without triggering an
inflammatory response?
A) Necrosis
B) Pyroptosis
C) Apoptosis
D) Autophagy
Answer: C. Apoptosis is programmed, energy-dependent (ATP-requiring) cell
death that is clean and does not elicit inflammation. Necrosis (A) is unplanned,
causes cell swelling, rupture, and triggers a robust inflammatory response.
Pyroptosis (B) is inflammatory programmed cell death. Autophagy (D) is the cell's
recycling mechanism.
,6. A patient with a rare genetic disorder has a mutation in the gene encoding the
CFTR protein, leading to defective chloride transport. The resulting thick mucus
production in the lungs and pancreas is a classic feature of:
A) Huntington's disease
B) Cystic fibrosis
C) Marfan syndrome
D) Duchenne muscular dystrophy
Answer: B. Cystic fibrosis is an autosomal recessive disorder caused by a mutation
in the CFTR gene on chromosome 7. Huntington's (A) is a trinucleotide repeat
disorder. Marfan (C) affects fibrillin. Duchenne (D) affects dystrophin.
7. A tumor biopsy reveals cells that are poorly differentiated and have invaded
the basement membrane into surrounding tissue. This tumor is best described
as:
A) Benign and in situ
B) Malignant and in situ
C) Benign and invasive
D) Malignant and invasive
Answer: D. Poorly differentiated (anaplasia) + invasion through the basement
membrane = malignant (cancerous) and invasive. "In situ" (A/B) means it has NOT
invaded the basement membrane. Benign tumors (C) are well-differentiated and
do not invade.
8. The "Hayflick limit" refers to:
A) The maximum number of times a normal cell can divide before senescence
B) The minimum number of oncogenes required for malignant transformation
C) The duration of the S-phase of the cell cycle
D) The threshold for apoptosis activation
Answer: A. The Hayflick limit describes the finite number of cell divisions (around
40–60) that normal human somatic cells can undergo before entering replicative
senescence, largely due to telomere shortening.
9. A newborn presents with hypotonia, feeding difficulties, and hypogonadism.
A DNA test reveals a deletion on the paternal chromosome 15. This infant most
, likely has:
A) Angelman syndrome
B) Prader-Willi syndrome
C) Down syndrome
D) Fragile X syndrome
Answer: B. Prader-Willi syndrome is caused by a deletion on
the paternal chromosome 15. Angelman (A) is the maternal deletion. Down (C) is
trisomy 21. Fragile X (D) is a trinucleotide repeat on the X chromosome.
10. Which of the following is a classic example of a gain-of-function mutation
that acts as a dominant oncogene?
A) p53 mutation
B) BRCA1 mutation
C) RAS mutation
D) RB mutation
Answer: C. RAS is a proto-oncogene; when mutated, it becomes an oncogene via a
gain-of-function (it is stuck in the "on" position, continuously signaling cell
division). p53 (A), BRCA1 (B), and RB (D) are tumor suppressors that lose function
(loss-of-function) via a "two-hit" hypothesis.
Immunity & Inflammation (Questions 11–20)
11. A patient develops hives, bronchospasm, and hypotension within minutes of
receiving intravenous penicillin. This reaction is mediated by which
immunoglobulin and cell type?
A) IgG; Macrophages
B) IgA; Neutrophils
C) IgE; Mast cells
D) IgM; Natural Killer cells
Answer: C. This is a classic Type I hypersensitivity (anaphylactic) reaction. It is
mediated by IgE binding to Fc receptors on mast cells and basophils, causing
degranulation and release of histamine and other vasoactive amines.
