NURS 6501 ADVANCED PATHOPHYSIOLOGY
PRACTICE EXAMINATION 2026–2027 — STUDY GUIDE
| LATEST UPDATE 2026/2027 | PRACTICE QUESTIONS
AND ANSWERS | EXAM REVIEW | 100% CORRECT
ANSWERS | VERIFIED SOLUTIONS | ALREADY
GRADED A+
1. A 55-year-old male with a history of chronic hypertension develops left
ventricular hypertrophy. Which cellular adaptation is primarily responsible?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct Answer: B
Hypertrophy is an increase in cell size, not number, leading to enlarged left
ventricular muscle mass due to increased workload from hypertension.
Hyperplasia is increased cell number. Atrophy is decreased size. Metaplasia is
replacement of one cell type with another.
2. A 30-year-old female has a mutation in the BRCA1 gene. What is the most
significant cancer risk?
A) Colorectal cancer
B) Breast and ovarian cancer
C) Lung cancer
D) Melanoma
Correct Answer: B
BRCA1 mutations significantly increase the risk of breast and ovarian cancer.
,Colorectal cancer is more associated with Lynch syndrome. Lung cancer and
melanoma have different genetic and environmental risk factors.
3. A patient with chronic gastroesophageal reflux disease undergoes
endoscopy, which shows replacement of esophageal squamous epithelium
with columnar epithelium. This is an example of:
A) Dysplasia
B) Metaplasia
C) Neoplasia
D) Hypertrophy
Correct Answer: B
Barrett esophagus is metaplasia, where squamous cells are replaced by columnar
cells in response to chronic acid exposure. Dysplasia is disordered cell growth.
Neoplasia is uncontrolled proliferation. Hypertrophy is increased cell size.
4. A 45-year-old male has a mutation in the p53 tumor suppressor gene. What
is the most likely consequence?
A) Increased apoptosis
B) Uncontrolled cell proliferation and reduced DNA repair
C) Decreased angiogenesis
D) Enhanced immune surveillance
Correct Answer: B
p53 normally regulates the cell cycle, promotes apoptosis, and repairs DNA. Loss
of p53 function leads to uncontrolled cell proliferation and genomic instability.
Apoptosis is decreased, not increased. Angiogenesis and immune surveillance are
not enhanced.
5. A patient with a history of chronic alcohol use develops liver steatosis.
Which cellular change is present?
A) Intracellular lipid accumulation
B) Glycogen depletion
C) Protein misfolding
D) Calcium deposition
,Correct Answer: A
Hepatic steatosis (fatty liver) involves accumulation of triglycerides within
hepatocytes. Glycogen depletion, protein misfolding, and calcium deposition are
not the primary changes in steatosis.
6. A 25-year-old female has a homozygous mutation in the CFTR gene. What is
the primary pathophysiologic defect?
A) Abnormal hemoglobin structure
B) Impaired chloride transport and thick secretions
C) Deficiency of alpha-1 antitrypsin
D) Mutation in the LDL receptor
Correct Answer: B
Cystic fibrosis results from CFTR mutations causing defective chloride transport,
leading to thick mucus in lungs, pancreas, and other organs. Hemoglobin defects
cause sickle cell. Alpha-1 antitrypsin deficiency causes emphysema. LDL receptor
mutation causes familial hypercholesterolemia.
7. A 60-year-old male with a 40-pack-year smoking history develops a cough
and is found to have squamous cell carcinoma of the lung. Which
carcinogenic mechanism is most likely?
A) Radiation-induced DNA damage
B) Chemical carcinogenesis from tobacco smoke
C) Viral oncogenesis
D) Hormonal carcinogenesis
Correct Answer: B
Tobacco smoke contains numerous chemical carcinogens that cause DNA
mutations. Radiation, viral, and hormonal mechanisms are not the primary factors
in smoking-related lung cancer.
8. A 50-year-old female has an elevated CA-125 level. Which cancer is most
commonly associated?
A) Breast cancer
B) Ovarian cancer
, C) Pancreatic cancer
D) Colon cancer
Correct Answer: B
CA-125 is a tumor marker primarily associated with ovarian cancer. CEA is
associated with colon and pancreatic cancers. CA 15-3 is associated with breast
cancer.
9. A patient with type 1 diabetes mellitus develops ketoacidosis. Which acid-
base disturbance is most likely?
A) Metabolic alkalosis
B) Metabolic acidosis
C) Respiratory acidosis
D) Respiratory alkalosis
Correct Answer: B
Diabetic ketoacidosis causes accumulation of ketoacids, leading to metabolic
acidosis with anion gap. Respiratory compensation causes Kussmaul breathing but
the primary disturbance is metabolic acidosis.
10.A 70-year-old male has benign prostatic hyperplasia. Which
pathophysiologic process is involved?
A) Increased androgen-dependent cell proliferation
B) Malignant transformation of prostate cells
C) Decreased apoptosis only
D) Metaplasia of prostate epithelium
Correct Answer: A
BPH is characterized by androgen-dependent hyperplasia of prostatic stromal and
epithelial cells, causing urinary obstruction. It is benign, not malignant. Metaplasia
is not the primary process.
11.A patient has a genetic disorder characterized by a defect in collagen
synthesis, causing skin hyperelasticity and joint hypermobility. Which
condition is most likely?
A) Marfan syndrome
PRACTICE EXAMINATION 2026–2027 — STUDY GUIDE
| LATEST UPDATE 2026/2027 | PRACTICE QUESTIONS
AND ANSWERS | EXAM REVIEW | 100% CORRECT
ANSWERS | VERIFIED SOLUTIONS | ALREADY
GRADED A+
1. A 55-year-old male with a history of chronic hypertension develops left
ventricular hypertrophy. Which cellular adaptation is primarily responsible?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct Answer: B
Hypertrophy is an increase in cell size, not number, leading to enlarged left
ventricular muscle mass due to increased workload from hypertension.
Hyperplasia is increased cell number. Atrophy is decreased size. Metaplasia is
replacement of one cell type with another.
2. A 30-year-old female has a mutation in the BRCA1 gene. What is the most
significant cancer risk?
A) Colorectal cancer
B) Breast and ovarian cancer
C) Lung cancer
D) Melanoma
Correct Answer: B
BRCA1 mutations significantly increase the risk of breast and ovarian cancer.
,Colorectal cancer is more associated with Lynch syndrome. Lung cancer and
melanoma have different genetic and environmental risk factors.
3. A patient with chronic gastroesophageal reflux disease undergoes
endoscopy, which shows replacement of esophageal squamous epithelium
with columnar epithelium. This is an example of:
A) Dysplasia
B) Metaplasia
C) Neoplasia
D) Hypertrophy
Correct Answer: B
Barrett esophagus is metaplasia, where squamous cells are replaced by columnar
cells in response to chronic acid exposure. Dysplasia is disordered cell growth.
Neoplasia is uncontrolled proliferation. Hypertrophy is increased cell size.
4. A 45-year-old male has a mutation in the p53 tumor suppressor gene. What
is the most likely consequence?
A) Increased apoptosis
B) Uncontrolled cell proliferation and reduced DNA repair
C) Decreased angiogenesis
D) Enhanced immune surveillance
Correct Answer: B
p53 normally regulates the cell cycle, promotes apoptosis, and repairs DNA. Loss
of p53 function leads to uncontrolled cell proliferation and genomic instability.
Apoptosis is decreased, not increased. Angiogenesis and immune surveillance are
not enhanced.
5. A patient with a history of chronic alcohol use develops liver steatosis.
Which cellular change is present?
A) Intracellular lipid accumulation
B) Glycogen depletion
C) Protein misfolding
D) Calcium deposition
,Correct Answer: A
Hepatic steatosis (fatty liver) involves accumulation of triglycerides within
hepatocytes. Glycogen depletion, protein misfolding, and calcium deposition are
not the primary changes in steatosis.
6. A 25-year-old female has a homozygous mutation in the CFTR gene. What is
the primary pathophysiologic defect?
A) Abnormal hemoglobin structure
B) Impaired chloride transport and thick secretions
C) Deficiency of alpha-1 antitrypsin
D) Mutation in the LDL receptor
Correct Answer: B
Cystic fibrosis results from CFTR mutations causing defective chloride transport,
leading to thick mucus in lungs, pancreas, and other organs. Hemoglobin defects
cause sickle cell. Alpha-1 antitrypsin deficiency causes emphysema. LDL receptor
mutation causes familial hypercholesterolemia.
7. A 60-year-old male with a 40-pack-year smoking history develops a cough
and is found to have squamous cell carcinoma of the lung. Which
carcinogenic mechanism is most likely?
A) Radiation-induced DNA damage
B) Chemical carcinogenesis from tobacco smoke
C) Viral oncogenesis
D) Hormonal carcinogenesis
Correct Answer: B
Tobacco smoke contains numerous chemical carcinogens that cause DNA
mutations. Radiation, viral, and hormonal mechanisms are not the primary factors
in smoking-related lung cancer.
8. A 50-year-old female has an elevated CA-125 level. Which cancer is most
commonly associated?
A) Breast cancer
B) Ovarian cancer
, C) Pancreatic cancer
D) Colon cancer
Correct Answer: B
CA-125 is a tumor marker primarily associated with ovarian cancer. CEA is
associated with colon and pancreatic cancers. CA 15-3 is associated with breast
cancer.
9. A patient with type 1 diabetes mellitus develops ketoacidosis. Which acid-
base disturbance is most likely?
A) Metabolic alkalosis
B) Metabolic acidosis
C) Respiratory acidosis
D) Respiratory alkalosis
Correct Answer: B
Diabetic ketoacidosis causes accumulation of ketoacids, leading to metabolic
acidosis with anion gap. Respiratory compensation causes Kussmaul breathing but
the primary disturbance is metabolic acidosis.
10.A 70-year-old male has benign prostatic hyperplasia. Which
pathophysiologic process is involved?
A) Increased androgen-dependent cell proliferation
B) Malignant transformation of prostate cells
C) Decreased apoptosis only
D) Metaplasia of prostate epithelium
Correct Answer: A
BPH is characterized by androgen-dependent hyperplasia of prostatic stromal and
epithelial cells, causing urinary obstruction. It is benign, not malignant. Metaplasia
is not the primary process.
11.A patient has a genetic disorder characterized by a defect in collagen
synthesis, causing skin hyperelasticity and joint hypermobility. Which
condition is most likely?
A) Marfan syndrome
