,HESI Pathophysiology Exam Questions And Answers | Nursing |
2026/2027
1.** A patient with chronic, untreated hypertension develops a thickened left
ventricular wall. The nurse recognizes this adaptive structural change as:
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Dysplasia
**Correct Answer:** C) Hypertrophy
**Rationale:** Hypertrophy is an increase in cell size, often in response to
increased workload. In hypertension, the increased afterload causes cardiac
myocytes to enlarge, leading to left ventricular hypertrophy. This is a
compensatory adaptation that can become pathologic over time.
---
**2.** A tissue biopsy of a chronic smoker's bronchi reveals that normal
ciliated columnar epithelial cells have been replaced by stratified squamous
epithelial cells. This is an example of which process?
A) Anaplasia
B) Metaplasia
C) Dysplasia
D) Atrophy
**Correct Answer:** B) Metaplasia
,**Rationale:** Metaplasia is the reversible replacement of one mature cell
type by another, less specialized cell type, often in response to chronic
irritation. In smokers, the respiratory epithelium changes from ciliated
columnar to stratified squamous cells, which are more resistant to irritation
but lose protective functions.
---
**3.** During an ischemic event, a lack of oxygen leads to a decrease in
cellular ATP production. Which immediate consequence occurs within the
cell?
A) Shrinkage of the nucleus
B) Failure of the sodium-potassium pump, leading to cellular swelling
C) Decreased intracellular calcium levels
D) Increased intracellular pH
**Correct Answer:** B) Failure of the sodium-potassium pump, leading to
cellular swelling
**Rationale:** Decreased ATP causes the Na⁺/K⁺ ATPase pump to fail. Sodium
accumulates inside the cell, pulling water in by osmosis, which results in
acute cellular swelling. This is an early sign of reversible cell injury.
---
**4.** A patient with a myocardial infarction has cardiac tissue that is dead
but maintains cell outlines. The nurse recognizes this as:
, A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
**Correct Answer:** A) Coagulative necrosis
**Rationale:** Coagulative necrosis is the most common type of necrosis,
typically occurring from hypoxia. The cell outlines are preserved, and the
tissue appears firm. This is seen in myocardial infarction and renal infarction.
---
**5.** A patient with tuberculosis has a lung lesion with a cheese-like
appearance on biopsy. This is characteristic of:
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
**Correct Answer:** C) Caseous necrosis
**Rationale:** Caseous necrosis is a combination of coagulative and
liquefactive necrosis, resulting in a cheese-like (caseous) appearance. It is
most commonly associated with tuberculosis and certain fungal infections.
---
2026/2027
1.** A patient with chronic, untreated hypertension develops a thickened left
ventricular wall. The nurse recognizes this adaptive structural change as:
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Dysplasia
**Correct Answer:** C) Hypertrophy
**Rationale:** Hypertrophy is an increase in cell size, often in response to
increased workload. In hypertension, the increased afterload causes cardiac
myocytes to enlarge, leading to left ventricular hypertrophy. This is a
compensatory adaptation that can become pathologic over time.
---
**2.** A tissue biopsy of a chronic smoker's bronchi reveals that normal
ciliated columnar epithelial cells have been replaced by stratified squamous
epithelial cells. This is an example of which process?
A) Anaplasia
B) Metaplasia
C) Dysplasia
D) Atrophy
**Correct Answer:** B) Metaplasia
,**Rationale:** Metaplasia is the reversible replacement of one mature cell
type by another, less specialized cell type, often in response to chronic
irritation. In smokers, the respiratory epithelium changes from ciliated
columnar to stratified squamous cells, which are more resistant to irritation
but lose protective functions.
---
**3.** During an ischemic event, a lack of oxygen leads to a decrease in
cellular ATP production. Which immediate consequence occurs within the
cell?
A) Shrinkage of the nucleus
B) Failure of the sodium-potassium pump, leading to cellular swelling
C) Decreased intracellular calcium levels
D) Increased intracellular pH
**Correct Answer:** B) Failure of the sodium-potassium pump, leading to
cellular swelling
**Rationale:** Decreased ATP causes the Na⁺/K⁺ ATPase pump to fail. Sodium
accumulates inside the cell, pulling water in by osmosis, which results in
acute cellular swelling. This is an early sign of reversible cell injury.
---
**4.** A patient with a myocardial infarction has cardiac tissue that is dead
but maintains cell outlines. The nurse recognizes this as:
, A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
**Correct Answer:** A) Coagulative necrosis
**Rationale:** Coagulative necrosis is the most common type of necrosis,
typically occurring from hypoxia. The cell outlines are preserved, and the
tissue appears firm. This is seen in myocardial infarction and renal infarction.
---
**5.** A patient with tuberculosis has a lung lesion with a cheese-like
appearance on biopsy. This is characteristic of:
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
**Correct Answer:** C) Caseous necrosis
**Rationale:** Caseous necrosis is a combination of coagulative and
liquefactive necrosis, resulting in a cheese-like (caseous) appearance. It is
most commonly associated with tuberculosis and certain fungal infections.
---
