Page 1 of 68
NSG 5140 ADVANCED PATHOPHYSIOLOGY FINAL EXAM
2026/2027 COMPLETE (150) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
PATHOPHYSIOLOGY
Prepare effectively for the NSG 5140 Advanced Pathophysiology Final Exam with this
focused study resource. It supports review of advanced disease processes,
pathophysiological mechanisms, cellular responses, clinical manifestations, and
physiological changes associated with illness. Use the material to reinforce your
understanding, review key topics, and identify areas that may require additional study.
This resource is suited for graduate nursing students, advanced practice nursing
learners, and candidates preparing for the NSG 5140 final examination.
MULTIPLE CHOICE.
SECTION 1: CELLULAR ADAPTATION, INJURY, AND DEATH (Questions 1–25)
1. A cell adapts to a decreased workload by decreasing in size. This
adaptive change is BEST described as:
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Correct Answer: C
Rationale: Atrophy is a decrease in cell size in response to decreased
workload, loss of innervation, diminished blood supply, or inadequate
nutrition. Hypertrophy is an increase in cell size; hyperplasia is an
increase in cell number; metaplasia is the replacement of one cell type
with another.
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2. A 58-year-old male with a 40-pack-year smoking history undergoes a
bronchial biopsy. The pathologist notes replacement of normal ciliated
columnar epithelium with stratified squamous epithelium in the bronchi.
This cellular change is BEST described as:
A. Dysplasia
B. Metaplasia
C. Anaplasia
D. Neoplasia
Correct Answer: B
Rationale: Metaplasia is the reversible replacement of one differentiated
cell type with another in response to chronic irritation. Smoking causes
squamous metaplasia of the respiratory epithelium. Dysplasia involves
disordered cellular growth; anaplasia refers to loss of differentiation in
malignant cells.
3. A patient with chronic hypertension develops left ventricular
hypertrophy. This adaptation is BEST described as:
A. Metaplasia
B. Hyperplasia
C. Hypertrophy
D. Dysplasia
Correct Answer: C
Rationale: Hypertrophy is an increase in cell size in response to increased
workload. Chronic hypertension causes pressure overload on the left
ventricle, leading to concentric hypertrophy. Cardiac myocytes cannot
undergo hyperplasia (increased cell number).
4. Which cellular process is responsible for eliminating damaged cells
without triggering an inflammatory response?
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A. Necrosis
B. Apoptosis
C. Autophagy
D. Pyroptosis
Correct Answer: B
Rationale: Apoptosis is programmed cell death that eliminates damaged
cells without triggering inflammation. It is a tightly regulated process
involving caspases. Necrosis is unregulated cell death that causes
inflammation.
5. A patient with a myocardial infarction develops necrosis of cardiac
myocytes. Which type of necrosis is MOST characteristic of ischemic
injury in the heart?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
Correct Answer: A
Rationale: Coagulative necrosis is the hallmark of ischemic injury in solid
organs such as the heart, kidney, and spleen. Liquefactive necrosis is
seen in the brain; caseous necrosis in tuberculosis; fat necrosis in
pancreatic injury.
6. A patient with chronic renal failure develops anemia. This anemia is
MOST likely due to:
A. Iron deficiency
B. Decreased erythropoietin production
C. Vitamin B12 deficiency
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D. Folate deficiency
Correct Answer: B
Rationale: The kidneys produce erythropoietin, which stimulates red
blood cell production. In chronic renal failure, decreased erythropoietin
production leads to normocytic, normochromic anemia.
7. A patient with chronic liver disease develops gynecomastia and spider
angiomas. These findings are MOST likely due to:
A. Increased aldosterone
B. Decreased estrogen metabolism
C. Increased cortisol
D. Decreased testosterone production
Correct Answer: B
Rationale: The liver metabolizes estrogen. In chronic liver disease,
decreased estrogen metabolism leads to elevated estrogen levels,
causing gynecomastia, spider angiomas, and palmar erythema.
8. A patient with chronic hypoxia develops pulmonary hypertension.
Which cellular adaptation occurs in the pulmonary arterioles in response
to chronic hypoxia?
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
Correct Answer: B
Rationale: Chronic hypoxia causes vasoconstriction of pulmonary
arterioles, leading to increased pulmonary vascular resistance. This
NSG 5140 ADVANCED PATHOPHYSIOLOGY FINAL EXAM
2026/2027 COMPLETE (150) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
PATHOPHYSIOLOGY
Prepare effectively for the NSG 5140 Advanced Pathophysiology Final Exam with this
focused study resource. It supports review of advanced disease processes,
pathophysiological mechanisms, cellular responses, clinical manifestations, and
physiological changes associated with illness. Use the material to reinforce your
understanding, review key topics, and identify areas that may require additional study.
This resource is suited for graduate nursing students, advanced practice nursing
learners, and candidates preparing for the NSG 5140 final examination.
MULTIPLE CHOICE.
SECTION 1: CELLULAR ADAPTATION, INJURY, AND DEATH (Questions 1–25)
1. A cell adapts to a decreased workload by decreasing in size. This
adaptive change is BEST described as:
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Correct Answer: C
Rationale: Atrophy is a decrease in cell size in response to decreased
workload, loss of innervation, diminished blood supply, or inadequate
nutrition. Hypertrophy is an increase in cell size; hyperplasia is an
increase in cell number; metaplasia is the replacement of one cell type
with another.
, Page 2 of 68
2. A 58-year-old male with a 40-pack-year smoking history undergoes a
bronchial biopsy. The pathologist notes replacement of normal ciliated
columnar epithelium with stratified squamous epithelium in the bronchi.
This cellular change is BEST described as:
A. Dysplasia
B. Metaplasia
C. Anaplasia
D. Neoplasia
Correct Answer: B
Rationale: Metaplasia is the reversible replacement of one differentiated
cell type with another in response to chronic irritation. Smoking causes
squamous metaplasia of the respiratory epithelium. Dysplasia involves
disordered cellular growth; anaplasia refers to loss of differentiation in
malignant cells.
3. A patient with chronic hypertension develops left ventricular
hypertrophy. This adaptation is BEST described as:
A. Metaplasia
B. Hyperplasia
C. Hypertrophy
D. Dysplasia
Correct Answer: C
Rationale: Hypertrophy is an increase in cell size in response to increased
workload. Chronic hypertension causes pressure overload on the left
ventricle, leading to concentric hypertrophy. Cardiac myocytes cannot
undergo hyperplasia (increased cell number).
4. Which cellular process is responsible for eliminating damaged cells
without triggering an inflammatory response?
, Page 3 of 68
A. Necrosis
B. Apoptosis
C. Autophagy
D. Pyroptosis
Correct Answer: B
Rationale: Apoptosis is programmed cell death that eliminates damaged
cells without triggering inflammation. It is a tightly regulated process
involving caspases. Necrosis is unregulated cell death that causes
inflammation.
5. A patient with a myocardial infarction develops necrosis of cardiac
myocytes. Which type of necrosis is MOST characteristic of ischemic
injury in the heart?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
Correct Answer: A
Rationale: Coagulative necrosis is the hallmark of ischemic injury in solid
organs such as the heart, kidney, and spleen. Liquefactive necrosis is
seen in the brain; caseous necrosis in tuberculosis; fat necrosis in
pancreatic injury.
6. A patient with chronic renal failure develops anemia. This anemia is
MOST likely due to:
A. Iron deficiency
B. Decreased erythropoietin production
C. Vitamin B12 deficiency
, Page 4 of 68
D. Folate deficiency
Correct Answer: B
Rationale: The kidneys produce erythropoietin, which stimulates red
blood cell production. In chronic renal failure, decreased erythropoietin
production leads to normocytic, normochromic anemia.
7. A patient with chronic liver disease develops gynecomastia and spider
angiomas. These findings are MOST likely due to:
A. Increased aldosterone
B. Decreased estrogen metabolism
C. Increased cortisol
D. Decreased testosterone production
Correct Answer: B
Rationale: The liver metabolizes estrogen. In chronic liver disease,
decreased estrogen metabolism leads to elevated estrogen levels,
causing gynecomastia, spider angiomas, and palmar erythema.
8. A patient with chronic hypoxia develops pulmonary hypertension.
Which cellular adaptation occurs in the pulmonary arterioles in response
to chronic hypoxia?
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
Correct Answer: B
Rationale: Chronic hypoxia causes vasoconstriction of pulmonary
arterioles, leading to increased pulmonary vascular resistance. This
