NSG 120 NURSING PATHOPHYSIOLOGY | HERZING
UNIVERSITY | ACADEMIC YEAR 2026/2027 | MIDTERM
COMPREHENSIVE EXAMINATION | 50 VERIFIED
QUESTIONS AND CORRECT ANSWER RATIONALES |
LATEST UPDATE 2026/2027 | STUDY GUIDE |
PRACTICE QUESTIONS AND ANSWERS | EXAM
REVIEW | 100% CORRECT ANSWERS | VERIFIED
SOLUTIONS
This comprehensive practice examination is designed for nursing students preparing for the NSG
120 Nursing Pathophysiology Midterm Comprehensive Examination at Herzing University. The
examination assesses understanding of cellular adaptation, injury, and death; inflammation and
immunity; infection; fluid, electrolyte, and acid-base imbalances; genetics and neoplasia; stress
and pain; and major system-specific pathophysiologic processes affecting the cardiovascular,
respiratory, renal, gastrointestinal, endocrine, neurologic, and hematologic systems. Each
question is formatted to reflect the rigor of a nursing pathophysiology midterm and includes
detailed answer rationales that reinforce clinical judgment, prioritization, and application of
pathophysiologic principles. This guide is based on the latest 2026/2027 curriculum materials
and is intended to help candidates identify knowledge gaps, strengthen exam readiness, and
improve success on the comprehensive midterm assessment.
Table of Contents
1. Cellular Adaptation, Injury, and Death
2. Inflammation, Immunity, and Infection
3. Fluid, Electrolyte, and Acid-Base Balance
4. Genetics and Neoplasia
5. Stress and Pain
6. Cardiovascular Pathophysiology
7. Respiratory Pathophysiology
8. Renal and Urinary Pathophysiology
9. Gastrointestinal and Endocrine Pathophysiology
10. Neurologic and Hematologic Pathophysiology
,Question 1: A client’s bronchial epithelium changes from ciliated columnar cells to stratified
squamous cells after years of smoking. Which cellular adaptation does the nurse identify?
A) Atrophy
B) Hypertrophy
C) Metaplasia
D) Dysplasia
Correct Answer: C
Metaplasia is the reversible replacement of one mature cell type with another mature cell type
that is better able to survive the stressful environment. In smokers, chronic irritation causes
bronchial epithelium to change to stratified squamous epithelium. Atrophy is shrinkage,
hypertrophy is enlargement, and dysplasia involves disordered growth but not a change in cell
type.
Question 2: A client has a cerebral infarct. Which type of necrosis is most likely present in the
affected brain tissue?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
Correct Answer: B
Liquefactive necrosis commonly occurs in brain infarcts because digestive enzymes and lack of
structural support cause the dead tissue to become soft and liquid. Coagulative necrosis is
typical in ischemic injury to heart, kidney, and spleen. Caseous necrosis occurs in tuberculosis,
and fat necrosis occurs in pancreatitis or breast trauma.
Question 3: Which statement best describes apoptosis?
A) Programmed cell death that does not trigger inflammation
B) Uncontrolled cell death that always causes inflammation
C) Death of a group of cells due to ischemia
D) Death caused by bacterial toxins only
Correct Answer: A
Apoptosis is an energy-dependent, programmed form of cell death that removes unwanted or
damaged cells without inciting an inflammatory response. Necrosis is uncontrolled cell death
that typically triggers inflammation. Ischemic injury and bacterial toxins more often cause
necrosis.
Question 4: During acute inflammation, which vascular change occurs first?
, A) Decreased capillary permeability
B) Vasoconstriction lasting several hours
C) Reduced blood flow to the area
D) Vasodilation followed by increased capillary permeability
Correct Answer: D
Acute inflammation begins with vasodilation, which increases blood flow and causes redness
and heat, followed by increased capillary permeability that allows plasma proteins and
leukocytes into the tissue. Vasoconstriction may occur briefly but is not the main early change.
Decreased permeability and reduced blood flow are not characteristic of acute inflammation.
Question 5: Which cell type predominates in chronic inflammation?
A) Neutrophils
B) Macrophages and lymphocytes
C) Eosinophils
D) Basophils
Correct Answer: B
Chronic inflammation is characterized by infiltration with macrophages and lymphocytes, along
with tissue destruction and attempts at repair. Neutrophils are the predominant cells in acute
inflammation. Eosinophils are associated with allergic and parasitic responses, and basophils
are involved in allergic reactions.
Question 6: A client develops hives, wheezing, and hypotension minutes after receiving
penicillin. Which hypersensitivity reaction is occurring?
A) Type I
B) Type II
C) Type III
D) Type IV
Correct Answer: A
Type I hypersensitivity is an immediate IgE-mediated reaction involving mast cell degranulation
and release of histamine, causing urticaria, bronchospasm, and hypotension. Type II is antibody-
mediated cell destruction, Type III is immune complex deposition, and Type IV is delayed T-cell-
mediated hypersensitivity.
Question 7: A client experiences a hemolytic transfusion reaction after receiving incompatible
blood. Which hypersensitivity mechanism is most likely?
A) Type II
B) Type I
C) Type III
D) Type IV
UNIVERSITY | ACADEMIC YEAR 2026/2027 | MIDTERM
COMPREHENSIVE EXAMINATION | 50 VERIFIED
QUESTIONS AND CORRECT ANSWER RATIONALES |
LATEST UPDATE 2026/2027 | STUDY GUIDE |
PRACTICE QUESTIONS AND ANSWERS | EXAM
REVIEW | 100% CORRECT ANSWERS | VERIFIED
SOLUTIONS
This comprehensive practice examination is designed for nursing students preparing for the NSG
120 Nursing Pathophysiology Midterm Comprehensive Examination at Herzing University. The
examination assesses understanding of cellular adaptation, injury, and death; inflammation and
immunity; infection; fluid, electrolyte, and acid-base imbalances; genetics and neoplasia; stress
and pain; and major system-specific pathophysiologic processes affecting the cardiovascular,
respiratory, renal, gastrointestinal, endocrine, neurologic, and hematologic systems. Each
question is formatted to reflect the rigor of a nursing pathophysiology midterm and includes
detailed answer rationales that reinforce clinical judgment, prioritization, and application of
pathophysiologic principles. This guide is based on the latest 2026/2027 curriculum materials
and is intended to help candidates identify knowledge gaps, strengthen exam readiness, and
improve success on the comprehensive midterm assessment.
Table of Contents
1. Cellular Adaptation, Injury, and Death
2. Inflammation, Immunity, and Infection
3. Fluid, Electrolyte, and Acid-Base Balance
4. Genetics and Neoplasia
5. Stress and Pain
6. Cardiovascular Pathophysiology
7. Respiratory Pathophysiology
8. Renal and Urinary Pathophysiology
9. Gastrointestinal and Endocrine Pathophysiology
10. Neurologic and Hematologic Pathophysiology
,Question 1: A client’s bronchial epithelium changes from ciliated columnar cells to stratified
squamous cells after years of smoking. Which cellular adaptation does the nurse identify?
A) Atrophy
B) Hypertrophy
C) Metaplasia
D) Dysplasia
Correct Answer: C
Metaplasia is the reversible replacement of one mature cell type with another mature cell type
that is better able to survive the stressful environment. In smokers, chronic irritation causes
bronchial epithelium to change to stratified squamous epithelium. Atrophy is shrinkage,
hypertrophy is enlargement, and dysplasia involves disordered growth but not a change in cell
type.
Question 2: A client has a cerebral infarct. Which type of necrosis is most likely present in the
affected brain tissue?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
Correct Answer: B
Liquefactive necrosis commonly occurs in brain infarcts because digestive enzymes and lack of
structural support cause the dead tissue to become soft and liquid. Coagulative necrosis is
typical in ischemic injury to heart, kidney, and spleen. Caseous necrosis occurs in tuberculosis,
and fat necrosis occurs in pancreatitis or breast trauma.
Question 3: Which statement best describes apoptosis?
A) Programmed cell death that does not trigger inflammation
B) Uncontrolled cell death that always causes inflammation
C) Death of a group of cells due to ischemia
D) Death caused by bacterial toxins only
Correct Answer: A
Apoptosis is an energy-dependent, programmed form of cell death that removes unwanted or
damaged cells without inciting an inflammatory response. Necrosis is uncontrolled cell death
that typically triggers inflammation. Ischemic injury and bacterial toxins more often cause
necrosis.
Question 4: During acute inflammation, which vascular change occurs first?
, A) Decreased capillary permeability
B) Vasoconstriction lasting several hours
C) Reduced blood flow to the area
D) Vasodilation followed by increased capillary permeability
Correct Answer: D
Acute inflammation begins with vasodilation, which increases blood flow and causes redness
and heat, followed by increased capillary permeability that allows plasma proteins and
leukocytes into the tissue. Vasoconstriction may occur briefly but is not the main early change.
Decreased permeability and reduced blood flow are not characteristic of acute inflammation.
Question 5: Which cell type predominates in chronic inflammation?
A) Neutrophils
B) Macrophages and lymphocytes
C) Eosinophils
D) Basophils
Correct Answer: B
Chronic inflammation is characterized by infiltration with macrophages and lymphocytes, along
with tissue destruction and attempts at repair. Neutrophils are the predominant cells in acute
inflammation. Eosinophils are associated with allergic and parasitic responses, and basophils
are involved in allergic reactions.
Question 6: A client develops hives, wheezing, and hypotension minutes after receiving
penicillin. Which hypersensitivity reaction is occurring?
A) Type I
B) Type II
C) Type III
D) Type IV
Correct Answer: A
Type I hypersensitivity is an immediate IgE-mediated reaction involving mast cell degranulation
and release of histamine, causing urticaria, bronchospasm, and hypotension. Type II is antibody-
mediated cell destruction, Type III is immune complex deposition, and Type IV is delayed T-cell-
mediated hypersensitivity.
Question 7: A client experiences a hemolytic transfusion reaction after receiving incompatible
blood. Which hypersensitivity mechanism is most likely?
A) Type II
B) Type I
C) Type III
D) Type IV
