HESI Pathophysiology Study Guide |
Nursing Disease Processes, Practice
Questions & Exam Prep
2026/2027
,Which of the following best describes the pathophysiology b) chronic inflammation and bronchoconstriction of the airways
of asthma?
a) Excessive mucus production in the airways leading to
obstruction
b) Chronic inflammation and bronchoconstriction of the
airways
c) Destruction of alveoli and decreased lung elasticity
d) Thickening and scarring of lung tissue leading to
reduced compliance
A patient with diabetes mellitus is experiencing polyuria, a) hyperglycemia-induced osmotic diuresis
polydipsia, and polyphagia. Which of the following
pathophysiological mechanisms is primarily responsible for
these symptoms?
a) Hyperglycemia-induced osmotic diuresis
b) Decreased insulin production by the pancreas
c) Insulin resistance at the cellular level
d) Glycosylation of proteins leading to tissue damage
In a patient with congestive heart failure, which of the b) sympathetic nervous system stimulation
following pathophysiological changes is most likely to
occur initially as a compensatory mechanism?
a) Activation of the renin-angiotensin-aldosterone system
(RAAS)
b) Sympathetic nervous system stimulation
c) Ventricular hypertrophy
d) Pulmonary vasoconstriction
What is the primary pathophysiological mechanism a) autoimmune destruction of joint cartilage and synovial membrane
underlying rheumatoid arthritis?
a) Autoimmune destruction of joint cartilage and synovial
membrane
b) Degeneration of articular cartilage due to mechanical
stress
c) Accumulation of uric acid crystals in the joints
d) Excessive production of synovial fluid leading to joint
effusion
Which of the following pathophysiological changes is a) destruction of alveoli and loss of lung elasticity
characteristic of chronic obstructive pulmonary disease
(COPD)?
a) Destruction of alveoli and loss of lung elasticity
b) Inflammation and scarring of the pleura
c) Increased production of surfactant in the lungs
d) Constriction of bronchioles due to smooth muscle
hypertrophy
What is the primary pathophysiological mechanism a) blockage of cerebral blood vessels by a thrombus or embolus
underlying ischemic stroke?
a) Blockage of cerebral blood vessels by a thrombus or
embolus
b) Rupture of cerebral blood vessels leading to
hemorrhage
c) Impaired cerebral perfusion due to systemic
hypotension
d) Compression of cerebral tissue by a tumor or hematoma
Which of the following pathophysiological mechanisms is d) progressive loss of nephrons and renal function over time
responsible for the development of chronic kidney disease
(CKD)?
a) Glomerular hyperfiltration and hypertrophy
b) Immune-mediated destruction of renal tubules
c) Obstruction of urinary flow due to kidney stones
d) Progressive loss of nephrons and renal function over
time
,In a patient with type 2 diabetes mellitus, which of the b) impaired glucose uptake by peripheral tissues
following pathophysiological changes is primarily
responsible for insulin resistance?
a) Decreased secretion of insulin by pancreatic beta cells
b) Impaired glucose uptake by peripheral tissues
c) Hyperglycemia-induced inhibition of insulin receptor
signaling
d) Dysregulation of hepatic glucose production
Which of the following pathophysiological mechanisms is c) chronic inflammation and infection with H. pylori
associated with the development of peptic ulcer disease?
a) Excessive production of gastric acid by parietal cells
b) Impaired mucosal blood flow leading to ischemia
c) Chronic inflammation and infection with Helicobacter
pylori
d) Dysfunction of the lower esophageal sphincter allowing
reflux of gastric contents
What is the primary pathophysiological mechanism a) accumulation of amyloid plaques and neurofibrillary tangles in the brain
underlying Alzheimer's disease?
a) Accumulation of amyloid plaques and neurofibrillary
tangles in the brain
b) Degeneration of motor neurons in the spinal cord
c) Impaired transmission of acetylcholine at the
neuromuscular junction
d) Blockage of cerebral blood vessels by thrombi or emboli
What is the primary cause of cystic fibrosis? c) mutations in the CFTR gene leading to defective chloride ion transport
a) Autoimmune destruction of pancreatic beta cells
b) Excessive production of mucus by bronchial glands
c) Mutations in the CFTR gene leading to defective
chloride ion transport
d) Chronic exposure to tobacco smoke and environmental
pollutants
What is the primary pathophysiological mechanism a) degeneration of dopaminergic neurons in the substantia nigra of the brain
underlying Parkinson's disease?
a) Degeneration of dopaminergic neurons in the substantia
nigra of the brain
b) Impaired transmission of serotonin in the spinal cord
c) Accumulation of tau protein aggregates in the cerebral
cortex
d) Blockage of cerebral blood vessels by atherosclerotic
plaques
Which of the following pathophysiological mechanisms is a) excessive production of parathyroid hormone leading to bone reabsorption
associated with the development of osteoporosis?
a) Excessive production of parathyroid hormone leading to
bone resorption
b) Decreased synthesis of collagen by osteoblasts
c) Impaired blood supply to bone tissues causing necrosis
d) Chronic inflammation of the synovial membrane in the
joints
What is the primary pathophysiological mechanism a) blockage of coronary arteries by atherosclerotic plaques
underlying myocardial infarction?
a) Blockage of coronary arteries by atherosclerotic plaques
b) Impaired electrical conduction in the myocardium
c) Chronic hypertension leading to left ventricular
hypertrophy
d) Dysfunction of heart valves resulting in regurgitation of
blood
What is the primary pathophysiological mechanism b) autoimmune destruction of pancreatic beta cells
underlying Type 1 diabetes mellitus?
a) Insulin resistance in peripheral tissues
b) Autoimmune destruction of pancreatic beta cells
c) Impaired insulin secretion by pancreatic alpha cells
d) Dysfunction of insulin receptors on target cells
, Which of the following pathophysiological changes is b) loss of myelin sheath in the central nervous system
characteristic of multiple sclerosis (MS)?
a) Degeneration of motor neurons in the spinal cord
b) Loss of myelin sheath in the central nervous system
c) Impaired production of dopamine in the basal ganglia
d) Excessive production of cerebrospinal fluid in the
ventricles
What is the primary cause of chronic liver disease? c) viral infection of liver cells
a) Autoimmune attack on hepatocytes
b) Chronic alcohol abuse
c) Viral infection of liver cells
d) Impaired blood supply to the liver
Which of the following pathophysiological mechanisms is c) dysfunction of the lower esophageal sphincter
associated with the development of gastroesophageal
reflux disease (GERD)?
a) Chronic inflammation of the gastric mucosa
b) Excessive production of gastric acid by parietal cells
c) Dysfunction of the lower esophageal sphincter
d) Impaired motility of the esophagus
What is the primary pathophysiological mechanism a) chronic inflammation and immune complex deposition in various tissues
underlying systemic lupus erythematosus (SLE)?
a) Chronic inflammation and immune complex deposition
in various tissues
b) Degeneration of neurons in the central nervous system
c) Excessive production of thyroid hormone by the thyroid
gland
d) Impaired blood clotting due to deficiency of clotting
factors
Which of the following pathophysiological mechanisms is a) chronic inflammation and scarring of heart valves
responsible for the development of rheumatic heart
disease?
a) Chronic inflammation and scarring of heart valves
b) Excessive production of thyroid hormone
c) Autoimmune destruction of cardiac muscle cells
d) Impaired electrical conduction in the heart
What is the primary pathophysiological mechanism b) bacterial infection of the bladder wall
underlying cystitis?
a) Obstruction of the urinary tract by kidney stones
b) Bacterial infection of the bladder wall
c) Chronic inflammation of the urethra
d) Impaired filtration by the glomeruli in the kidney
Which of the following pathophysiological changes is b) decreased hgb concentration in the blood
characteristic of anemia?
a) Excessive production of red blood cells by the bone
marrow
b) Decreased hemoglobin concentration in the blood
c) Impaired coagulation of blood
d) Chronic inflammation of blood vessels
What is the primary cause of osteoarthritis? c) degeneration of articular cartilage due to mechanical stress
a) Autoimmune attack on joint tissues
b) Excessive production of uric acid crystals in the joints
c) Degeneration of articular cartilage due to mechanical
stress
d) Impaired blood supply to the joints
Nursing Disease Processes, Practice
Questions & Exam Prep
2026/2027
,Which of the following best describes the pathophysiology b) chronic inflammation and bronchoconstriction of the airways
of asthma?
a) Excessive mucus production in the airways leading to
obstruction
b) Chronic inflammation and bronchoconstriction of the
airways
c) Destruction of alveoli and decreased lung elasticity
d) Thickening and scarring of lung tissue leading to
reduced compliance
A patient with diabetes mellitus is experiencing polyuria, a) hyperglycemia-induced osmotic diuresis
polydipsia, and polyphagia. Which of the following
pathophysiological mechanisms is primarily responsible for
these symptoms?
a) Hyperglycemia-induced osmotic diuresis
b) Decreased insulin production by the pancreas
c) Insulin resistance at the cellular level
d) Glycosylation of proteins leading to tissue damage
In a patient with congestive heart failure, which of the b) sympathetic nervous system stimulation
following pathophysiological changes is most likely to
occur initially as a compensatory mechanism?
a) Activation of the renin-angiotensin-aldosterone system
(RAAS)
b) Sympathetic nervous system stimulation
c) Ventricular hypertrophy
d) Pulmonary vasoconstriction
What is the primary pathophysiological mechanism a) autoimmune destruction of joint cartilage and synovial membrane
underlying rheumatoid arthritis?
a) Autoimmune destruction of joint cartilage and synovial
membrane
b) Degeneration of articular cartilage due to mechanical
stress
c) Accumulation of uric acid crystals in the joints
d) Excessive production of synovial fluid leading to joint
effusion
Which of the following pathophysiological changes is a) destruction of alveoli and loss of lung elasticity
characteristic of chronic obstructive pulmonary disease
(COPD)?
a) Destruction of alveoli and loss of lung elasticity
b) Inflammation and scarring of the pleura
c) Increased production of surfactant in the lungs
d) Constriction of bronchioles due to smooth muscle
hypertrophy
What is the primary pathophysiological mechanism a) blockage of cerebral blood vessels by a thrombus or embolus
underlying ischemic stroke?
a) Blockage of cerebral blood vessels by a thrombus or
embolus
b) Rupture of cerebral blood vessels leading to
hemorrhage
c) Impaired cerebral perfusion due to systemic
hypotension
d) Compression of cerebral tissue by a tumor or hematoma
Which of the following pathophysiological mechanisms is d) progressive loss of nephrons and renal function over time
responsible for the development of chronic kidney disease
(CKD)?
a) Glomerular hyperfiltration and hypertrophy
b) Immune-mediated destruction of renal tubules
c) Obstruction of urinary flow due to kidney stones
d) Progressive loss of nephrons and renal function over
time
,In a patient with type 2 diabetes mellitus, which of the b) impaired glucose uptake by peripheral tissues
following pathophysiological changes is primarily
responsible for insulin resistance?
a) Decreased secretion of insulin by pancreatic beta cells
b) Impaired glucose uptake by peripheral tissues
c) Hyperglycemia-induced inhibition of insulin receptor
signaling
d) Dysregulation of hepatic glucose production
Which of the following pathophysiological mechanisms is c) chronic inflammation and infection with H. pylori
associated with the development of peptic ulcer disease?
a) Excessive production of gastric acid by parietal cells
b) Impaired mucosal blood flow leading to ischemia
c) Chronic inflammation and infection with Helicobacter
pylori
d) Dysfunction of the lower esophageal sphincter allowing
reflux of gastric contents
What is the primary pathophysiological mechanism a) accumulation of amyloid plaques and neurofibrillary tangles in the brain
underlying Alzheimer's disease?
a) Accumulation of amyloid plaques and neurofibrillary
tangles in the brain
b) Degeneration of motor neurons in the spinal cord
c) Impaired transmission of acetylcholine at the
neuromuscular junction
d) Blockage of cerebral blood vessels by thrombi or emboli
What is the primary cause of cystic fibrosis? c) mutations in the CFTR gene leading to defective chloride ion transport
a) Autoimmune destruction of pancreatic beta cells
b) Excessive production of mucus by bronchial glands
c) Mutations in the CFTR gene leading to defective
chloride ion transport
d) Chronic exposure to tobacco smoke and environmental
pollutants
What is the primary pathophysiological mechanism a) degeneration of dopaminergic neurons in the substantia nigra of the brain
underlying Parkinson's disease?
a) Degeneration of dopaminergic neurons in the substantia
nigra of the brain
b) Impaired transmission of serotonin in the spinal cord
c) Accumulation of tau protein aggregates in the cerebral
cortex
d) Blockage of cerebral blood vessels by atherosclerotic
plaques
Which of the following pathophysiological mechanisms is a) excessive production of parathyroid hormone leading to bone reabsorption
associated with the development of osteoporosis?
a) Excessive production of parathyroid hormone leading to
bone resorption
b) Decreased synthesis of collagen by osteoblasts
c) Impaired blood supply to bone tissues causing necrosis
d) Chronic inflammation of the synovial membrane in the
joints
What is the primary pathophysiological mechanism a) blockage of coronary arteries by atherosclerotic plaques
underlying myocardial infarction?
a) Blockage of coronary arteries by atherosclerotic plaques
b) Impaired electrical conduction in the myocardium
c) Chronic hypertension leading to left ventricular
hypertrophy
d) Dysfunction of heart valves resulting in regurgitation of
blood
What is the primary pathophysiological mechanism b) autoimmune destruction of pancreatic beta cells
underlying Type 1 diabetes mellitus?
a) Insulin resistance in peripheral tissues
b) Autoimmune destruction of pancreatic beta cells
c) Impaired insulin secretion by pancreatic alpha cells
d) Dysfunction of insulin receptors on target cells
, Which of the following pathophysiological changes is b) loss of myelin sheath in the central nervous system
characteristic of multiple sclerosis (MS)?
a) Degeneration of motor neurons in the spinal cord
b) Loss of myelin sheath in the central nervous system
c) Impaired production of dopamine in the basal ganglia
d) Excessive production of cerebrospinal fluid in the
ventricles
What is the primary cause of chronic liver disease? c) viral infection of liver cells
a) Autoimmune attack on hepatocytes
b) Chronic alcohol abuse
c) Viral infection of liver cells
d) Impaired blood supply to the liver
Which of the following pathophysiological mechanisms is c) dysfunction of the lower esophageal sphincter
associated with the development of gastroesophageal
reflux disease (GERD)?
a) Chronic inflammation of the gastric mucosa
b) Excessive production of gastric acid by parietal cells
c) Dysfunction of the lower esophageal sphincter
d) Impaired motility of the esophagus
What is the primary pathophysiological mechanism a) chronic inflammation and immune complex deposition in various tissues
underlying systemic lupus erythematosus (SLE)?
a) Chronic inflammation and immune complex deposition
in various tissues
b) Degeneration of neurons in the central nervous system
c) Excessive production of thyroid hormone by the thyroid
gland
d) Impaired blood clotting due to deficiency of clotting
factors
Which of the following pathophysiological mechanisms is a) chronic inflammation and scarring of heart valves
responsible for the development of rheumatic heart
disease?
a) Chronic inflammation and scarring of heart valves
b) Excessive production of thyroid hormone
c) Autoimmune destruction of cardiac muscle cells
d) Impaired electrical conduction in the heart
What is the primary pathophysiological mechanism b) bacterial infection of the bladder wall
underlying cystitis?
a) Obstruction of the urinary tract by kidney stones
b) Bacterial infection of the bladder wall
c) Chronic inflammation of the urethra
d) Impaired filtration by the glomeruli in the kidney
Which of the following pathophysiological changes is b) decreased hgb concentration in the blood
characteristic of anemia?
a) Excessive production of red blood cells by the bone
marrow
b) Decreased hemoglobin concentration in the blood
c) Impaired coagulation of blood
d) Chronic inflammation of blood vessels
What is the primary cause of osteoarthritis? c) degeneration of articular cartilage due to mechanical stress
a) Autoimmune attack on joint tissues
b) Excessive production of uric acid crystals in the joints
c) Degeneration of articular cartilage due to mechanical
stress
d) Impaired blood supply to the joints
