HESI Advanced Pathophysiology Final
Exam: 100 Questions & Verified Answers
(2025/2026 Edition)
HESI Advanced Pathophysiology Final Exam –
Part 1 (Q1–25)
Neurology
Q1. A patient presents with sudden onset left-sided
weakness, facial droop, and slurred speech. CT scan is
negative for bleeding. What is the most likely
pathophysiology?
A. Hemorrhagic stroke
B. Ischemic stroke due to thrombus or embolus
C. Subarachnoid hemorrhage
D. Transient ischemic attack
Answer: B. Ischemic stroke due to thrombus or
embolus
• Rationale: Negative CT excludes hemorrhage
initially. Acute focal deficits suggest ischemic stroke.
TIAs resolve quickly (<24 hrs).
Q2. In Parkinson’s disease, what is the primary
neurotransmitter imbalance?
,A. Excess serotonin
B. Excess dopamine
C. Decreased acetylcholine
D. Decreased dopamine
Answer: D. Decreased dopamine
• Rationale: Degeneration of substantia nigra leads to
dopamine deficiency, causing resting tremor, rigidity,
bradykinesia.
Q3. Multiple sclerosis is characterized by:
A. Destruction of neuromuscular junctions
B. Autoimmune demyelination of CNS neurons
C. Excess acetylcholine
D. Cerebral ischemia
Answer: B. Autoimmune demyelination of CNS
neurons
• Rationale: MS involves T-cell mediated attack on
myelin sheaths in CNS → impaired nerve
conduction.
Q4. Which electrolyte imbalance increases seizure risk?
A. Hypernatremia
B. Hyponatremia
,C. Hypercalcemia
D. Hypermagnesemia
Answer: B. Hyponatremia
• Rationale: Low sodium causes neuronal swelling,
increased excitability → seizures.
Q5. A patient with Alzheimer’s disease has memory loss
and personality changes. What is the pathophysiologic
hallmark?
A. Amyloid plaques and neurofibrillary tangles
B. Dopamine depletion
C. GABA excess
D. Glutamate deficiency
Answer: A. Amyloid plaques and neurofibrillary
tangles
• Rationale: Accumulation of abnormal proteins leads
to progressive cortical degeneration.
Cardiac
Q6. What hemodynamic change is most characteristic of
left-sided heart failure?
A. Increased pulmonary venous pressure
, B. Systemic venous congestion
C. Reduced pulmonary blood flow
D. Elevated right atrial pressure
Answer: A. Increased pulmonary venous pressure
• Rationale: Left HF causes pulmonary congestion,
dyspnea, orthopnea.
Q7. In coronary artery disease (CAD), which mechanism
leads to angina?
A. Decreased preload
B. Coronary vasodilation
C. Myocardial oxygen supply-demand mismatch
D. Reduced afterload
Answer: C. Myocardial oxygen supply-demand
mismatch
• Rationale: Narrowed arteries can’t supply enough
oxygen when demand rises.
Q8. A patient with uncontrolled hypertension develops
LV hypertrophy. This adaptation is an example of:
A. Hyperplasia
B. Hypertrophy
Exam: 100 Questions & Verified Answers
(2025/2026 Edition)
HESI Advanced Pathophysiology Final Exam –
Part 1 (Q1–25)
Neurology
Q1. A patient presents with sudden onset left-sided
weakness, facial droop, and slurred speech. CT scan is
negative for bleeding. What is the most likely
pathophysiology?
A. Hemorrhagic stroke
B. Ischemic stroke due to thrombus or embolus
C. Subarachnoid hemorrhage
D. Transient ischemic attack
Answer: B. Ischemic stroke due to thrombus or
embolus
• Rationale: Negative CT excludes hemorrhage
initially. Acute focal deficits suggest ischemic stroke.
TIAs resolve quickly (<24 hrs).
Q2. In Parkinson’s disease, what is the primary
neurotransmitter imbalance?
,A. Excess serotonin
B. Excess dopamine
C. Decreased acetylcholine
D. Decreased dopamine
Answer: D. Decreased dopamine
• Rationale: Degeneration of substantia nigra leads to
dopamine deficiency, causing resting tremor, rigidity,
bradykinesia.
Q3. Multiple sclerosis is characterized by:
A. Destruction of neuromuscular junctions
B. Autoimmune demyelination of CNS neurons
C. Excess acetylcholine
D. Cerebral ischemia
Answer: B. Autoimmune demyelination of CNS
neurons
• Rationale: MS involves T-cell mediated attack on
myelin sheaths in CNS → impaired nerve
conduction.
Q4. Which electrolyte imbalance increases seizure risk?
A. Hypernatremia
B. Hyponatremia
,C. Hypercalcemia
D. Hypermagnesemia
Answer: B. Hyponatremia
• Rationale: Low sodium causes neuronal swelling,
increased excitability → seizures.
Q5. A patient with Alzheimer’s disease has memory loss
and personality changes. What is the pathophysiologic
hallmark?
A. Amyloid plaques and neurofibrillary tangles
B. Dopamine depletion
C. GABA excess
D. Glutamate deficiency
Answer: A. Amyloid plaques and neurofibrillary
tangles
• Rationale: Accumulation of abnormal proteins leads
to progressive cortical degeneration.
Cardiac
Q6. What hemodynamic change is most characteristic of
left-sided heart failure?
A. Increased pulmonary venous pressure
, B. Systemic venous congestion
C. Reduced pulmonary blood flow
D. Elevated right atrial pressure
Answer: A. Increased pulmonary venous pressure
• Rationale: Left HF causes pulmonary congestion,
dyspnea, orthopnea.
Q7. In coronary artery disease (CAD), which mechanism
leads to angina?
A. Decreased preload
B. Coronary vasodilation
C. Myocardial oxygen supply-demand mismatch
D. Reduced afterload
Answer: C. Myocardial oxygen supply-demand
mismatch
• Rationale: Narrowed arteries can’t supply enough
oxygen when demand rises.
Q8. A patient with uncontrolled hypertension develops
LV hypertrophy. This adaptation is an example of:
A. Hyperplasia
B. Hypertrophy
