GALEN COLLEGE OF NURSING
NSG 3300 CONCEPTS OF
PATHOPHYSIOLOGY FOR NURSING
FINAL EXAM
2026
Multiple Choice (15)
A 55-year-old patient presents with sudden onset chest pain radiating to the left arm. ECG
shows ST-segment elevation. What pathological process is most likely occurring? A) Stable
angina B) Myocardial infarction due to coronary artery occlusion C) Pericarditis D) Aortic
dissection
Answer: B
Rationale: ST-segment elevation indicates myocardial injury typically caused by coronary
artery occlusion leading to infarction.
2. Which cellular adaptation is primarily characterized by reversible cell shrinking due to
nutrient deprivation?
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Answer: C
Rationale: Atrophy is shrinkage of cells due to decreased workload or nutrient supply.
3. In acute inflammation, which of the following is the earliest vascular response?
A) Leukocyte migration
B) Vasodilation
C) Fibroblast proliferation
D) Scar tissue formation
Answer: B
Rationale: Vasodilation occurs early to increase blood flow to the injured tissue.
4. A patient with chronic kidney disease develops metabolic acidosis. What is the primary
reason for this acid-base imbalance?
A) Increased bicarbonate reabsorption
B) Decreased acid excretion by the kidneys
C) Excessive vomiting
D) Hyperventilation
Answer: B
,Rationale: Kidney failure impairs acid excretion, leading to metabolic acidosis.
5. Which cytokine primarily mediates the fever response in systemic inflammation?
A) IL-1
B) IL-4
C) IL-10
D) TGF-beta
Answer: A
Rationale: IL-1 acts on the hypothalamus to induce fever.
6. In heart failure, which compensatory mechanism initially improves cardiac output?
A) Parasympathetic activation
B) Activation of the renin-angiotensin-aldosterone system
C) Decreased preload
D) Vasodilation
Answer: B
Rationale: RAAS causes vasoconstriction and fluid retention to increase cardiac output.
7. The hallmark of Type 1 hypersensitivity reactions includes:
A) Delayed cell-mediated immunity
B) IgE antibody binding to mast cells
C) Immune complex deposition
D) Autoantibody formation
Answer: B
Rationale: Type 1 hypersensitivity is IgE mediated, triggering mast cell degranulation.
8. A patient with chronic obstructive pulmonary disease (COPD) often shows which acid-base
imbalance?
A) Respiratory alkalosis
B) Metabolic acidosis
C) Respiratory acidosis
D) Metabolic alkalosis
Answer: C
Rationale: COPD leads to CO2 retention causing respiratory acidosis.
9. Which of the following is true regarding necrosis as compared to apoptosis?
A) Necrosis is an energy-dependent programmed cell death
B) Apoptosis typically causes inflammation
C) Necrosis causes uncontrolled cell death with membrane rupture
D) Apoptosis leads to cell swelling and lysis
Answer: C
Rationale: Necrosis is uncontrolled death with rupture that triggers inflammation.
10. In diabetes mellitus type 1, beta cell destruction is mediated primarily by:
A) Autoimmune T cell attack
B) Insulin resistance
,C) Viral infection
D) Excess glucagon
Answer: A
Rationale: Type 1 DM involves autoimmune-mediated destruction of pancreatic beta cells.
11. Which lab marker is highly specific for diagnosing myocardial infarction?
A) CK-MB
B) Troponin I
C) Myoglobin
D) ALT
Answer: B
Rationale: Troponin I is highly cardiac-specific and sensitive for myocardial injury.
12. A patient with liver failure develops increased bleeding tendency because of:
A) Increased platelet count
B) Decreased synthesis of clotting factors
C) Increased prothrombin levels
D) Enhanced fibrinolysis
Answer: B
Rationale: Liver synthesizes clotting factors; failure reduces production causing bleeding.
13. Which is the major cellular site for aerobic ATP production?
A) Ribosomes
B) Endoplasmic reticulum
C) Mitochondria
D) Golgi apparatus
Answer: C
Rationale: Mitochondria carry out oxidative phosphorylation producing ATP.
14. Match the following cell injury types with their causes:
a) Hypoxic injury
b) Chemical injury
c) Infectious injury
d) Physical injury
Toxin exposure
Ischemia
Trauma
Bacterial invasion
Answer:
a-2, b-1, c-4, d-3
Rationale: Each type correlates with the listed causes.
15. Which electrolyte abnormality is commonly associated with significant cell injury?
A) Hypokalemia
B) Hypernatremia
, C) Intracellular calcium overload
D) Hypocalcemia
Answer: C
Rationale: Increased intracellular calcium activates enzymes that damage cell structures.
True/False (10)
T/F: Chronic inflammation only occurs when acute inflammation resolves fully.
Answer: False
Rationale: Chronic inflammation can result from persistent injury or unresolved acute
inflammation.
T/F: Metaplasia is an irreversible change in cell type.
Answer: False
Rationale: Metaplasia is reversible if the stressor is removed.
T/F: In apoptosis, cell contents are released causing inflammation.
Answer: False
Rationale: Apoptosis is controlled cell death without causing inflammation.
T/F: Edema results from increased hydrostatic pressure in capillaries.
Answer: True
Rationale: Elevated hydrostatic pressure pushes fluid into interstitial spaces causing edema.
T/F: Hypoxia is the most common cause of cell injury.
Answer: True
Rationale: Oxygen deprivation is a primary cause of cellular injury.
T/F: In autoimmune diseases, the immune system attacks self-antigens.
Answer: True
Rationale: Autoimmunity is characterized by immune responses against self.
T/F: Insulin resistance is mainly a feature of Type 2 diabetes mellitus.
Answer: True
Rationale: Type 2 DM involves insulin resistance and relative insulin deficiency.
T/F: Lipid peroxidation is a mechanism of cell injury mediated by reactive oxygen species.
Answer: True
Rationale: ROS cause oxidative damage including lipid peroxidation.
T/F: Ischemia-reperfusion injury exacerbates cell damage after oxygen restoration.
Answer: True
Rationale: Reperfusion causes oxidative stress and inflammation.
T/F: The inflammatory exudate consists primarily of red blood cells.
Answer: False
Rationale: Exudate mainly contains neutrophils, proteins, and fluid, not RBCs.
Short Answer (10)
26. Describe the difference between dry and wet gangrene.
Answer: Dry gangrene is ischemic necrosis with tissue drying and mummification, often
NSG 3300 CONCEPTS OF
PATHOPHYSIOLOGY FOR NURSING
FINAL EXAM
2026
Multiple Choice (15)
A 55-year-old patient presents with sudden onset chest pain radiating to the left arm. ECG
shows ST-segment elevation. What pathological process is most likely occurring? A) Stable
angina B) Myocardial infarction due to coronary artery occlusion C) Pericarditis D) Aortic
dissection
Answer: B
Rationale: ST-segment elevation indicates myocardial injury typically caused by coronary
artery occlusion leading to infarction.
2. Which cellular adaptation is primarily characterized by reversible cell shrinking due to
nutrient deprivation?
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Answer: C
Rationale: Atrophy is shrinkage of cells due to decreased workload or nutrient supply.
3. In acute inflammation, which of the following is the earliest vascular response?
A) Leukocyte migration
B) Vasodilation
C) Fibroblast proliferation
D) Scar tissue formation
Answer: B
Rationale: Vasodilation occurs early to increase blood flow to the injured tissue.
4. A patient with chronic kidney disease develops metabolic acidosis. What is the primary
reason for this acid-base imbalance?
A) Increased bicarbonate reabsorption
B) Decreased acid excretion by the kidneys
C) Excessive vomiting
D) Hyperventilation
Answer: B
,Rationale: Kidney failure impairs acid excretion, leading to metabolic acidosis.
5. Which cytokine primarily mediates the fever response in systemic inflammation?
A) IL-1
B) IL-4
C) IL-10
D) TGF-beta
Answer: A
Rationale: IL-1 acts on the hypothalamus to induce fever.
6. In heart failure, which compensatory mechanism initially improves cardiac output?
A) Parasympathetic activation
B) Activation of the renin-angiotensin-aldosterone system
C) Decreased preload
D) Vasodilation
Answer: B
Rationale: RAAS causes vasoconstriction and fluid retention to increase cardiac output.
7. The hallmark of Type 1 hypersensitivity reactions includes:
A) Delayed cell-mediated immunity
B) IgE antibody binding to mast cells
C) Immune complex deposition
D) Autoantibody formation
Answer: B
Rationale: Type 1 hypersensitivity is IgE mediated, triggering mast cell degranulation.
8. A patient with chronic obstructive pulmonary disease (COPD) often shows which acid-base
imbalance?
A) Respiratory alkalosis
B) Metabolic acidosis
C) Respiratory acidosis
D) Metabolic alkalosis
Answer: C
Rationale: COPD leads to CO2 retention causing respiratory acidosis.
9. Which of the following is true regarding necrosis as compared to apoptosis?
A) Necrosis is an energy-dependent programmed cell death
B) Apoptosis typically causes inflammation
C) Necrosis causes uncontrolled cell death with membrane rupture
D) Apoptosis leads to cell swelling and lysis
Answer: C
Rationale: Necrosis is uncontrolled death with rupture that triggers inflammation.
10. In diabetes mellitus type 1, beta cell destruction is mediated primarily by:
A) Autoimmune T cell attack
B) Insulin resistance
,C) Viral infection
D) Excess glucagon
Answer: A
Rationale: Type 1 DM involves autoimmune-mediated destruction of pancreatic beta cells.
11. Which lab marker is highly specific for diagnosing myocardial infarction?
A) CK-MB
B) Troponin I
C) Myoglobin
D) ALT
Answer: B
Rationale: Troponin I is highly cardiac-specific and sensitive for myocardial injury.
12. A patient with liver failure develops increased bleeding tendency because of:
A) Increased platelet count
B) Decreased synthesis of clotting factors
C) Increased prothrombin levels
D) Enhanced fibrinolysis
Answer: B
Rationale: Liver synthesizes clotting factors; failure reduces production causing bleeding.
13. Which is the major cellular site for aerobic ATP production?
A) Ribosomes
B) Endoplasmic reticulum
C) Mitochondria
D) Golgi apparatus
Answer: C
Rationale: Mitochondria carry out oxidative phosphorylation producing ATP.
14. Match the following cell injury types with their causes:
a) Hypoxic injury
b) Chemical injury
c) Infectious injury
d) Physical injury
Toxin exposure
Ischemia
Trauma
Bacterial invasion
Answer:
a-2, b-1, c-4, d-3
Rationale: Each type correlates with the listed causes.
15. Which electrolyte abnormality is commonly associated with significant cell injury?
A) Hypokalemia
B) Hypernatremia
, C) Intracellular calcium overload
D) Hypocalcemia
Answer: C
Rationale: Increased intracellular calcium activates enzymes that damage cell structures.
True/False (10)
T/F: Chronic inflammation only occurs when acute inflammation resolves fully.
Answer: False
Rationale: Chronic inflammation can result from persistent injury or unresolved acute
inflammation.
T/F: Metaplasia is an irreversible change in cell type.
Answer: False
Rationale: Metaplasia is reversible if the stressor is removed.
T/F: In apoptosis, cell contents are released causing inflammation.
Answer: False
Rationale: Apoptosis is controlled cell death without causing inflammation.
T/F: Edema results from increased hydrostatic pressure in capillaries.
Answer: True
Rationale: Elevated hydrostatic pressure pushes fluid into interstitial spaces causing edema.
T/F: Hypoxia is the most common cause of cell injury.
Answer: True
Rationale: Oxygen deprivation is a primary cause of cellular injury.
T/F: In autoimmune diseases, the immune system attacks self-antigens.
Answer: True
Rationale: Autoimmunity is characterized by immune responses against self.
T/F: Insulin resistance is mainly a feature of Type 2 diabetes mellitus.
Answer: True
Rationale: Type 2 DM involves insulin resistance and relative insulin deficiency.
T/F: Lipid peroxidation is a mechanism of cell injury mediated by reactive oxygen species.
Answer: True
Rationale: ROS cause oxidative damage including lipid peroxidation.
T/F: Ischemia-reperfusion injury exacerbates cell damage after oxygen restoration.
Answer: True
Rationale: Reperfusion causes oxidative stress and inflammation.
T/F: The inflammatory exudate consists primarily of red blood cells.
Answer: False
Rationale: Exudate mainly contains neutrophils, proteins, and fluid, not RBCs.
Short Answer (10)
26. Describe the difference between dry and wet gangrene.
Answer: Dry gangrene is ischemic necrosis with tissue drying and mummification, often
