NSG120: Nursing Pathophysiology Final Exam Review
Actual Exam 2026/2027 – Complete Exam-Style Questions
with Detailed Rationales | 100% Verified | Pass Guaranteed –
A+ Graded
SECTION 1: Cellular Adaptation, Injury, & Neoplasia (Q1-Q15)
Q1: A patient with heart failure develops an enlarged heart muscle. The pathophysiology
instructor explains that this is an example of:
A. Atrophy
B. Hypertrophy [CORRECT]
C. Hyperplasia
D. Metaplasia
Correct Answer: B
Rationale: Hypertrophy is an increase in cell size, resulting in enlargement of the tissue
or organ. Cardiac hypertrophy occurs in response to increased workload (pressure
overload in hypertension, volume overload in valvular regurgitation). Atrophy is decrease
in cell size. Hyperplasia is increase in cell number. Metaplasia is replacement of one cell
type with another. [100% VERIFIED – Herzing NSG120]
Q2: A patient with chronic bronchitis has an increase in the number of goblet cells in the
bronchial mucosa. This cellular adaptation is called:
A. Atrophy
B. Hypertrophy
C. Hyperplasia [CORRECT]
D. Dysplasia
Correct Answer: C
Rationale: Hyperplasia is an increase in the number of cells in a tissue or organ. In
chronic bronchitis, repeated irritation causes increased goblet cell numbers
,(hyperplasia) leading to excessive mucus production. Atrophy is decreased cell size.
Hypertrophy is increased cell size. Dysplasia is abnormal cell growth with loss of
normal tissue architecture and is considered pre-neoplastic. [100% VERIFIED – Herzing
NSG120]
Q3: A patient with chronic gastroesophageal reflux develops Barrett's esophagus, where
squamous epithelium is replaced by columnar epithelium. This is an example of:
A. Hyperplasia
B. Hypertrophy
C. Metaplasia [CORRECT]
D. Anaplasia
Correct Answer: C
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with
another. Barrett's esophagus is metaplasia of squamous epithelium to columnar
epithelium in response to chronic acid exposure. While metaplasia is adaptive, it
increases cancer risk (Barrett's is pre-malignant). Hyperplasia is increased cell number.
Hypertrophy is increased cell size. Anaplasia is loss of differentiation in malignant cells.
[100% VERIFIED – Herzing NSG120]
Q4: A Pap smear shows cells with abnormal size, shape, and organization but does not
invade the basement membrane. This finding is called:
A. Metaplasia
B. Hyperplasia
C. Dysplasia [CORRECT]
D. Hypertrophy
Correct Answer: C
Rationale: Dysplasia is abnormal cell growth characterized by variations in cell size and
shape, loss of normal tissue architecture, and increased nuclear-to-cytoplasmic ratio. It
is considered pre-neoplastic and may progress to carcinoma in situ or invasive cancer.
Dysplasia does not invade the basement membrane (that defines invasive cancer).
,Metaplasia, hyperplasia, and hypertrophy are not pre-neoplastic. [100% VERIFIED –
Herzing NSG120]
Q5: A patient with peripheral artery disease develops tissue death in the lower extremity
due to reduced blood supply. The most common cause of this cell injury is:
A. Chemical toxicity
B. Hypoxia from ischemia [CORRECT]
C. Radiation exposure
D. Nutritional deficiency
Correct Answer: B
Rationale: Hypoxia (decreased oxygen supply) is the most common cause of cell injury.
Ischemia (reduced blood flow) causes hypoxia by limiting oxygen delivery and removing
metabolic wastes. In peripheral artery disease, arterial occlusion causes ischemic
hypoxia leading to tissue necrosis. While chemical toxicity, radiation, and nutritional
deficiencies cause cell injury, hypoxia from ischemia is the most common cause overall.
[100% VERIFIED – Herzing NSG120]
Q6: A patient with myocardial infarction has tissue death that preserves tissue
architecture but loses nuclei and cytoplasmic detail. The pathologist identifies this as:
A. Liquefactive necrosis
B. Coagulative necrosis [CORRECT]
C. Caseous necrosis
D. Fat necrosis
Correct Answer: B
Rationale: Coagulative necrosis occurs in ischemic injury to all tissues except the brain.
It is characterized by denaturation of proteins, preservation of tissue architecture, and
loss of nuclei. It is typical of myocardial infarction and renal infarction. Liquefactive
necrosis occurs in the brain and with bacterial infections. Caseous necrosis occurs in
tuberculosis. Fat necrosis occurs in pancreatitis and breast trauma. [100% VERIFIED –
Herzing NSG120]
, Q7: A patient with bacterial meningitis has tissue destruction characterized by pus
formation and liquefaction. The type of necrosis present is:
A. Coagulative necrosis
B. Liquefactive necrosis [CORRECT]
C. Caseous necrosis
D. Gangrenous necrosis
Correct Answer: B
Rationale: Liquefactive necrosis occurs when enzymatic digestion (from bacterial or
tissue enzymes) liquefies tissue, forming pus. It is characteristic of bacterial infections
(abscesses, meningitis) and ischemic injury in the brain (cerebral infarction).
Coagulative necrosis preserves architecture. Caseous necrosis has a cheese-like
appearance (tuberculosis). Gangrenous necrosis refers to ischemic necrosis of a limb
(dry, wet, or gas gangrene). [100% VERIFIED – Herzing NSG120]
Q8: A patient with tuberculosis has granulomas with central areas of amorphous,
granular debris. The pathologist identifies this as:
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis [CORRECT]
D. Fat necrosis
Correct Answer: C
Rationale: Caseous necrosis is characteristic of tuberculosis and certain fungal
infections. It has a cheese-like (caseous) appearance on gross examination and
appears as amorphous, granular debris microscopically. It is a form of cell death
associated with granulomatous inflammation. Coagulative necrosis preserves
architecture. Liquefactive necrosis forms pus. Fat necrosis occurs in pancreatitis and
trauma. [100% VERIFIED – Herzing NSG120]
Q9: A patient with acute pancreatitis develops chalky white deposits in the
peripancreatic fat. This represents:
Actual Exam 2026/2027 – Complete Exam-Style Questions
with Detailed Rationales | 100% Verified | Pass Guaranteed –
A+ Graded
SECTION 1: Cellular Adaptation, Injury, & Neoplasia (Q1-Q15)
Q1: A patient with heart failure develops an enlarged heart muscle. The pathophysiology
instructor explains that this is an example of:
A. Atrophy
B. Hypertrophy [CORRECT]
C. Hyperplasia
D. Metaplasia
Correct Answer: B
Rationale: Hypertrophy is an increase in cell size, resulting in enlargement of the tissue
or organ. Cardiac hypertrophy occurs in response to increased workload (pressure
overload in hypertension, volume overload in valvular regurgitation). Atrophy is decrease
in cell size. Hyperplasia is increase in cell number. Metaplasia is replacement of one cell
type with another. [100% VERIFIED – Herzing NSG120]
Q2: A patient with chronic bronchitis has an increase in the number of goblet cells in the
bronchial mucosa. This cellular adaptation is called:
A. Atrophy
B. Hypertrophy
C. Hyperplasia [CORRECT]
D. Dysplasia
Correct Answer: C
Rationale: Hyperplasia is an increase in the number of cells in a tissue or organ. In
chronic bronchitis, repeated irritation causes increased goblet cell numbers
,(hyperplasia) leading to excessive mucus production. Atrophy is decreased cell size.
Hypertrophy is increased cell size. Dysplasia is abnormal cell growth with loss of
normal tissue architecture and is considered pre-neoplastic. [100% VERIFIED – Herzing
NSG120]
Q3: A patient with chronic gastroesophageal reflux develops Barrett's esophagus, where
squamous epithelium is replaced by columnar epithelium. This is an example of:
A. Hyperplasia
B. Hypertrophy
C. Metaplasia [CORRECT]
D. Anaplasia
Correct Answer: C
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with
another. Barrett's esophagus is metaplasia of squamous epithelium to columnar
epithelium in response to chronic acid exposure. While metaplasia is adaptive, it
increases cancer risk (Barrett's is pre-malignant). Hyperplasia is increased cell number.
Hypertrophy is increased cell size. Anaplasia is loss of differentiation in malignant cells.
[100% VERIFIED – Herzing NSG120]
Q4: A Pap smear shows cells with abnormal size, shape, and organization but does not
invade the basement membrane. This finding is called:
A. Metaplasia
B. Hyperplasia
C. Dysplasia [CORRECT]
D. Hypertrophy
Correct Answer: C
Rationale: Dysplasia is abnormal cell growth characterized by variations in cell size and
shape, loss of normal tissue architecture, and increased nuclear-to-cytoplasmic ratio. It
is considered pre-neoplastic and may progress to carcinoma in situ or invasive cancer.
Dysplasia does not invade the basement membrane (that defines invasive cancer).
,Metaplasia, hyperplasia, and hypertrophy are not pre-neoplastic. [100% VERIFIED –
Herzing NSG120]
Q5: A patient with peripheral artery disease develops tissue death in the lower extremity
due to reduced blood supply. The most common cause of this cell injury is:
A. Chemical toxicity
B. Hypoxia from ischemia [CORRECT]
C. Radiation exposure
D. Nutritional deficiency
Correct Answer: B
Rationale: Hypoxia (decreased oxygen supply) is the most common cause of cell injury.
Ischemia (reduced blood flow) causes hypoxia by limiting oxygen delivery and removing
metabolic wastes. In peripheral artery disease, arterial occlusion causes ischemic
hypoxia leading to tissue necrosis. While chemical toxicity, radiation, and nutritional
deficiencies cause cell injury, hypoxia from ischemia is the most common cause overall.
[100% VERIFIED – Herzing NSG120]
Q6: A patient with myocardial infarction has tissue death that preserves tissue
architecture but loses nuclei and cytoplasmic detail. The pathologist identifies this as:
A. Liquefactive necrosis
B. Coagulative necrosis [CORRECT]
C. Caseous necrosis
D. Fat necrosis
Correct Answer: B
Rationale: Coagulative necrosis occurs in ischemic injury to all tissues except the brain.
It is characterized by denaturation of proteins, preservation of tissue architecture, and
loss of nuclei. It is typical of myocardial infarction and renal infarction. Liquefactive
necrosis occurs in the brain and with bacterial infections. Caseous necrosis occurs in
tuberculosis. Fat necrosis occurs in pancreatitis and breast trauma. [100% VERIFIED –
Herzing NSG120]
, Q7: A patient with bacterial meningitis has tissue destruction characterized by pus
formation and liquefaction. The type of necrosis present is:
A. Coagulative necrosis
B. Liquefactive necrosis [CORRECT]
C. Caseous necrosis
D. Gangrenous necrosis
Correct Answer: B
Rationale: Liquefactive necrosis occurs when enzymatic digestion (from bacterial or
tissue enzymes) liquefies tissue, forming pus. It is characteristic of bacterial infections
(abscesses, meningitis) and ischemic injury in the brain (cerebral infarction).
Coagulative necrosis preserves architecture. Caseous necrosis has a cheese-like
appearance (tuberculosis). Gangrenous necrosis refers to ischemic necrosis of a limb
(dry, wet, or gas gangrene). [100% VERIFIED – Herzing NSG120]
Q8: A patient with tuberculosis has granulomas with central areas of amorphous,
granular debris. The pathologist identifies this as:
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis [CORRECT]
D. Fat necrosis
Correct Answer: C
Rationale: Caseous necrosis is characteristic of tuberculosis and certain fungal
infections. It has a cheese-like (caseous) appearance on gross examination and
appears as amorphous, granular debris microscopically. It is a form of cell death
associated with granulomatous inflammation. Coagulative necrosis preserves
architecture. Liquefactive necrosis forms pus. Fat necrosis occurs in pancreatitis and
trauma. [100% VERIFIED – Herzing NSG120]
Q9: A patient with acute pancreatitis develops chalky white deposits in the
peripancreatic fat. This represents:
