BSN 246 PATHOPHYSIOLOGY
NIGHTINGALE FINAL TEST EXAM
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
• Cellular Adaptation, Injury, and Death
• Genetics and Genetic Disorders
• Inflammation and Immune Response
• Fluid, Electrolyte, and Acid-Base Balance
• Cardiovascular Pathophysiology
• Respiratory Pathophysiology
• Renal and Urinary Pathophysiology
• Gastrointestinal and Hepatobiliary Pathophysiology
• Endocrine Pathophysiology
• Neurological and Musculoskeletal Pathophysiology
Introduction
This comprehensive examination evaluates mastery of pathophysiological
concepts essential for nursing practice. It assesses understanding of
disease mechanisms, cellular alterations, and systemic responses across
the lifespan. The test employs multiple-choice and scenario-based
questions that require critical thinking and clinical application of
pathophysiological principles. Emphasis is placed on linking underlying
mechanisms to clinical manifestations, diagnostic findings, and treatment
rationale. This assessment serves as a critical measure of readiness for
,professional nursing practice and evidence-based clinical decision-
making.
Section One: Questions 1–100
1. A patient with chronic hypertension develops left ventricular
hypertrophy. Which type of cellular adaptation does this
represent?
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Atrophy
B. Hypertrophy
RATIONALE: Hypertrophy is an increase in cell size, often in
response to increased workload. In hypertension, the left ventricle
undergoes hypertrophy to compensate for increased afterload.
Hyperplasia is an increase in cell number; metaplasia is a change in cell
type; atrophy is a decrease in cell size.
2. Which of the following is the primary mechanism of cell injury in
ischemia?
A. ATP depletion
B. Free radical formation
C. Calcium influx
D. Membrane pump failure
A. ATP depletion
RATIONALE: Ischemia reduces oxygen delivery, leading to
decreased oxidative phosphorylation and ATP depletion. This is the
initial and most critical event, causing failure of ATP-dependent ion
pumps, leading to cell swelling and death.
, 3. A biopsy of the cervix shows disorganized, atypical cells that have
not invaded the basement membrane. This finding is most
consistent with:
A. Metaplasia
B. Dysplasia
C. Neoplasia
D. Anaplasia
B. Dysplasia
RATIONALE: Dysplasia is characterized by disordered, atypical cells
that have not breached the basement membrane. It is a pre-cancerous
condition. Metaplasia is a reversible change to a different cell type.
Neoplasia implies autonomous growth. Anaplasia is a lack of
differentiation, seen in malignant tumors.
4. Which of the following is a hallmark of apoptosis?
A. Cell swelling and lysis
B. Inflammatory response
C. Programmed cell death without inflammation
D. Random DNA fragmentation
C. Programmed cell death without inflammation
RATIONALE: Apoptosis is a regulated, energy-dependent process of
programmed cell death that does not incite inflammation. Necrosis, in
contrast, causes cell swelling, lysis, and inflammation.
5. A patient has a mutation in the CFTR gene. Which
pathophysiological process is most directly affected?
A. Chloride transport across epithelial membranes
B. Sodium reabsorption in the proximal tubule
C. Potassium excretion in the distal tubule
D. Glucose reabsorption in the intestine
A. Chloride transport across epithelial membranes
, RATIONALE: The CFTR gene encodes a chloride channel. Mutations
lead to defective chloride transport, causing thick, viscous secretions in
lungs, pancreas, and other organs, characteristic of cystic fibrosis.
6. In autosomal recessive inheritance, what is the probability that a
child will be affected if both parents are carriers?
A. 0%
B. 25%
C. 50%
D. 75%
B. 25%
RATIONALE: If both parents are carriers (heterozygous), each
pregnancy has a 25% chance of an affected child (homozygous
recessive), a 50% chance of a carrier child, and a 25% chance of a
homozygous normal child.
7. Which immunoglobulin is primarily responsible for allergic
reactions (Type I hypersensitivity)?
A. IgA
B. IgG
C. IgM
D. IgE
D. IgE
RATIONALE: IgE binds to mast cells and basophils. Upon allergen
exposure, it triggers degranulation and release of histamine and other
mediators, causing Type I hypersensitivity reactions (e.g., anaphylaxis,
allergies).
8. A patient with systemic lupus erythematosus (SLE) is most likely to
have which type of hypersensitivity reaction?
A. Type I
B. Type II
NIGHTINGALE FINAL TEST EXAM
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
• Cellular Adaptation, Injury, and Death
• Genetics and Genetic Disorders
• Inflammation and Immune Response
• Fluid, Electrolyte, and Acid-Base Balance
• Cardiovascular Pathophysiology
• Respiratory Pathophysiology
• Renal and Urinary Pathophysiology
• Gastrointestinal and Hepatobiliary Pathophysiology
• Endocrine Pathophysiology
• Neurological and Musculoskeletal Pathophysiology
Introduction
This comprehensive examination evaluates mastery of pathophysiological
concepts essential for nursing practice. It assesses understanding of
disease mechanisms, cellular alterations, and systemic responses across
the lifespan. The test employs multiple-choice and scenario-based
questions that require critical thinking and clinical application of
pathophysiological principles. Emphasis is placed on linking underlying
mechanisms to clinical manifestations, diagnostic findings, and treatment
rationale. This assessment serves as a critical measure of readiness for
,professional nursing practice and evidence-based clinical decision-
making.
Section One: Questions 1–100
1. A patient with chronic hypertension develops left ventricular
hypertrophy. Which type of cellular adaptation does this
represent?
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Atrophy
B. Hypertrophy
RATIONALE: Hypertrophy is an increase in cell size, often in
response to increased workload. In hypertension, the left ventricle
undergoes hypertrophy to compensate for increased afterload.
Hyperplasia is an increase in cell number; metaplasia is a change in cell
type; atrophy is a decrease in cell size.
2. Which of the following is the primary mechanism of cell injury in
ischemia?
A. ATP depletion
B. Free radical formation
C. Calcium influx
D. Membrane pump failure
A. ATP depletion
RATIONALE: Ischemia reduces oxygen delivery, leading to
decreased oxidative phosphorylation and ATP depletion. This is the
initial and most critical event, causing failure of ATP-dependent ion
pumps, leading to cell swelling and death.
, 3. A biopsy of the cervix shows disorganized, atypical cells that have
not invaded the basement membrane. This finding is most
consistent with:
A. Metaplasia
B. Dysplasia
C. Neoplasia
D. Anaplasia
B. Dysplasia
RATIONALE: Dysplasia is characterized by disordered, atypical cells
that have not breached the basement membrane. It is a pre-cancerous
condition. Metaplasia is a reversible change to a different cell type.
Neoplasia implies autonomous growth. Anaplasia is a lack of
differentiation, seen in malignant tumors.
4. Which of the following is a hallmark of apoptosis?
A. Cell swelling and lysis
B. Inflammatory response
C. Programmed cell death without inflammation
D. Random DNA fragmentation
C. Programmed cell death without inflammation
RATIONALE: Apoptosis is a regulated, energy-dependent process of
programmed cell death that does not incite inflammation. Necrosis, in
contrast, causes cell swelling, lysis, and inflammation.
5. A patient has a mutation in the CFTR gene. Which
pathophysiological process is most directly affected?
A. Chloride transport across epithelial membranes
B. Sodium reabsorption in the proximal tubule
C. Potassium excretion in the distal tubule
D. Glucose reabsorption in the intestine
A. Chloride transport across epithelial membranes
, RATIONALE: The CFTR gene encodes a chloride channel. Mutations
lead to defective chloride transport, causing thick, viscous secretions in
lungs, pancreas, and other organs, characteristic of cystic fibrosis.
6. In autosomal recessive inheritance, what is the probability that a
child will be affected if both parents are carriers?
A. 0%
B. 25%
C. 50%
D. 75%
B. 25%
RATIONALE: If both parents are carriers (heterozygous), each
pregnancy has a 25% chance of an affected child (homozygous
recessive), a 50% chance of a carrier child, and a 25% chance of a
homozygous normal child.
7. Which immunoglobulin is primarily responsible for allergic
reactions (Type I hypersensitivity)?
A. IgA
B. IgG
C. IgM
D. IgE
D. IgE
RATIONALE: IgE binds to mast cells and basophils. Upon allergen
exposure, it triggers degranulation and release of histamine and other
mediators, causing Type I hypersensitivity reactions (e.g., anaphylaxis,
allergies).
8. A patient with systemic lupus erythematosus (SLE) is most likely to
have which type of hypersensitivity reaction?
A. Type I
B. Type II
