HESI / Elsevier | Pathophysiology Comprehensive Examination
HESI Pathophysiology
Comprehensive Examination
2026/2027 | Verified Questions
HESI / Elsevier | Pathophysiology Comprehensive Examination | University-Level Nursing Students
120 Verified Questions | 4 Core Domains | Academic Year 2026/2027
Prepared by
HESI / Elsevier | Pathophysiology Comprehensive Examination
Comprehensive Proctored Examination Actual Exam | Academic Year 2026/2027
HESI Pathophysiology Comprehensive Examination 2026/2027 | Verified Questions
,INTRODUCTION
This comprehensive examination contains 120 verified questions designed to reinforce the official HESI
Pathophysiology Comprehensive Examination course objectives for the Comprehensive Proctored
Examination. The questions are organized across four core domains: Cellular and Genetic
Pathophysiology; Inflammation, Immunity, and Infection; Cardiovascular, Respiratory, and Hematologic
Disorders; and Neurologic, Endocrine, and Gastrointestinal Disorders. Content is original and aligned to
the 2026/2027 academic year, emphasizing pathophysiological reasoning and foundational nursing
knowledge required for actual exam readiness and clinical proficiency.
ACTUAL QUESTIONS
Domain 1: Cellular and Genetic Pathophysiology
Question 1. What is the primary mechanism of cellular injury caused by hypoxia?
A. Direct DNA damage
B. Increased antioxidant activity
C. Excessive protein synthesis
D. ATP depletion leading to failure of sodium-potassium pumps and cellular swelling
Correct Answer: D
Rationale: Hypoxia impairs oxidative phosphorylation, depleting ATP and causing failure of membrane
ion pumps, which leads to cellular swelling.
Question 2. Which type of cellular adaptation occurs when cells increase in size in
response to increased workload?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Correct Answer: A
Rationale: Hypertrophy is an increase in cell size, commonly seen in skeletal and cardiac muscle under
increased demand.
Question 3. What is apoptosis?
A. Uncontrolled cell death causing inflammation
B. Programmed cell death that does not typically provoke inflammation
C. Cell division
D. Cellular swelling only
Correct Answer: B
Rationale: Apoptosis is a regulated process of cell death that eliminates cells without eliciting a
significant inflammatory response.
Question 4. Which genetic term describes the presence of two different alleles at a locus?
A. Homozygous
B. Hemizygous
C. Heterozygous
D. Nullizygous
Correct Answer: C
Rationale: A heterozygous individual carries two different alleles for a given gene.
Question 5. What is the most common cause of cellular accumulation of lipids?
HESI Pathophysiology Comprehensive Examination 2026/2027 | Verified Questions
, A. Increased protein synthesis
B. Decreased membrane permeability
C. Excessive DNA replication
D. Imbalance between uptake, synthesis, and metabolism of lipids, often seen in steatosis
Correct Answer: D
Rationale: Fatty change (steatosis) results from altered lipid handling and is commonly observed in the
liver.
Question 6. Which process describes the replacement of one differentiated cell type by
another?
A. Hypertrophy
B. Metaplasia
C. Hyperplasia
D. Atrophy
Correct Answer: B
Rationale: Metaplasia is the reversible replacement of one mature cell type by another, often in
response to chronic irritation.
Question 7. What is the primary defect in autosomal dominant disorders?
A. Both alleles must be mutated
B. Only males are affected
C. A single mutant allele is sufficient to produce the phenotype
D. The mutation is always lethal
Correct Answer: C
Rationale: In autosomal dominant inheritance, one copy of the mutant allele produces the disease
phenotype.
Question 8. Which organelle is primarily damaged by free radicals?
A. Membranes through lipid peroxidation
B. Ribosomes exclusively
C. Nucleolus only
D. Cytoskeleton exclusively
Correct Answer: A
Rationale: Reactive oxygen species attack polyunsaturated fatty acids in membranes, causing lipid
peroxidation and membrane damage.
Question 9. What is dysplasia?
A. Normal cellular maturation
B. Increase in cell number only
C. Disordered growth and maturation of cells, often a precursor to malignancy
D. Decrease in cell size
Correct Answer: C
Rationale: Dysplasia involves atypical hyperplasia with disordered architecture and is considered a
premalignant change.
Question 10. Which type of necrosis is characterized by preservation of tissue architecture
and is typical of ischemic injury in solid organs?
A. Liquefactive necrosis
B. Coagulative necrosis
C. Caseous necrosis
HESI Pathophysiology Comprehensive Examination 2026/2027 | Verified Questions
HESI Pathophysiology
Comprehensive Examination
2026/2027 | Verified Questions
HESI / Elsevier | Pathophysiology Comprehensive Examination | University-Level Nursing Students
120 Verified Questions | 4 Core Domains | Academic Year 2026/2027
Prepared by
HESI / Elsevier | Pathophysiology Comprehensive Examination
Comprehensive Proctored Examination Actual Exam | Academic Year 2026/2027
HESI Pathophysiology Comprehensive Examination 2026/2027 | Verified Questions
,INTRODUCTION
This comprehensive examination contains 120 verified questions designed to reinforce the official HESI
Pathophysiology Comprehensive Examination course objectives for the Comprehensive Proctored
Examination. The questions are organized across four core domains: Cellular and Genetic
Pathophysiology; Inflammation, Immunity, and Infection; Cardiovascular, Respiratory, and Hematologic
Disorders; and Neurologic, Endocrine, and Gastrointestinal Disorders. Content is original and aligned to
the 2026/2027 academic year, emphasizing pathophysiological reasoning and foundational nursing
knowledge required for actual exam readiness and clinical proficiency.
ACTUAL QUESTIONS
Domain 1: Cellular and Genetic Pathophysiology
Question 1. What is the primary mechanism of cellular injury caused by hypoxia?
A. Direct DNA damage
B. Increased antioxidant activity
C. Excessive protein synthesis
D. ATP depletion leading to failure of sodium-potassium pumps and cellular swelling
Correct Answer: D
Rationale: Hypoxia impairs oxidative phosphorylation, depleting ATP and causing failure of membrane
ion pumps, which leads to cellular swelling.
Question 2. Which type of cellular adaptation occurs when cells increase in size in
response to increased workload?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Correct Answer: A
Rationale: Hypertrophy is an increase in cell size, commonly seen in skeletal and cardiac muscle under
increased demand.
Question 3. What is apoptosis?
A. Uncontrolled cell death causing inflammation
B. Programmed cell death that does not typically provoke inflammation
C. Cell division
D. Cellular swelling only
Correct Answer: B
Rationale: Apoptosis is a regulated process of cell death that eliminates cells without eliciting a
significant inflammatory response.
Question 4. Which genetic term describes the presence of two different alleles at a locus?
A. Homozygous
B. Hemizygous
C. Heterozygous
D. Nullizygous
Correct Answer: C
Rationale: A heterozygous individual carries two different alleles for a given gene.
Question 5. What is the most common cause of cellular accumulation of lipids?
HESI Pathophysiology Comprehensive Examination 2026/2027 | Verified Questions
, A. Increased protein synthesis
B. Decreased membrane permeability
C. Excessive DNA replication
D. Imbalance between uptake, synthesis, and metabolism of lipids, often seen in steatosis
Correct Answer: D
Rationale: Fatty change (steatosis) results from altered lipid handling and is commonly observed in the
liver.
Question 6. Which process describes the replacement of one differentiated cell type by
another?
A. Hypertrophy
B. Metaplasia
C. Hyperplasia
D. Atrophy
Correct Answer: B
Rationale: Metaplasia is the reversible replacement of one mature cell type by another, often in
response to chronic irritation.
Question 7. What is the primary defect in autosomal dominant disorders?
A. Both alleles must be mutated
B. Only males are affected
C. A single mutant allele is sufficient to produce the phenotype
D. The mutation is always lethal
Correct Answer: C
Rationale: In autosomal dominant inheritance, one copy of the mutant allele produces the disease
phenotype.
Question 8. Which organelle is primarily damaged by free radicals?
A. Membranes through lipid peroxidation
B. Ribosomes exclusively
C. Nucleolus only
D. Cytoskeleton exclusively
Correct Answer: A
Rationale: Reactive oxygen species attack polyunsaturated fatty acids in membranes, causing lipid
peroxidation and membrane damage.
Question 9. What is dysplasia?
A. Normal cellular maturation
B. Increase in cell number only
C. Disordered growth and maturation of cells, often a precursor to malignancy
D. Decrease in cell size
Correct Answer: C
Rationale: Dysplasia involves atypical hyperplasia with disordered architecture and is considered a
premalignant change.
Question 10. Which type of necrosis is characterized by preservation of tissue architecture
and is typical of ischemic injury in solid organs?
A. Liquefactive necrosis
B. Coagulative necrosis
C. Caseous necrosis
HESI Pathophysiology Comprehensive Examination 2026/2027 | Verified Questions
