GOULD'S PATHOPHYSIOLOGY FOR THE
HEALTH PROFESSIONS
7TH EDITION
• AUTHOR(S)KARIN C. VANMETER;
ROBERT J. HUBERT
TEST BANK
Ch. 1 — Introduction to Pathophysiology — Homeostasis and
Compensation
Stem: A 58-year-old patient develops gradual hypertension. The
nurse educator explains that homeostatic mechanisms initially
maintain perfusion but eventually change. Which explanation
best links the concept of homeostasis to the development of
organ-level pathophysiology?
A. Homeostasis solely depends on fixed physiologic set points
that do not change over time.
B. Homeostatic mechanisms activate compensatory responses
that, when persistent, produce maladaptive structural and
functional changes.
,C. Homeostasis prevents any cellular adaptation, so disease
only occurs when homeostasis fails completely.
D. Homeostasis is a passive property of tissues and does not
involve energy-dependent processes.
Correct answer: B
Rationale — Correct (B): Chronic activation of compensatory
mechanisms (e.g., neurohormonal vasoconstriction, increased
vascular resistance) alters tissue structure/function over time;
persistent compensation becomes maladaptive and leads to
pathologic change, consistent with Gould’s emphasis on
dynamic homeostasis and compensation.
Rationale — A: Incorrect — set points can be regulated and
altered; homeostasis is active, not fixed.
Rationale — C: Incorrect — homeostatic responses include
adaptive changes (not absence of adaptation); disease often
results from maladaptive compensation.
Rationale — D: Incorrect — homeostasis frequently requires
energy-dependent mechanisms (ion pumps, signaling).
Teaching point: Chronic compensation can become maladaptive
and drive progressive disease.
Citation: VanMeter, K. C., & Hubert, R. J. (2024). Gould’s
Pathophysiology for the Health Professions (7th ed.). Ch. 1.
Ch. 1 — Introduction to Pathophysiology — Definition and
Scope
,Stem: A first-year nursing student asks why pathophysiology is
distinct from pathology and physiology when studying disease.
Which statement best captures the scope of pathophysiology?
A. Pathophysiology describes only the gross anatomic changes
visible after death.
B. Pathophysiology explains disrupted physiologic processes
and mechanisms that produce signs and symptoms.
C. Pathophysiology focuses exclusively on microbial causes of
disease.
D. Pathophysiology studies normal physiology without
reference to disease.
Correct answer: B
Rationale — Correct (B): Pathophysiology integrates altered
function and mechanisms (cellular, tissue, system levels) that
produce clinical manifestations; it bridges normal physiology
and pathologic change as highlighted in Gould.
Rationale — A: Incorrect — that’s descriptive pathology
(morphology), not the mechanistic focus of pathophysiology.
Rationale — C: Incorrect — microbial causes are one etiology
among many; pathophysiology covers mechanisms beyond
infection.
Rationale — D: Incorrect — it explicitly addresses abnormal
physiology in disease states.
Teaching point: Pathophysiology links altered physiological
mechanisms to clinical signs and symptoms.
Citation: VanMeter & Hubert (2024). Ch. 1.
, Ch. 1 — Introduction to Cellular Changes — Reversible Cell
Injury (Cell Swelling)
Stem: After prolonged hypotension from blood loss, a patient’s
cells show pallor and enlarged, pale cytoplasm on biopsy. Which
mechanism most directly explains the early reversible cellular
swelling?
A. Increased ATP production causing increased ion gradients.
B. Loss of ATP → Na⁺/K⁺-ATPase failure → intracellular Na⁺ and
water accumulation.
C. Increased protein synthesis in the rough ER leading to
cytoplasmic expansion.
D. Activation of lysosomal enzymes causing immediate
membrane dissolution.
Correct answer: B
Rationale — Correct (B): Hypoxic/ischemic injury decreases
ATP, impairing Na⁺/K⁺ pumps; intracellular Na⁺ rises, water
follows, causing cellular swelling — the classic reversible injury
described in Gould.
Rationale — A: Incorrect — ATP production is reduced, not
increased, in hypoxic injury.
Rationale — C: Incorrect — increased protein synthesis does
not explain acute cytoplasmic pallor and swelling seen early.
Rationale — D: Incorrect — lysosomal enzyme activation and
membrane dissolution are features of irreversible
injury/necrosis, not initial reversible swelling.
HEALTH PROFESSIONS
7TH EDITION
• AUTHOR(S)KARIN C. VANMETER;
ROBERT J. HUBERT
TEST BANK
Ch. 1 — Introduction to Pathophysiology — Homeostasis and
Compensation
Stem: A 58-year-old patient develops gradual hypertension. The
nurse educator explains that homeostatic mechanisms initially
maintain perfusion but eventually change. Which explanation
best links the concept of homeostasis to the development of
organ-level pathophysiology?
A. Homeostasis solely depends on fixed physiologic set points
that do not change over time.
B. Homeostatic mechanisms activate compensatory responses
that, when persistent, produce maladaptive structural and
functional changes.
,C. Homeostasis prevents any cellular adaptation, so disease
only occurs when homeostasis fails completely.
D. Homeostasis is a passive property of tissues and does not
involve energy-dependent processes.
Correct answer: B
Rationale — Correct (B): Chronic activation of compensatory
mechanisms (e.g., neurohormonal vasoconstriction, increased
vascular resistance) alters tissue structure/function over time;
persistent compensation becomes maladaptive and leads to
pathologic change, consistent with Gould’s emphasis on
dynamic homeostasis and compensation.
Rationale — A: Incorrect — set points can be regulated and
altered; homeostasis is active, not fixed.
Rationale — C: Incorrect — homeostatic responses include
adaptive changes (not absence of adaptation); disease often
results from maladaptive compensation.
Rationale — D: Incorrect — homeostasis frequently requires
energy-dependent mechanisms (ion pumps, signaling).
Teaching point: Chronic compensation can become maladaptive
and drive progressive disease.
Citation: VanMeter, K. C., & Hubert, R. J. (2024). Gould’s
Pathophysiology for the Health Professions (7th ed.). Ch. 1.
Ch. 1 — Introduction to Pathophysiology — Definition and
Scope
,Stem: A first-year nursing student asks why pathophysiology is
distinct from pathology and physiology when studying disease.
Which statement best captures the scope of pathophysiology?
A. Pathophysiology describes only the gross anatomic changes
visible after death.
B. Pathophysiology explains disrupted physiologic processes
and mechanisms that produce signs and symptoms.
C. Pathophysiology focuses exclusively on microbial causes of
disease.
D. Pathophysiology studies normal physiology without
reference to disease.
Correct answer: B
Rationale — Correct (B): Pathophysiology integrates altered
function and mechanisms (cellular, tissue, system levels) that
produce clinical manifestations; it bridges normal physiology
and pathologic change as highlighted in Gould.
Rationale — A: Incorrect — that’s descriptive pathology
(morphology), not the mechanistic focus of pathophysiology.
Rationale — C: Incorrect — microbial causes are one etiology
among many; pathophysiology covers mechanisms beyond
infection.
Rationale — D: Incorrect — it explicitly addresses abnormal
physiology in disease states.
Teaching point: Pathophysiology links altered physiological
mechanisms to clinical signs and symptoms.
Citation: VanMeter & Hubert (2024). Ch. 1.
, Ch. 1 — Introduction to Cellular Changes — Reversible Cell
Injury (Cell Swelling)
Stem: After prolonged hypotension from blood loss, a patient’s
cells show pallor and enlarged, pale cytoplasm on biopsy. Which
mechanism most directly explains the early reversible cellular
swelling?
A. Increased ATP production causing increased ion gradients.
B. Loss of ATP → Na⁺/K⁺-ATPase failure → intracellular Na⁺ and
water accumulation.
C. Increased protein synthesis in the rough ER leading to
cytoplasmic expansion.
D. Activation of lysosomal enzymes causing immediate
membrane dissolution.
Correct answer: B
Rationale — Correct (B): Hypoxic/ischemic injury decreases
ATP, impairing Na⁺/K⁺ pumps; intracellular Na⁺ rises, water
follows, causing cellular swelling — the classic reversible injury
described in Gould.
Rationale — A: Incorrect — ATP production is reduced, not
increased, in hypoxic injury.
Rationale — C: Incorrect — increased protein synthesis does
not explain acute cytoplasmic pallor and swelling seen early.
Rationale — D: Incorrect — lysosomal enzyme activation and
membrane dissolution are features of irreversible
injury/necrosis, not initial reversible swelling.
