RASMUSSEN PATHOPHYSIOLOGY
EXAM 1 ACTUAL EXAM 2026/2027 |
NUR2063 Edition | Comprehensive
Practice Test | Verified Q&A | Pass
Guaranteed - A+ Graded
SECTION 1: CELLULAR BIOLOGY, INJURY & ADAPTATION
(25 Questions)
Q1: A 68-year-old male with chronic heart failure has decreased muscle mass in his lower
extremities due to disuse. The nurse recognizes this cellular adaptation as:
A. Hypertrophy
B. Hyperplasia
C. Atrophy [CORRECT]
D. Metaplasia
Correct Answer: C
Rationale: Atrophy is the decrease in cell size due to reduced workload, disuse, or diminished
blood supply/nutrition. In heart failure, skeletal muscle atrophy occurs from decreased
activity and possibly malnutrition. Hypertrophy increases cell size, hyperplasia increases cell
number, and metaplasia changes cell type. Atrophy is often reversible with increased activity
if underlying cause is addressed.
Q2: A patient with chronic hypertension presents with left ventricular wall thickening on
echocardiogram. This cellular adaptation represents:
A. Physiologic atrophy
B. Pathologic hypertrophy [CORRECT]
,C. Compensatory hyperplasia
D. Dysplasia
Correct Answer: B
Rationale: Pathologic hypertrophy occurs when cells enlarge due to increased demand or
stress beyond normal physiologic limits, such as cardiac muscle enlarging to overcome
increased afterload in hypertension. This differs from physiologic hypertrophy
(exercise-induced). Hyperplasia involves cell division (rare in cardiac muscle), and dysplasia
represents disordered, pre-neoplastic cell growth.
Q3: A 45-year-old female with endometrial hyperplasia is found to have excessive estrogen
exposure. This cellular adaptation is characterized by:
A. Decrease in cell size
B. Increase in cell number [CORRECT]
C. Change in cell type
D. Disordered cell arrangement
Correct Answer: B
Rationale: Hyperplasia is an increase in cell number in response to hormonal stimulation or
chronic irritation, explaining endometrial thickening with estrogen exposure. Atrophy
decreases cell size, metaplasia changes cell type, and dysplasia shows disordered
architecture. Endometrial hyperplasia carries cancer risk and requires monitoring or
progestin therapy.
Q4: A chronic smoker develops stratified squamous epithelium in the bronchial lining,
replacing normal pseudostratified columnar epithelium. This adaptation is:
A. Atrophy
B. Hypertrophy
C. Metaplasia [CORRECT]
D. Anaplasia
Correct Answer: C
,Rationale: Metaplasia is the reversible replacement of one differentiated cell type with
another, often as protective adaptation to chronic irritation—squamous epithelium better
withstands cigarette smoke than ciliated columnar cells. While reversible if irritant removed,
metaplasia may progress to dysplasia and malignancy. Anaplasia indicates loss of
differentiation in cancer cells.
Q5: A cervical Pap smear reveals disordered squamous cell maturation with nuclear
hyperchromasia and pleomorphism. This finding represents:
A. Normal metaplasia
B. Cervical intraepithelial neoplasia (dysplasia) [CORRECT]
C. Benign hyperplasia
D. Physiologic hypertrophy
Correct Answer: B
Rationale: Dysplasia is disordered, dysfunctional cell growth with loss of normal tissue
architecture and abnormal cellular features, representing pre-neoplastic change requiring
intervention. Cervical dysplasia (CIN) grades progress from mild to severe/carcinoma in situ.
Unlike metaplasia (reversible change), dysplasia may be irreversible and precedes
malignancy.
Q6: A patient experiencing a myocardial infarction has cellular injury primarily caused by:
A. Infectious agent invasion
B. Hypoxia and ischemia [CORRECT]
C. Physical trauma
D. Chemical toxicity
Correct Answer: B
Rationale: Hypoxia (inadequate oxygen) and ischemia (inadequate blood flow) are the most
common causes of cellular injury, particularly in cardiovascular disease. Myocardial cells are
exquisitely sensitive to oxygen deprivation, with irreversible injury beginning after 20-40
minutes of ischemia. Prompt reperfusion therapy limits infarct size.
, Q7: A trauma patient with crushed limb releases myoglobin and potassium upon reperfusion.
This injury mechanism is:
A. Hypoxic injury
B. Reperfusion injury [CORRECT]
C. Apoptotic injury
D. Nutritional deficiency
Correct Answer: B
Rationale: Reperfusion injury occurs when blood flow returns to ischemic tissue, generating
oxygen free radicals, calcium overload, and inflammatory responses that paradoxically
worsen cellular damage. Crush syndrome involves myoglobinuria causing renal failure and
hyperkalemia causing cardiac arrhythmias. Gradual reperfusion and alkalinization of urine
may reduce complications.
Q8: A patient with carbon monoxide poisoning has cellular injury due to:
A. Direct membrane damage
B. Inhibition of cytochrome oxidase
C. Decreased oxygen-carrying capacity and left shift of oxyhemoglobin curve [CORRECT]
D. Depletion of ATP stores only
Correct Answer: C
Rationale: Carbon monoxide binds hemoglobin with 240 times greater affinity than oxygen,
forming carboxyhemoglobin that cannot transport oxygen, while also shifting the
oxyhemoglobin dissociation curve left, further impairing oxygen release to tissues. This
causes tissue hypoxia despite normal PaO2. Cytochrome oxidase inhibition occurs with
cyanide poisoning.
Q9: A patient receiving radiation therapy develops cellular injury from hydroxyl radicals. This
represents:
A. Hypoxic injury
B. Free radical injury [CORRECT]
EXAM 1 ACTUAL EXAM 2026/2027 |
NUR2063 Edition | Comprehensive
Practice Test | Verified Q&A | Pass
Guaranteed - A+ Graded
SECTION 1: CELLULAR BIOLOGY, INJURY & ADAPTATION
(25 Questions)
Q1: A 68-year-old male with chronic heart failure has decreased muscle mass in his lower
extremities due to disuse. The nurse recognizes this cellular adaptation as:
A. Hypertrophy
B. Hyperplasia
C. Atrophy [CORRECT]
D. Metaplasia
Correct Answer: C
Rationale: Atrophy is the decrease in cell size due to reduced workload, disuse, or diminished
blood supply/nutrition. In heart failure, skeletal muscle atrophy occurs from decreased
activity and possibly malnutrition. Hypertrophy increases cell size, hyperplasia increases cell
number, and metaplasia changes cell type. Atrophy is often reversible with increased activity
if underlying cause is addressed.
Q2: A patient with chronic hypertension presents with left ventricular wall thickening on
echocardiogram. This cellular adaptation represents:
A. Physiologic atrophy
B. Pathologic hypertrophy [CORRECT]
,C. Compensatory hyperplasia
D. Dysplasia
Correct Answer: B
Rationale: Pathologic hypertrophy occurs when cells enlarge due to increased demand or
stress beyond normal physiologic limits, such as cardiac muscle enlarging to overcome
increased afterload in hypertension. This differs from physiologic hypertrophy
(exercise-induced). Hyperplasia involves cell division (rare in cardiac muscle), and dysplasia
represents disordered, pre-neoplastic cell growth.
Q3: A 45-year-old female with endometrial hyperplasia is found to have excessive estrogen
exposure. This cellular adaptation is characterized by:
A. Decrease in cell size
B. Increase in cell number [CORRECT]
C. Change in cell type
D. Disordered cell arrangement
Correct Answer: B
Rationale: Hyperplasia is an increase in cell number in response to hormonal stimulation or
chronic irritation, explaining endometrial thickening with estrogen exposure. Atrophy
decreases cell size, metaplasia changes cell type, and dysplasia shows disordered
architecture. Endometrial hyperplasia carries cancer risk and requires monitoring or
progestin therapy.
Q4: A chronic smoker develops stratified squamous epithelium in the bronchial lining,
replacing normal pseudostratified columnar epithelium. This adaptation is:
A. Atrophy
B. Hypertrophy
C. Metaplasia [CORRECT]
D. Anaplasia
Correct Answer: C
,Rationale: Metaplasia is the reversible replacement of one differentiated cell type with
another, often as protective adaptation to chronic irritation—squamous epithelium better
withstands cigarette smoke than ciliated columnar cells. While reversible if irritant removed,
metaplasia may progress to dysplasia and malignancy. Anaplasia indicates loss of
differentiation in cancer cells.
Q5: A cervical Pap smear reveals disordered squamous cell maturation with nuclear
hyperchromasia and pleomorphism. This finding represents:
A. Normal metaplasia
B. Cervical intraepithelial neoplasia (dysplasia) [CORRECT]
C. Benign hyperplasia
D. Physiologic hypertrophy
Correct Answer: B
Rationale: Dysplasia is disordered, dysfunctional cell growth with loss of normal tissue
architecture and abnormal cellular features, representing pre-neoplastic change requiring
intervention. Cervical dysplasia (CIN) grades progress from mild to severe/carcinoma in situ.
Unlike metaplasia (reversible change), dysplasia may be irreversible and precedes
malignancy.
Q6: A patient experiencing a myocardial infarction has cellular injury primarily caused by:
A. Infectious agent invasion
B. Hypoxia and ischemia [CORRECT]
C. Physical trauma
D. Chemical toxicity
Correct Answer: B
Rationale: Hypoxia (inadequate oxygen) and ischemia (inadequate blood flow) are the most
common causes of cellular injury, particularly in cardiovascular disease. Myocardial cells are
exquisitely sensitive to oxygen deprivation, with irreversible injury beginning after 20-40
minutes of ischemia. Prompt reperfusion therapy limits infarct size.
, Q7: A trauma patient with crushed limb releases myoglobin and potassium upon reperfusion.
This injury mechanism is:
A. Hypoxic injury
B. Reperfusion injury [CORRECT]
C. Apoptotic injury
D. Nutritional deficiency
Correct Answer: B
Rationale: Reperfusion injury occurs when blood flow returns to ischemic tissue, generating
oxygen free radicals, calcium overload, and inflammatory responses that paradoxically
worsen cellular damage. Crush syndrome involves myoglobinuria causing renal failure and
hyperkalemia causing cardiac arrhythmias. Gradual reperfusion and alkalinization of urine
may reduce complications.
Q8: A patient with carbon monoxide poisoning has cellular injury due to:
A. Direct membrane damage
B. Inhibition of cytochrome oxidase
C. Decreased oxygen-carrying capacity and left shift of oxyhemoglobin curve [CORRECT]
D. Depletion of ATP stores only
Correct Answer: C
Rationale: Carbon monoxide binds hemoglobin with 240 times greater affinity than oxygen,
forming carboxyhemoglobin that cannot transport oxygen, while also shifting the
oxyhemoglobin dissociation curve left, further impairing oxygen release to tissues. This
causes tissue hypoxia despite normal PaO2. Cytochrome oxidase inhibition occurs with
cyanide poisoning.
Q9: A patient receiving radiation therapy develops cellular injury from hydroxyl radicals. This
represents:
A. Hypoxic injury
B. Free radical injury [CORRECT]
