WGU D236 PRE-ASSESSMENT PATHOPHYSIOLOGY EXAM
2026/2027 | Questions & Verified Answers | Grade A | Pass
Guaranteed - A+ Graded
Section 1: Cellular & Genetic Foundations
This section covers the building blocks of disease—how cells adapt, get injured, and die,
plus the genetic basics that set the stage for many disorders you'll study.
Q1: A nursing student is reviewing cell adaptations and comes across a term describing
an increase in cell size. Which process explains why a bodybuilder's skeletal muscle
cells grow larger with weight training?
A. Hyperplasia—an increase in the number of cells
B. Hypertrophy—an increase in cell size [CORRECT]
C. Metaplasia—a change from one cell type to another
D. Dysplasia—abnormal, disordered cell growth
Correct Answer: B
Rationale: Good job if you caught this—hypertrophy is all about cell size increasing, not
cell number. When that bodybuilder lifts, the muscle fibers themselves get bigger
through increased protein synthesis. Hyperplasia (A) would mean more muscle cells,
which isn't what happens in adult skeletal muscle. Metaplasia (C) and dysplasia (D) are
adaptive changes but not related to this normal physiologic growth.
,Q2: A patient with coronary artery disease experiences a sudden blockage of blood flow
to the heart muscle. The cells in that region lose their ability to maintain ionic balance
and develop swelling. Which type of cell death is most likely occurring?
A. Apoptosis—programmed, energy-dependent cell suicide
B. Coagulative necrosis due to ischemia [CORRECT]
C. Caseous necrosis with cheese-like appearance
D. Liquefactive necrosis with enzymatic digestion
Correct Answer: B
Rationale: Remember that ischemia in most solid organs (except brain) leads to
coagulative necrosis—this preserves the tissue architecture for a while even though the
cells are dead. The cell swelling and ion pump failure are classic early signs. Apoptosis
(A) is programmed and doesn't cause inflammation; caseous (C) is for TB; liquefactive
(D) happens in brain and abscesses.
Q3: During a genetics review session, a student learns about a disorder caused by an
extra copy of chromosome 21. Which characteristic findings would this student expect
to see in a newborn with this condition?
A. Webbed neck, short stature, and ovarian dysgenesis
B. Severe intellectual disability, congenital heart defects, and characteristic facial
features [CORRECT]
C. Tall stature, long limbs, and severe mitral valve prolapse
D. Cleft palate, polydactyly, and rocker-bottom feet
,Correct Answer: B
Rationale: This is Down syndrome (trisomy 21), and if you got this right, you're solid on
your chromosomal disorders. The classic triad includes some degree of intellectual
disability (variable), heart defects (especially AV canal), and that flat facial profile with
upward-slanting eyes. The other options describe Turner (A), Marfan (C), and
Edwards/trisomy 18 (D).
Q4: A cell exposed to chronic irritation undergoes a change where the normal
pseudostratified ciliated columnar epithelium of the bronchial lining transforms to
stratified squamous epithelium. What is this adaptive process called?
A. Hypertrophy
B. Hyperplasia
C. Metaplasia [CORRECT]
D. Anaplasia
Correct Answer: C
Rationale: Metaplasia is when one mature cell type replaces another—it's reversible if
you remove the irritation. Smokers often show this squamous metaplasia in their
airways. Anaplasia (D) is a loss of differentiation in cancer cells, not an adaptive
change. Hypertrophy (A) and hyperplasia (B) don't involve cell type switching.
Q5: A patient presents with jaundice, dark urine, and pale stools. Laboratory studies
show elevated direct bilirubin. Which type of cellular accumulation explains the jaundice
in this patient with a bile duct obstruction?
, A. Lipofuscin accumulation from aging
B. Hemosiderin from iron overload
C. Bilirubin pigment accumulation [CORRECT]
D. Glycogen storage from metabolic disorder
Correct Answer: C
Rationale: When bile can't flow out (obstructive/cholestatic jaundice), conjugated
bilirubin backs up into the blood—that's the direct bilirubin rising and depositing in
tissues. The dark urine is conjugated bilirubin being water-soluble and excreted by
kidneys. Lipofuscin (A) is "wear-and-tear" pigment; hemosiderin (B) causes bronze skin
in hemochromatosis; glycogen (D) doesn't cause jaundice.
Q6: A 25-year-old woman has a family history of breast cancer and undergoes genetic
testing. She is found to have a mutation in a tumor suppressor gene that normally helps
repair DNA damage. Which gene is most likely affected?
A. BRCA1 or BRCA2 [CORRECT]
B. HER2/neu oncogene
C. BCL2 apoptosis regulator
D. RAS proto-oncogene
Correct Answer: A
Rationale: BRCA1 and BRCA2 are classic tumor suppressor genes involved in DNA
repair—when they're mutated, cells can't fix DNA damage properly, leading to breast and
ovarian cancer risk. HER2 (B) is an oncogene (overactive growth signaling), not a tumor
2026/2027 | Questions & Verified Answers | Grade A | Pass
Guaranteed - A+ Graded
Section 1: Cellular & Genetic Foundations
This section covers the building blocks of disease—how cells adapt, get injured, and die,
plus the genetic basics that set the stage for many disorders you'll study.
Q1: A nursing student is reviewing cell adaptations and comes across a term describing
an increase in cell size. Which process explains why a bodybuilder's skeletal muscle
cells grow larger with weight training?
A. Hyperplasia—an increase in the number of cells
B. Hypertrophy—an increase in cell size [CORRECT]
C. Metaplasia—a change from one cell type to another
D. Dysplasia—abnormal, disordered cell growth
Correct Answer: B
Rationale: Good job if you caught this—hypertrophy is all about cell size increasing, not
cell number. When that bodybuilder lifts, the muscle fibers themselves get bigger
through increased protein synthesis. Hyperplasia (A) would mean more muscle cells,
which isn't what happens in adult skeletal muscle. Metaplasia (C) and dysplasia (D) are
adaptive changes but not related to this normal physiologic growth.
,Q2: A patient with coronary artery disease experiences a sudden blockage of blood flow
to the heart muscle. The cells in that region lose their ability to maintain ionic balance
and develop swelling. Which type of cell death is most likely occurring?
A. Apoptosis—programmed, energy-dependent cell suicide
B. Coagulative necrosis due to ischemia [CORRECT]
C. Caseous necrosis with cheese-like appearance
D. Liquefactive necrosis with enzymatic digestion
Correct Answer: B
Rationale: Remember that ischemia in most solid organs (except brain) leads to
coagulative necrosis—this preserves the tissue architecture for a while even though the
cells are dead. The cell swelling and ion pump failure are classic early signs. Apoptosis
(A) is programmed and doesn't cause inflammation; caseous (C) is for TB; liquefactive
(D) happens in brain and abscesses.
Q3: During a genetics review session, a student learns about a disorder caused by an
extra copy of chromosome 21. Which characteristic findings would this student expect
to see in a newborn with this condition?
A. Webbed neck, short stature, and ovarian dysgenesis
B. Severe intellectual disability, congenital heart defects, and characteristic facial
features [CORRECT]
C. Tall stature, long limbs, and severe mitral valve prolapse
D. Cleft palate, polydactyly, and rocker-bottom feet
,Correct Answer: B
Rationale: This is Down syndrome (trisomy 21), and if you got this right, you're solid on
your chromosomal disorders. The classic triad includes some degree of intellectual
disability (variable), heart defects (especially AV canal), and that flat facial profile with
upward-slanting eyes. The other options describe Turner (A), Marfan (C), and
Edwards/trisomy 18 (D).
Q4: A cell exposed to chronic irritation undergoes a change where the normal
pseudostratified ciliated columnar epithelium of the bronchial lining transforms to
stratified squamous epithelium. What is this adaptive process called?
A. Hypertrophy
B. Hyperplasia
C. Metaplasia [CORRECT]
D. Anaplasia
Correct Answer: C
Rationale: Metaplasia is when one mature cell type replaces another—it's reversible if
you remove the irritation. Smokers often show this squamous metaplasia in their
airways. Anaplasia (D) is a loss of differentiation in cancer cells, not an adaptive
change. Hypertrophy (A) and hyperplasia (B) don't involve cell type switching.
Q5: A patient presents with jaundice, dark urine, and pale stools. Laboratory studies
show elevated direct bilirubin. Which type of cellular accumulation explains the jaundice
in this patient with a bile duct obstruction?
, A. Lipofuscin accumulation from aging
B. Hemosiderin from iron overload
C. Bilirubin pigment accumulation [CORRECT]
D. Glycogen storage from metabolic disorder
Correct Answer: C
Rationale: When bile can't flow out (obstructive/cholestatic jaundice), conjugated
bilirubin backs up into the blood—that's the direct bilirubin rising and depositing in
tissues. The dark urine is conjugated bilirubin being water-soluble and excreted by
kidneys. Lipofuscin (A) is "wear-and-tear" pigment; hemosiderin (B) causes bronze skin
in hemochromatosis; glycogen (D) doesn't cause jaundice.
Q6: A 25-year-old woman has a family history of breast cancer and undergoes genetic
testing. She is found to have a mutation in a tumor suppressor gene that normally helps
repair DNA damage. Which gene is most likely affected?
A. BRCA1 or BRCA2 [CORRECT]
B. HER2/neu oncogene
C. BCL2 apoptosis regulator
D. RAS proto-oncogene
Correct Answer: A
Rationale: BRCA1 and BRCA2 are classic tumor suppressor genes involved in DNA
repair—when they're mutated, cells can't fix DNA damage properly, leading to breast and
ovarian cancer risk. HER2 (B) is an oncogene (overactive growth signaling), not a tumor
