NEW!! REVISED EDITION TEST BANK FOR APPLIED PATHOPHYSIOLOGY FOR THE
ADVANCED PRACTICE NURSE, 2ND EDITION – DLUGASCH & STORY – COMPLETE TEST
BANK WITH ANSWERS
,TABLE OF CONTENTS
Applied Pathophysiology for the Advanced Practice Nurse, 2nd Edition
Test Bank | Updated 2026–2027
UNIT I: FOUNDATIONS OF PATHOPHYSIOLOGY
Chapter 1. Cellular Function ..........................................................
Questions 1–25
Chapter 2. Immunity ......................................................................
Questions 26–50
Chapter 3. Hematopoietic Function ..............................................
Questions 51–75
UNIT II: MAJOR BODY SYSTEMS
Chapter 4. Cardiovascular Function ..............................................
Questions 76–100
Chapter 5. Pulmonary Function .....................................................
Questions 101–125
Chapter 6. Fluid, Electrolyte, and Acid-Base Homeostasis ............
Questions 126–150
Chapter 7. Urinary Function ...........................................................
Questions 151–175
Chapter 8. Reproductive Function .................................................
Questions 176–200
Chapter 9. Gastrointestinal Function ............................................
Questions 201–225
Chapter 10. Endocrine Function ...................................................
Questions 226–250
Chapter 11. Neural Function .........................................................
Questions 251–275
Chapter 12. Musculoskeletal Function ..........................................
Questions 276–300
Chapter 13. Integumentary Function ............................................
Questions 301–325
,Chapter 14. Sensory Function .......................................................
Questions 326–350
TOTAL QUESTIONS: 350
FEATURES OF THIS TEST BANK
• Chapter-Based Organization
• NCLEX-Style Multiple-Choice Questions
• Advanced Practice Nurse Examination Preparation
• Detailed Rationales for Correct Answers
• Simplified Explanations for Incorrect Options
• Clinical Application and Pathophysiology Focus
• Comprehensive Coverage of Major Body Systems
• Board Examination Preparation Format
• Updated for 2026–2027 Academic Use
UNIT I: FOUNDATIONS OF PATHOPHYSIOLOGY
Chapter 1: Cellular Function
1. Which cellular structure is primarily responsible for ATP production?
A. Ribosome
B. Lysosome
C. Mitochondrion
D. Golgi apparatus
Answer: C. Mitochondrion
Rationale: Mitochondria are known as the "powerhouses" of the cell because they generate ATP through
aerobic cellular respiration. ATP provides energy for virtually all cellular activities.
Why Not the Others?
• A. Ribosome: Produces proteins, not ATP.
• B. Lysosome: Digests cellular waste and debris.
• D. Golgi apparatus: Modifies and packages proteins.
Keywords: ATP, mitochondria, cellular respiration, energy production
2. A patient develops tissue injury due to inadequate oxygen supply. Which cellular adaptation is most likely
to occur initially?
A. Atrophy
B. Necrosis
,C. Anaerobic metabolism
D. Apoptosis
Answer: C. Anaerobic metabolism
Rationale: When oxygen levels decrease, cells switch from aerobic to anaerobic metabolism to generate ATP.
This produces less energy and leads to lactic acid accumulation.
Why Not the Others?
• A. Atrophy: Occurs over time due to decreased workload.
• B. Necrosis: Represents irreversible cell death.
• D. Apoptosis: Programmed cell death, not an immediate response.
Keywords: Hypoxia, anaerobic metabolism, ATP depletion, lactic acid
3. Which organelle is responsible for protein synthesis?
A. Ribosome
B. Nucleus
C. Centriole
D. Peroxisome
Answer: A. Ribosome
Rationale: Ribosomes translate messenger RNA into proteins, making them the primary site of protein
synthesis.
Why Not the Others?
• B. Nucleus: Contains genetic material.
• C. Centriole: Involved in cell division.
• D. Peroxisome: Breaks down fatty acids and toxins.
Keywords: Ribosomes, protein synthesis, translation
4. Cellular swelling during injury is primarily caused by failure of which mechanism?
A. DNA replication
B. Sodium-potassium pump
C. Protein synthesis
D. Calcium storage
Answer: B. Sodium-potassium pump
Rationale: ATP depletion impairs the sodium-potassium pump, allowing sodium and water to accumulate
inside the cell, causing swelling.
Why Not the Others?
, • A. DNA replication: Not responsible for fluid balance.
• C. Protein synthesis: Affects cellular function but not initial swelling.
• D. Calcium storage: Secondary factor in injury.
Keywords: Cell swelling, ATP depletion, sodium-potassium pump
5. Which type of cell death is considered programmed and controlled?
A. Necrosis
B. Gangrene
C. Apoptosis
D. Liquefaction
Answer: C. Apoptosis
Rationale: Apoptosis is genetically programmed cell death that eliminates damaged cells without triggering
inflammation.
Why Not the Others?
• A. Necrosis: Uncontrolled cell death.
• B. Gangrene: Tissue death from ischemia or infection.
• D. Liquefaction: A pattern of necrotic tissue destruction.
Keywords: Apoptosis, programmed cell death, homeostasis
6. The plasma membrane is primarily composed of:
A. Carbohydrates only
B. Phospholipid bilayer
C. DNA strands
D. Collagen fibers
Answer: B. Phospholipid bilayer
Rationale: The plasma membrane consists mainly of a phospholipid bilayer with embedded proteins that
regulate transport and communication.
Why Not the Others?
• A. Carbohydrates only: Present but not the main structure.
• C. DNA strands: Located in the nucleus.
• D. Collagen fibers: Found in connective tissue.
Keywords: Cell membrane, phospholipid bilayer, membrane transport
7. Which electrolyte is most abundant inside the cell?
,A. Sodium
B. Chloride
C. Potassium
D. Calcium
Answer: C. Potassium
Rationale: Potassium is the major intracellular cation and is critical for membrane potential and cellular
function.
Why Not the Others?
• A. Sodium: Major extracellular cation.
• B. Chloride: Major extracellular anion.
• D. Calcium: Normally maintained at low intracellular levels.
Keywords: Potassium, intracellular fluid, electrolyte balance
8. Which process moves molecules from an area of high concentration to low concentration without energy
expenditure?
A. Active transport
B. Endocytosis
C. Diffusion
D. Pinocytosis
Answer: C. Diffusion
Rationale: Diffusion is passive movement down a concentration gradient and requires no ATP.
Why Not the Others?
• A. Active transport: Requires energy.
• B. Endocytosis: Requires vesicle formation.
• D. Pinocytosis: Energy-dependent fluid uptake.
Keywords: Diffusion, passive transport, concentration gradient
9. Excess intracellular calcium during injury primarily leads to:
A. Increased ATP production
B. Activation of destructive enzymes
C. Increased protein synthesis
D. Enhanced membrane stability
Answer: B. Activation of destructive enzymes
Rationale: Elevated calcium activates phospholipases, proteases, and endonucleases that damage cellular
structures.
,Why Not the Others?
• A. Increased ATP production: Usually ATP decreases.
• C. Increased protein synthesis: Injury suppresses synthesis.
• D. Enhanced membrane stability: Calcium promotes damage.
Keywords: Calcium overload, cellular injury, enzyme activation
10. Which organelle contains the genetic blueprint of the cell?
A. Nucleus
B. Golgi apparatus
C. Lysosome
D. Endoplasmic reticulum
Answer: A. Nucleus
Rationale: The nucleus houses DNA, which controls cell growth, metabolism, and reproduction.
Why Not the Others?
• B. Golgi apparatus: Packages proteins.
• C. Lysosome: Digests waste.
• D. Endoplasmic reticulum: Synthesizes proteins and lipids.
Keywords: DNA, nucleus, genetic control
11. Hyperplasia refers to:
A. Increase in cell size
B. Increase in cell number
C. Cell death
D. Cell shrinkage
Answer: B. Increase in cell number
Rationale: Hyperplasia occurs when cells divide, increasing the total number of cells in a tissue.
Why Not the Others?
• A. Increase in cell size: Hypertrophy.
• C. Cell death: Necrosis or apoptosis.
• D. Cell shrinkage: Atrophy.
Keywords: Hyperplasia, cell proliferation, adaptation
12. Which adaptation occurs when skeletal muscles enlarge from exercise?
,A. Atrophy
B. Dysplasia
C. Hypertrophy
D. Metaplasia
Answer: C. Hypertrophy
Rationale: Hypertrophy is an increase in cell size resulting in larger tissue mass.
Why Not the Others?
• A. Atrophy: Decreased size.
• B. Dysplasia: Abnormal growth.
• D. Metaplasia: Change in cell type.
Keywords: Hypertrophy, muscle growth, adaptation
13. The major function of lysosomes is:
A. Protein synthesis
B. Cellular digestion
C. ATP production
D. DNA replication
Answer: B. Cellular digestion
Rationale: Lysosomes contain enzymes that digest worn-out organelles and foreign material.
Why Not the Others?
• A. Protein synthesis: Ribosomes.
• C. ATP production: Mitochondria.
• D. DNA replication: Nucleus.
Keywords: Lysosomes, digestion, intracellular enzymes
14. Which condition most directly causes cellular hypoxia?
A. Anemia
B. Hyperkalemia
C. Hypertension
D. Hyperglycemia
Answer: A. Anemia
Rationale: Anemia reduces oxygen-carrying capacity, decreasing oxygen delivery to tissues.
Why Not the Others?
• B. Hyperkalemia: Potassium imbalance.
, • C. Hypertension: Elevated blood pressure.
• D. Hyperglycemia: High blood glucose.
Keywords: Hypoxia, anemia, oxygen delivery
15. Metaplasia is best defined as:
A. Increase in cell number
B. Increase in cell size
C. Replacement of one mature cell type by another
D. Irreversible cell death
Answer: C. Replacement of one mature cell type by another
Rationale: Metaplasia is a reversible adaptation where one differentiated cell type changes into another better
suited to stress.
Why Not the Others?
• A. Increase in cell number: Hyperplasia.
• B. Increase in cell size: Hypertrophy.
• D. Irreversible cell death: Necrosis.
Keywords: Metaplasia, adaptation, cellular change
16. Which process requires ATP?
A. Diffusion
B. Osmosis
C. Filtration
D. Active transport
Answer: D. Active transport
Rationale: Active transport moves substances against their concentration gradient and requires cellular energy.
Why Not the Others?
• A. Diffusion: Passive.
• B. Osmosis: Passive water movement.
• C. Filtration: Pressure driven.
Keywords: Active transport, ATP, concentration gradient
17. The most common cause of cell injury is:
A. Oxygen deprivation
B. Excess vitamins
, C. Elevated protein synthesis
D. Increased DNA replication
Answer: A. Oxygen deprivation
Rationale: Hypoxia is one of the most frequent causes of cellular injury and can rapidly impair ATP production.
Why Not the Others?
• B. Excess vitamins: Rare cause.
• C. Elevated protein synthesis: Not usually harmful.
• D. Increased DNA replication: Not a common injury mechanism.
Keywords: Hypoxia, cell injury, ischemia
18. Which intracellular organelle detoxifies harmful substances?
A. Ribosome
B. Golgi apparatus
C. Smooth endoplasmic reticulum
D. Nucleolus
Answer: C. Smooth endoplasmic reticulum
Rationale: The smooth ER participates in detoxification of drugs and toxins, especially in liver cells.
Why Not the Others?
• A. Ribosome: Protein synthesis.
• B. Golgi apparatus: Packaging.
• D. Nucleolus: Ribosome formation.
Keywords: Smooth ER, detoxification, liver function
19. Necrosis usually triggers:
A. No inflammation
B. Tissue regeneration only
C. Inflammatory response
D. Controlled cell removal
Answer: C. Inflammatory response
Rationale: Necrotic cells rupture and release contents that stimulate inflammation.
Why Not the Others?
• A. No inflammation: Characteristic of apoptosis.
• B. Tissue regeneration only: Not immediate.
ADVANCED PRACTICE NURSE, 2ND EDITION – DLUGASCH & STORY – COMPLETE TEST
BANK WITH ANSWERS
,TABLE OF CONTENTS
Applied Pathophysiology for the Advanced Practice Nurse, 2nd Edition
Test Bank | Updated 2026–2027
UNIT I: FOUNDATIONS OF PATHOPHYSIOLOGY
Chapter 1. Cellular Function ..........................................................
Questions 1–25
Chapter 2. Immunity ......................................................................
Questions 26–50
Chapter 3. Hematopoietic Function ..............................................
Questions 51–75
UNIT II: MAJOR BODY SYSTEMS
Chapter 4. Cardiovascular Function ..............................................
Questions 76–100
Chapter 5. Pulmonary Function .....................................................
Questions 101–125
Chapter 6. Fluid, Electrolyte, and Acid-Base Homeostasis ............
Questions 126–150
Chapter 7. Urinary Function ...........................................................
Questions 151–175
Chapter 8. Reproductive Function .................................................
Questions 176–200
Chapter 9. Gastrointestinal Function ............................................
Questions 201–225
Chapter 10. Endocrine Function ...................................................
Questions 226–250
Chapter 11. Neural Function .........................................................
Questions 251–275
Chapter 12. Musculoskeletal Function ..........................................
Questions 276–300
Chapter 13. Integumentary Function ............................................
Questions 301–325
,Chapter 14. Sensory Function .......................................................
Questions 326–350
TOTAL QUESTIONS: 350
FEATURES OF THIS TEST BANK
• Chapter-Based Organization
• NCLEX-Style Multiple-Choice Questions
• Advanced Practice Nurse Examination Preparation
• Detailed Rationales for Correct Answers
• Simplified Explanations for Incorrect Options
• Clinical Application and Pathophysiology Focus
• Comprehensive Coverage of Major Body Systems
• Board Examination Preparation Format
• Updated for 2026–2027 Academic Use
UNIT I: FOUNDATIONS OF PATHOPHYSIOLOGY
Chapter 1: Cellular Function
1. Which cellular structure is primarily responsible for ATP production?
A. Ribosome
B. Lysosome
C. Mitochondrion
D. Golgi apparatus
Answer: C. Mitochondrion
Rationale: Mitochondria are known as the "powerhouses" of the cell because they generate ATP through
aerobic cellular respiration. ATP provides energy for virtually all cellular activities.
Why Not the Others?
• A. Ribosome: Produces proteins, not ATP.
• B. Lysosome: Digests cellular waste and debris.
• D. Golgi apparatus: Modifies and packages proteins.
Keywords: ATP, mitochondria, cellular respiration, energy production
2. A patient develops tissue injury due to inadequate oxygen supply. Which cellular adaptation is most likely
to occur initially?
A. Atrophy
B. Necrosis
,C. Anaerobic metabolism
D. Apoptosis
Answer: C. Anaerobic metabolism
Rationale: When oxygen levels decrease, cells switch from aerobic to anaerobic metabolism to generate ATP.
This produces less energy and leads to lactic acid accumulation.
Why Not the Others?
• A. Atrophy: Occurs over time due to decreased workload.
• B. Necrosis: Represents irreversible cell death.
• D. Apoptosis: Programmed cell death, not an immediate response.
Keywords: Hypoxia, anaerobic metabolism, ATP depletion, lactic acid
3. Which organelle is responsible for protein synthesis?
A. Ribosome
B. Nucleus
C. Centriole
D. Peroxisome
Answer: A. Ribosome
Rationale: Ribosomes translate messenger RNA into proteins, making them the primary site of protein
synthesis.
Why Not the Others?
• B. Nucleus: Contains genetic material.
• C. Centriole: Involved in cell division.
• D. Peroxisome: Breaks down fatty acids and toxins.
Keywords: Ribosomes, protein synthesis, translation
4. Cellular swelling during injury is primarily caused by failure of which mechanism?
A. DNA replication
B. Sodium-potassium pump
C. Protein synthesis
D. Calcium storage
Answer: B. Sodium-potassium pump
Rationale: ATP depletion impairs the sodium-potassium pump, allowing sodium and water to accumulate
inside the cell, causing swelling.
Why Not the Others?
, • A. DNA replication: Not responsible for fluid balance.
• C. Protein synthesis: Affects cellular function but not initial swelling.
• D. Calcium storage: Secondary factor in injury.
Keywords: Cell swelling, ATP depletion, sodium-potassium pump
5. Which type of cell death is considered programmed and controlled?
A. Necrosis
B. Gangrene
C. Apoptosis
D. Liquefaction
Answer: C. Apoptosis
Rationale: Apoptosis is genetically programmed cell death that eliminates damaged cells without triggering
inflammation.
Why Not the Others?
• A. Necrosis: Uncontrolled cell death.
• B. Gangrene: Tissue death from ischemia or infection.
• D. Liquefaction: A pattern of necrotic tissue destruction.
Keywords: Apoptosis, programmed cell death, homeostasis
6. The plasma membrane is primarily composed of:
A. Carbohydrates only
B. Phospholipid bilayer
C. DNA strands
D. Collagen fibers
Answer: B. Phospholipid bilayer
Rationale: The plasma membrane consists mainly of a phospholipid bilayer with embedded proteins that
regulate transport and communication.
Why Not the Others?
• A. Carbohydrates only: Present but not the main structure.
• C. DNA strands: Located in the nucleus.
• D. Collagen fibers: Found in connective tissue.
Keywords: Cell membrane, phospholipid bilayer, membrane transport
7. Which electrolyte is most abundant inside the cell?
,A. Sodium
B. Chloride
C. Potassium
D. Calcium
Answer: C. Potassium
Rationale: Potassium is the major intracellular cation and is critical for membrane potential and cellular
function.
Why Not the Others?
• A. Sodium: Major extracellular cation.
• B. Chloride: Major extracellular anion.
• D. Calcium: Normally maintained at low intracellular levels.
Keywords: Potassium, intracellular fluid, electrolyte balance
8. Which process moves molecules from an area of high concentration to low concentration without energy
expenditure?
A. Active transport
B. Endocytosis
C. Diffusion
D. Pinocytosis
Answer: C. Diffusion
Rationale: Diffusion is passive movement down a concentration gradient and requires no ATP.
Why Not the Others?
• A. Active transport: Requires energy.
• B. Endocytosis: Requires vesicle formation.
• D. Pinocytosis: Energy-dependent fluid uptake.
Keywords: Diffusion, passive transport, concentration gradient
9. Excess intracellular calcium during injury primarily leads to:
A. Increased ATP production
B. Activation of destructive enzymes
C. Increased protein synthesis
D. Enhanced membrane stability
Answer: B. Activation of destructive enzymes
Rationale: Elevated calcium activates phospholipases, proteases, and endonucleases that damage cellular
structures.
,Why Not the Others?
• A. Increased ATP production: Usually ATP decreases.
• C. Increased protein synthesis: Injury suppresses synthesis.
• D. Enhanced membrane stability: Calcium promotes damage.
Keywords: Calcium overload, cellular injury, enzyme activation
10. Which organelle contains the genetic blueprint of the cell?
A. Nucleus
B. Golgi apparatus
C. Lysosome
D. Endoplasmic reticulum
Answer: A. Nucleus
Rationale: The nucleus houses DNA, which controls cell growth, metabolism, and reproduction.
Why Not the Others?
• B. Golgi apparatus: Packages proteins.
• C. Lysosome: Digests waste.
• D. Endoplasmic reticulum: Synthesizes proteins and lipids.
Keywords: DNA, nucleus, genetic control
11. Hyperplasia refers to:
A. Increase in cell size
B. Increase in cell number
C. Cell death
D. Cell shrinkage
Answer: B. Increase in cell number
Rationale: Hyperplasia occurs when cells divide, increasing the total number of cells in a tissue.
Why Not the Others?
• A. Increase in cell size: Hypertrophy.
• C. Cell death: Necrosis or apoptosis.
• D. Cell shrinkage: Atrophy.
Keywords: Hyperplasia, cell proliferation, adaptation
12. Which adaptation occurs when skeletal muscles enlarge from exercise?
,A. Atrophy
B. Dysplasia
C. Hypertrophy
D. Metaplasia
Answer: C. Hypertrophy
Rationale: Hypertrophy is an increase in cell size resulting in larger tissue mass.
Why Not the Others?
• A. Atrophy: Decreased size.
• B. Dysplasia: Abnormal growth.
• D. Metaplasia: Change in cell type.
Keywords: Hypertrophy, muscle growth, adaptation
13. The major function of lysosomes is:
A. Protein synthesis
B. Cellular digestion
C. ATP production
D. DNA replication
Answer: B. Cellular digestion
Rationale: Lysosomes contain enzymes that digest worn-out organelles and foreign material.
Why Not the Others?
• A. Protein synthesis: Ribosomes.
• C. ATP production: Mitochondria.
• D. DNA replication: Nucleus.
Keywords: Lysosomes, digestion, intracellular enzymes
14. Which condition most directly causes cellular hypoxia?
A. Anemia
B. Hyperkalemia
C. Hypertension
D. Hyperglycemia
Answer: A. Anemia
Rationale: Anemia reduces oxygen-carrying capacity, decreasing oxygen delivery to tissues.
Why Not the Others?
• B. Hyperkalemia: Potassium imbalance.
, • C. Hypertension: Elevated blood pressure.
• D. Hyperglycemia: High blood glucose.
Keywords: Hypoxia, anemia, oxygen delivery
15. Metaplasia is best defined as:
A. Increase in cell number
B. Increase in cell size
C. Replacement of one mature cell type by another
D. Irreversible cell death
Answer: C. Replacement of one mature cell type by another
Rationale: Metaplasia is a reversible adaptation where one differentiated cell type changes into another better
suited to stress.
Why Not the Others?
• A. Increase in cell number: Hyperplasia.
• B. Increase in cell size: Hypertrophy.
• D. Irreversible cell death: Necrosis.
Keywords: Metaplasia, adaptation, cellular change
16. Which process requires ATP?
A. Diffusion
B. Osmosis
C. Filtration
D. Active transport
Answer: D. Active transport
Rationale: Active transport moves substances against their concentration gradient and requires cellular energy.
Why Not the Others?
• A. Diffusion: Passive.
• B. Osmosis: Passive water movement.
• C. Filtration: Pressure driven.
Keywords: Active transport, ATP, concentration gradient
17. The most common cause of cell injury is:
A. Oxygen deprivation
B. Excess vitamins
, C. Elevated protein synthesis
D. Increased DNA replication
Answer: A. Oxygen deprivation
Rationale: Hypoxia is one of the most frequent causes of cellular injury and can rapidly impair ATP production.
Why Not the Others?
• B. Excess vitamins: Rare cause.
• C. Elevated protein synthesis: Not usually harmful.
• D. Increased DNA replication: Not a common injury mechanism.
Keywords: Hypoxia, cell injury, ischemia
18. Which intracellular organelle detoxifies harmful substances?
A. Ribosome
B. Golgi apparatus
C. Smooth endoplasmic reticulum
D. Nucleolus
Answer: C. Smooth endoplasmic reticulum
Rationale: The smooth ER participates in detoxification of drugs and toxins, especially in liver cells.
Why Not the Others?
• A. Ribosome: Protein synthesis.
• B. Golgi apparatus: Packaging.
• D. Nucleolus: Ribosome formation.
Keywords: Smooth ER, detoxification, liver function
19. Necrosis usually triggers:
A. No inflammation
B. Tissue regeneration only
C. Inflammatory response
D. Controlled cell removal
Answer: C. Inflammatory response
Rationale: Necrotic cells rupture and release contents that stimulate inflammation.
Why Not the Others?
• A. No inflammation: Characteristic of apoptosis.
• B. Tissue regeneration only: Not immediate.
