NR283 Exam 1 Actual Exam Style V2 | NR
283 Pathophysiology | Chamberlain
1. A patient who has smoked for 20 years undergoes a biopsy of the bronchial mucosa, which
reveals that the normal columnar ciliated cells have been replaced by stratified squamous
cells. What is this process called?
A. Metaplasia
B. Hyperplasia
C. Dysplasia
D. Atrophy
Answer: A
Rationale: Metaplasia is the reversible replacement of one mature cell type by another
mature cell type. In this case, the bronchial lining adapts to the stress of smoking by
changing into a more durable cell type. However, this transition results in the loss of
important protective mechanisms like cilia and mucus secretion.
2. Which of the following cellular adaptations is most likely to occur in the left ventricle of a
patient with chronic untreated hypertension?
A. Hypertrophy
B. Atrophy
C. Hyperplasia
,D. Metaplasia
Answer: A
Rationale: Hypertrophy is an increase in the size of cells, which leads to an increase in the
size of the organ. In hypertension, the heart muscle must work harder to pump blood
against increased resistance, leading to thicker ventricular walls. Unlike hyperplasia, the
number of myocytes does not increase; instead, each individual cell gets larger.
3. An elderly patient is bedridden for several weeks following a hip fracture. What cellular
change would the nurse expect to see in the patient’s calf muscles?
A. Hyperplasia
B. Atrophy
C. Metaplasia
D. Dysplasia
Answer: B
Rationale: Atrophy is a decrease or shrinkage in cellular size. This often occurs due to
disuse, decreased protein synthesis, or increased protein catabolism. In a bedridden
patient, the lack of mechanical loading leads to muscle wasting.
4. A cervical Pap smear result indicates the presence of cells that are abnormal in size, shape,
and organization. Which term should the nurse use to document this?
A. Dysplasia
, B. Atrophy
C. Metaplasia
D. Hypertrophy
Answer: A
Rationale: Dysplasia refers to abnormal changes in the size, shape, and organization of
mature cells. It is often considered a ‘pre-cancerous’ change but is not a true adaptive
process. If the stimulus is removed, dysplasia can sometimes be reversible.
5. What is the most common cause of cellular injury in clinical practice?
A. Free radicals
B. Chemical agents
C. Genetic factors
D. Hypoxia
Answer: D
Rationale: Hypoxia, or lack of sufficient oxygen, is the single most common cause of
cellular injury. It typically results from ischemia, which is a reduced blood supply to tissues.
Without oxygen, the cell cannot produce ATP, leading to failure of the sodium-potassium
pump.
283 Pathophysiology | Chamberlain
1. A patient who has smoked for 20 years undergoes a biopsy of the bronchial mucosa, which
reveals that the normal columnar ciliated cells have been replaced by stratified squamous
cells. What is this process called?
A. Metaplasia
B. Hyperplasia
C. Dysplasia
D. Atrophy
Answer: A
Rationale: Metaplasia is the reversible replacement of one mature cell type by another
mature cell type. In this case, the bronchial lining adapts to the stress of smoking by
changing into a more durable cell type. However, this transition results in the loss of
important protective mechanisms like cilia and mucus secretion.
2. Which of the following cellular adaptations is most likely to occur in the left ventricle of a
patient with chronic untreated hypertension?
A. Hypertrophy
B. Atrophy
C. Hyperplasia
,D. Metaplasia
Answer: A
Rationale: Hypertrophy is an increase in the size of cells, which leads to an increase in the
size of the organ. In hypertension, the heart muscle must work harder to pump blood
against increased resistance, leading to thicker ventricular walls. Unlike hyperplasia, the
number of myocytes does not increase; instead, each individual cell gets larger.
3. An elderly patient is bedridden for several weeks following a hip fracture. What cellular
change would the nurse expect to see in the patient’s calf muscles?
A. Hyperplasia
B. Atrophy
C. Metaplasia
D. Dysplasia
Answer: B
Rationale: Atrophy is a decrease or shrinkage in cellular size. This often occurs due to
disuse, decreased protein synthesis, or increased protein catabolism. In a bedridden
patient, the lack of mechanical loading leads to muscle wasting.
4. A cervical Pap smear result indicates the presence of cells that are abnormal in size, shape,
and organization. Which term should the nurse use to document this?
A. Dysplasia
, B. Atrophy
C. Metaplasia
D. Hypertrophy
Answer: A
Rationale: Dysplasia refers to abnormal changes in the size, shape, and organization of
mature cells. It is often considered a ‘pre-cancerous’ change but is not a true adaptive
process. If the stimulus is removed, dysplasia can sometimes be reversible.
5. What is the most common cause of cellular injury in clinical practice?
A. Free radicals
B. Chemical agents
C. Genetic factors
D. Hypoxia
Answer: D
Rationale: Hypoxia, or lack of sufficient oxygen, is the single most common cause of
cellular injury. It typically results from ischemia, which is a reduced blood supply to tissues.
Without oxygen, the cell cannot produce ATP, leading to failure of the sodium-potassium
pump.
