NSG530 Exam 1 V1 | NSG 530 Advanced
Pathophysiology | Wilkes University
1. A patient with chronic hypertension exhibits an increase in the size of the left ventricular
myocardial cells. This cellular adaptation is known as:
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Answer: B
Rationale: Hypertrophy is an increase in the size of cells in response to mechanical stimuli
or increased workload. In the case of chronic hypertension, the heart must work harder to
pump blood against increased resistance, leading to thicker muscular walls. This process
involves increased protein synthesis rather than an increase in the number of cells.
2. Which process is characterized by programmed cell death and the lack of an inflammatory
response?
A. Apoptosis
B. Autophagy
C. Necrosis
,D. Ischemia
Answer: A
Rationale: Apoptosis is a highly regulated form of programmed cell death that eliminates
injured or aged cells. Unlike necrosis, it does not cause the cell to swell and burst, which
prevents the release of intracellular contents into the surrounding tissue. Consequently,
apoptosis is typically not associated with an inflammatory response.
3. A 55-year-old male smoker’s biopsy of the bronchial lining reveals that normal ciliated
columnar epithelium has been replaced by stratified squamous epithelium. This is an
example of:
A. Metaplasia
B. Anaplasia
C. Hyperplasia
D. Dysplasia
Answer: A
Rationale: Metaplasia is a reversible change in which one adult cell type is replaced by
another adult cell type. This often occurs as an adaptive response to chronic irritation, such
as cigarette smoke in the lungs. While the new cell type may be more resilient to the
stressor, it usually lacks the specialized functions of the original tissue, such as mucus
secretion or ciliary action.
, 4. A patient presents with a serum sodium level of 120 mEq/L. Which clinical manifestation
should the nurse prioritize for assessment?
A. Tachycardia and dry mucous membranes
B. Muscle tetany and positive Chvostek sign
C. Confusion, lethargy, and potential seizures
D. Polyuria and extreme thirst
Answer: C
Rationale: Severe hyponatremia, defined as sodium levels below 125 mEq/L, leads to an
osmotic shift of water into brain cells. This results in cerebral edema, which manifests as
neurological symptoms ranging from confusion to coma. Protecting the patient from
seizures and managing intracranial pressure are critical priorities in this electrolyte
imbalance.
5. The primary mechanism causing edema in a patient with liver failure and low serum
albumin is:
A. Decreased capillary oncotic pressure
B. Increased capillary hydrostatic pressure
C. Increased interstitial fluid oncotic pressure
D. Lymphatic obstruction
Answer: A
Pathophysiology | Wilkes University
1. A patient with chronic hypertension exhibits an increase in the size of the left ventricular
myocardial cells. This cellular adaptation is known as:
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Answer: B
Rationale: Hypertrophy is an increase in the size of cells in response to mechanical stimuli
or increased workload. In the case of chronic hypertension, the heart must work harder to
pump blood against increased resistance, leading to thicker muscular walls. This process
involves increased protein synthesis rather than an increase in the number of cells.
2. Which process is characterized by programmed cell death and the lack of an inflammatory
response?
A. Apoptosis
B. Autophagy
C. Necrosis
,D. Ischemia
Answer: A
Rationale: Apoptosis is a highly regulated form of programmed cell death that eliminates
injured or aged cells. Unlike necrosis, it does not cause the cell to swell and burst, which
prevents the release of intracellular contents into the surrounding tissue. Consequently,
apoptosis is typically not associated with an inflammatory response.
3. A 55-year-old male smoker’s biopsy of the bronchial lining reveals that normal ciliated
columnar epithelium has been replaced by stratified squamous epithelium. This is an
example of:
A. Metaplasia
B. Anaplasia
C. Hyperplasia
D. Dysplasia
Answer: A
Rationale: Metaplasia is a reversible change in which one adult cell type is replaced by
another adult cell type. This often occurs as an adaptive response to chronic irritation, such
as cigarette smoke in the lungs. While the new cell type may be more resilient to the
stressor, it usually lacks the specialized functions of the original tissue, such as mucus
secretion or ciliary action.
, 4. A patient presents with a serum sodium level of 120 mEq/L. Which clinical manifestation
should the nurse prioritize for assessment?
A. Tachycardia and dry mucous membranes
B. Muscle tetany and positive Chvostek sign
C. Confusion, lethargy, and potential seizures
D. Polyuria and extreme thirst
Answer: C
Rationale: Severe hyponatremia, defined as sodium levels below 125 mEq/L, leads to an
osmotic shift of water into brain cells. This results in cerebral edema, which manifests as
neurological symptoms ranging from confusion to coma. Protecting the patient from
seizures and managing intracranial pressure are critical priorities in this electrolyte
imbalance.
5. The primary mechanism causing edema in a patient with liver failure and low serum
albumin is:
A. Decreased capillary oncotic pressure
B. Increased capillary hydrostatic pressure
C. Increased interstitial fluid oncotic pressure
D. Lymphatic obstruction
Answer: A
