NSG 5140 RESEARCH METHODS IN NURSING (PDF) | 2026
EXAM QUESTIONS AND ANSWERS + RATIONALES | STUDY
GUIDE | 100% CORRECT
1. A patient with chronic hypertension develops left ventricular wall thickening. Which
mechanism best explains this adaptation?
A) Increased myocyte number due to cell division
B) Increased myocyte size due to increased workload
C) Replacement of cardiac cells with fibrous tissue
D) Transformation of cardiac cells into smooth muscle
Correct Answer: B) Increased myocyte size due to increased workload
Rationale: Cardiac myocytes are terminally differentiated and respond to increased workload
primarily through hypertrophy (an increase in individual cell size), not hyperplasia (an increase
in cell number) .
2. During ischemic injury, loss of adenosine triphosphate (ATP) most directly leads to:
A) Increased oxidative phosphorylation
B) Failure of the sodium–potassium pump
C) Increased protein synthesis
D) Mitochondrial membrane stabilization
Correct Answer: B) Failure of the sodium–potassium (Na⁺/K⁺) pump
Rationale: ATP is required for the function of the Na⁺/K⁺ ATPase pump. Its depletion causes this
pump to fail, leading to an influx of sodium and water into the cell, which results in cellular
swelling and is a key event in the pathway to cell death .
3. A patient's biopsy reveals an increase in the number of breast glandular cells due to
hormonal stimulation. What is this cellular adaptation called?
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Dysplasia
Correct Answer: B) Hyperplasia
Rationale: Hyperplasia is an increase in the number of cells in a tissue or organ. It occurs in
tissues capable of cell division, such as glandular epithelium, in response to stimuli like
hormonal stimulation .
4. A patient with Barrett's esophagus has the normal squamous epithelium of the esophagus
replaced by columnar epithelium. What is this cellular adaptation called?
A) Hypertrophy
B) Hyperplasia
, C) Metaplasia
D) Dysplasia
Correct Answer: C) Metaplasia
Rationale: Metaplasia is a reversible change in which one differentiated cell type is replaced by
another cell type. This is often an adaptive response to chronic irritation, such as acid reflux in
Barrett's esophagus .
5. Following a hypoxic event like a stroke, brain tissue often softens and liquefies. Which
type of necrosis is this?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
Correct Answer: B) Liquefactive necrosis
Rationale: Liquefactive necrosis is characteristic of the central nervous system (brain). It is
caused by the release of hydrolytic enzymes from dead cells and inflammatory cells, which
dissolve the tissue into a liquid, viscous mass .
6. Which organ is most susceptible to irreversible damage from ischemia?
A) Kidney
B) Liver
C) Brain
D) Skeletal muscle
Correct Answer: C) Brain
Rationale: Neurons rely almost exclusively on aerobic metabolism and have minimal energy
stores. They can suffer irreversible injury within just 4–6 minutes of complete ischemia, making
the brain the most vulnerable organ .
7. Which type of cell death is a programmed, energy-dependent process that does not trigger
inflammation?
A) Necrosis
B) Apoptosis
C) Autolysis
D) Gangrene
Correct Answer: B) Apoptosis
Rationale: Apoptosis, or "programmed cell death," is an ATP-dependent, tightly regulated
process. It eliminates unwanted or damaged cells without releasing cellular contents, thus
avoiding an inflammatory response .
8. A patient has a mutation where one DNA base pair is substituted for another, resulting in
a codon for a different amino acid. What type of mutation is this?
, A) Silent mutation
B) Missense mutation
C) Nonsense mutation
D) Frameshift mutation
Correct Answer: B) Missense mutation
Rationale: A missense mutation is a point mutation where a single nucleotide change results in a
codon that codes for a different amino acid. This can alter protein function, as seen in sickle cell
disease .
9. Which of the following best describes free radical injury?
A) Damage caused by protein misfolding
B) Cellular injury caused by unpaired electrons reacting with lipids, proteins, and DNA
C) ATP depletion from mitochondrial damage
D) Excessive apoptosis
Correct Answer: B) Cellular injury caused by unpaired electrons reacting with lipids, proteins,
and DNA
Rationale: Free radicals are highly reactive molecules with unpaired electrons. They cause
cellular injury by initiating chain reactions of lipid peroxidation in cell membranes, damaging
proteins via oxidation, and causing breaks in DNA strands .
10. A patient with a pulmonary tuberculosis infection has lung tissue that resembles crumbly
cheese. This is characteristic of which type of necrosis?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
Correct Answer: C) Caseous necrosis
Rationale: "Caseous" means cheese-like. This form of necrosis is a distinct combination of
coagulative and liquefactive necrosis and is classically seen in mycobacterial infections like
tuberculosis .
11. Which mediator is primarily responsible for early vasodilation in acute inflammation?
A) Leukotrienes
B) Histamine
C) Prostaglandins
D) Tumor necrosis factor-α (TNF-α)
Correct Answer: B) Histamine
Rationale: Histamine is released immediately from mast cells in response to injury. It is a key
mediator of the early stages of acute inflammation, causing rapid vasodilation (redness, heat) and
increased vascular permeability (swelling) .
EXAM QUESTIONS AND ANSWERS + RATIONALES | STUDY
GUIDE | 100% CORRECT
1. A patient with chronic hypertension develops left ventricular wall thickening. Which
mechanism best explains this adaptation?
A) Increased myocyte number due to cell division
B) Increased myocyte size due to increased workload
C) Replacement of cardiac cells with fibrous tissue
D) Transformation of cardiac cells into smooth muscle
Correct Answer: B) Increased myocyte size due to increased workload
Rationale: Cardiac myocytes are terminally differentiated and respond to increased workload
primarily through hypertrophy (an increase in individual cell size), not hyperplasia (an increase
in cell number) .
2. During ischemic injury, loss of adenosine triphosphate (ATP) most directly leads to:
A) Increased oxidative phosphorylation
B) Failure of the sodium–potassium pump
C) Increased protein synthesis
D) Mitochondrial membrane stabilization
Correct Answer: B) Failure of the sodium–potassium (Na⁺/K⁺) pump
Rationale: ATP is required for the function of the Na⁺/K⁺ ATPase pump. Its depletion causes this
pump to fail, leading to an influx of sodium and water into the cell, which results in cellular
swelling and is a key event in the pathway to cell death .
3. A patient's biopsy reveals an increase in the number of breast glandular cells due to
hormonal stimulation. What is this cellular adaptation called?
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Dysplasia
Correct Answer: B) Hyperplasia
Rationale: Hyperplasia is an increase in the number of cells in a tissue or organ. It occurs in
tissues capable of cell division, such as glandular epithelium, in response to stimuli like
hormonal stimulation .
4. A patient with Barrett's esophagus has the normal squamous epithelium of the esophagus
replaced by columnar epithelium. What is this cellular adaptation called?
A) Hypertrophy
B) Hyperplasia
, C) Metaplasia
D) Dysplasia
Correct Answer: C) Metaplasia
Rationale: Metaplasia is a reversible change in which one differentiated cell type is replaced by
another cell type. This is often an adaptive response to chronic irritation, such as acid reflux in
Barrett's esophagus .
5. Following a hypoxic event like a stroke, brain tissue often softens and liquefies. Which
type of necrosis is this?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
Correct Answer: B) Liquefactive necrosis
Rationale: Liquefactive necrosis is characteristic of the central nervous system (brain). It is
caused by the release of hydrolytic enzymes from dead cells and inflammatory cells, which
dissolve the tissue into a liquid, viscous mass .
6. Which organ is most susceptible to irreversible damage from ischemia?
A) Kidney
B) Liver
C) Brain
D) Skeletal muscle
Correct Answer: C) Brain
Rationale: Neurons rely almost exclusively on aerobic metabolism and have minimal energy
stores. They can suffer irreversible injury within just 4–6 minutes of complete ischemia, making
the brain the most vulnerable organ .
7. Which type of cell death is a programmed, energy-dependent process that does not trigger
inflammation?
A) Necrosis
B) Apoptosis
C) Autolysis
D) Gangrene
Correct Answer: B) Apoptosis
Rationale: Apoptosis, or "programmed cell death," is an ATP-dependent, tightly regulated
process. It eliminates unwanted or damaged cells without releasing cellular contents, thus
avoiding an inflammatory response .
8. A patient has a mutation where one DNA base pair is substituted for another, resulting in
a codon for a different amino acid. What type of mutation is this?
, A) Silent mutation
B) Missense mutation
C) Nonsense mutation
D) Frameshift mutation
Correct Answer: B) Missense mutation
Rationale: A missense mutation is a point mutation where a single nucleotide change results in a
codon that codes for a different amino acid. This can alter protein function, as seen in sickle cell
disease .
9. Which of the following best describes free radical injury?
A) Damage caused by protein misfolding
B) Cellular injury caused by unpaired electrons reacting with lipids, proteins, and DNA
C) ATP depletion from mitochondrial damage
D) Excessive apoptosis
Correct Answer: B) Cellular injury caused by unpaired electrons reacting with lipids, proteins,
and DNA
Rationale: Free radicals are highly reactive molecules with unpaired electrons. They cause
cellular injury by initiating chain reactions of lipid peroxidation in cell membranes, damaging
proteins via oxidation, and causing breaks in DNA strands .
10. A patient with a pulmonary tuberculosis infection has lung tissue that resembles crumbly
cheese. This is characteristic of which type of necrosis?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
Correct Answer: C) Caseous necrosis
Rationale: "Caseous" means cheese-like. This form of necrosis is a distinct combination of
coagulative and liquefactive necrosis and is classically seen in mycobacterial infections like
tuberculosis .
11. Which mediator is primarily responsible for early vasodilation in acute inflammation?
A) Leukotrienes
B) Histamine
C) Prostaglandins
D) Tumor necrosis factor-α (TNF-α)
Correct Answer: B) Histamine
Rationale: Histamine is released immediately from mast cells in response to injury. It is a key
mediator of the early stages of acute inflammation, causing rapid vasodilation (redness, heat) and
increased vascular permeability (swelling) .
