NSG3280/NSG 3280 Pathophysiology for Nurses I Review
Actual Exam 2026/2027 with Detailed Rationales | 100%
Verified | Pass Guaranteed
SECTION 1: CELLULAR ADAPTATION, INJURY & NEOPLASIA (15
Questions)
Q1: A 68-year-old male with a history of chronic heart failure presents with reduced
muscle mass in the lower extremities. The nurse recognizes this finding as an example
of which cellular adaptation?
A. Hypertrophy due to increased workload on skeletal muscle
B. Hyperplasia from compensatory cell division
C. Atrophy from decreased workload and disuse [CORRECT]
D. Metaplasia caused by chronic inflammatory stimulus
Correct Answer: C
Rationale: Correct because atrophy is a decrease in cell size resulting from decreased
workload, disuse, or inadequate nutrition. In chronic heart failure, reduced activity and
decreased blood flow to skeletal muscle lead to disuse atrophy, which matches the
clinical presentation of reduced muscle mass in the lower extremities.
Q2: A 45-year-old female who has been running marathons for 15 years is found to have
an enlarged left ventricular wall on echocardiography. The nurse identifies this as:
A. Pathologic hypertrophy from uncontrolled hypertension
,B. Physiologic hypertrophy from sustained aerobic exercise [CORRECT]
C. Hyperplasia from increased cardiac cell number
D. Dysplasia from abnormal cell maturation
Correct Answer: B
Rationale: Correct because physiologic hypertrophy is an adaptive increase in cell size
in response to normal increased demand. Sustained aerobic exercise increases cardiac
workload, causing the left ventricular wall to thicken as an adaptive response without
pathologic stimulus.
Q3: A postmenopausal woman is prescribed estrogen replacement therapy. The nurse
understands that endometrial thickening may occur due to which cellular process?
A. Atrophy from hormonal stimulation
B. Metaplasia from chronic irritation
C. Hyperplasia from hormonal stimulation [CORRECT]
D. Hypertrophy from mechanical stretch
Correct Answer: C
Rationale: Correct because hyperplasia is an increase in the number of cells in response
to a stimulus. Estrogen stimulates proliferation of endometrial cells, leading to
endometrial thickening through hyperplasia, which is a hormonally driven adaptive
response.
,Q4: A patient with chronic gastroesophageal reflux disease develops columnar
epithelium in the distal esophagus. The nurse recognizes this change as:
A. Dysplasia indicating premalignant transformation
B. Metaplasia, a reversible adaptation to chronic irritation [CORRECT]
C. Hyperplasia from increased cell division
D. Anaplasia representing loss of cellular differentiation
Correct Answer: B
Rationale: Correct because metaplasia is the reversible replacement of one
differentiated cell type with another better suited to withstand an adverse environment.
Chronic acid exposure in GERD causes squamous epithelium to be replaced by
columnar epithelium (Barrett esophagus), which is a protective metaplastic adaptation.
Q5: A cervical Pap smear reveals cells with abnormal size, shape, and organization but
no invasion through the basement membrane. The nurse identifies this as:
A. Carcinoma in situ with full-thickness involvement
B. Dysplasia, a potentially reversible disorder of cell maturation [CORRECT]
C. Metaplasia with replacement of normal epithelium
D. Hyperplasia with increased cell number only
Correct Answer: B
Rationale: Correct because dysplasia is characterized by abnormal variation in cell size
and shape, loss of normal tissue architecture, and increased mitotic activity without
, invasion. It represents a disorder of cell maturation that is potentially reversible if the
causative stimulus is removed.
Q6: A patient presents with tissue damage after 30 minutes of severe ischemia. The
nurse understands that the earliest morphologic change visible by light microscopy is:
A. Nuclear pyknosis and karyorrhexis
B. Cellular swelling with loss of microvilli [CORRECT]
C. Coagulative necrosis with preserved tissue architecture
D. Apoptotic body formation
Correct Answer: B
Rationale: Correct because cellular swelling is the earliest light-microscopic finding of
reversible cell injury, resulting from failure of the Na+/K+ ATPase pump and subsequent
influx of water. Loss of microvilli and mitochondrial swelling occur at the ultrastructural
level before nuclear changes become visible.
Q7: A patient exposed to carbon tetrachloride develops liver cell damage. The nurse
recognizes that the primary mechanism of injury involves:
A. Hypoxia from hemoglobin binding
B. Free radical formation and lipid peroxidation [CORRECT]
C. Direct DNA alkylation and cross-linking
D. Calcium overload activating phospholipases
Correct Answer: B
Actual Exam 2026/2027 with Detailed Rationales | 100%
Verified | Pass Guaranteed
SECTION 1: CELLULAR ADAPTATION, INJURY & NEOPLASIA (15
Questions)
Q1: A 68-year-old male with a history of chronic heart failure presents with reduced
muscle mass in the lower extremities. The nurse recognizes this finding as an example
of which cellular adaptation?
A. Hypertrophy due to increased workload on skeletal muscle
B. Hyperplasia from compensatory cell division
C. Atrophy from decreased workload and disuse [CORRECT]
D. Metaplasia caused by chronic inflammatory stimulus
Correct Answer: C
Rationale: Correct because atrophy is a decrease in cell size resulting from decreased
workload, disuse, or inadequate nutrition. In chronic heart failure, reduced activity and
decreased blood flow to skeletal muscle lead to disuse atrophy, which matches the
clinical presentation of reduced muscle mass in the lower extremities.
Q2: A 45-year-old female who has been running marathons for 15 years is found to have
an enlarged left ventricular wall on echocardiography. The nurse identifies this as:
A. Pathologic hypertrophy from uncontrolled hypertension
,B. Physiologic hypertrophy from sustained aerobic exercise [CORRECT]
C. Hyperplasia from increased cardiac cell number
D. Dysplasia from abnormal cell maturation
Correct Answer: B
Rationale: Correct because physiologic hypertrophy is an adaptive increase in cell size
in response to normal increased demand. Sustained aerobic exercise increases cardiac
workload, causing the left ventricular wall to thicken as an adaptive response without
pathologic stimulus.
Q3: A postmenopausal woman is prescribed estrogen replacement therapy. The nurse
understands that endometrial thickening may occur due to which cellular process?
A. Atrophy from hormonal stimulation
B. Metaplasia from chronic irritation
C. Hyperplasia from hormonal stimulation [CORRECT]
D. Hypertrophy from mechanical stretch
Correct Answer: C
Rationale: Correct because hyperplasia is an increase in the number of cells in response
to a stimulus. Estrogen stimulates proliferation of endometrial cells, leading to
endometrial thickening through hyperplasia, which is a hormonally driven adaptive
response.
,Q4: A patient with chronic gastroesophageal reflux disease develops columnar
epithelium in the distal esophagus. The nurse recognizes this change as:
A. Dysplasia indicating premalignant transformation
B. Metaplasia, a reversible adaptation to chronic irritation [CORRECT]
C. Hyperplasia from increased cell division
D. Anaplasia representing loss of cellular differentiation
Correct Answer: B
Rationale: Correct because metaplasia is the reversible replacement of one
differentiated cell type with another better suited to withstand an adverse environment.
Chronic acid exposure in GERD causes squamous epithelium to be replaced by
columnar epithelium (Barrett esophagus), which is a protective metaplastic adaptation.
Q5: A cervical Pap smear reveals cells with abnormal size, shape, and organization but
no invasion through the basement membrane. The nurse identifies this as:
A. Carcinoma in situ with full-thickness involvement
B. Dysplasia, a potentially reversible disorder of cell maturation [CORRECT]
C. Metaplasia with replacement of normal epithelium
D. Hyperplasia with increased cell number only
Correct Answer: B
Rationale: Correct because dysplasia is characterized by abnormal variation in cell size
and shape, loss of normal tissue architecture, and increased mitotic activity without
, invasion. It represents a disorder of cell maturation that is potentially reversible if the
causative stimulus is removed.
Q6: A patient presents with tissue damage after 30 minutes of severe ischemia. The
nurse understands that the earliest morphologic change visible by light microscopy is:
A. Nuclear pyknosis and karyorrhexis
B. Cellular swelling with loss of microvilli [CORRECT]
C. Coagulative necrosis with preserved tissue architecture
D. Apoptotic body formation
Correct Answer: B
Rationale: Correct because cellular swelling is the earliest light-microscopic finding of
reversible cell injury, resulting from failure of the Na+/K+ ATPase pump and subsequent
influx of water. Loss of microvilli and mitochondrial swelling occur at the ultrastructural
level before nuclear changes become visible.
Q7: A patient exposed to carbon tetrachloride develops liver cell damage. The nurse
recognizes that the primary mechanism of injury involves:
A. Hypoxia from hemoglobin binding
B. Free radical formation and lipid peroxidation [CORRECT]
C. Direct DNA alkylation and cross-linking
D. Calcium overload activating phospholipases
Correct Answer: B
