NR 507 /NR 507 – Midterm Exam Review |
Advanced Pathophysiology with Verified Questions
& Answers Plus Rationales | Guaranteed A Grade
Latest 2026/2027 Update - (Chamberlain
University)
SECTION 1: CELLULAR ADAPTATION & INJURY
Question 1
A patient with chronic hypertension has an enlarged heart. This increase in muscle mass is
primarily due to which cellular adaptation?
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Dysplasia
Answer: C
Hypertrophy is an increase in the size of cells, leading to an enlarged organ. Cardiac muscle cells are
terminally differentiated and cannot divide, so they adapt to increased workload through hypertrophy, not
hyperplasia (increase in cell number).
Question 2
The irreversible point in cellular injury where cell death is inevitable, even if the stressor is
removed, is known as the:
1|Page
,A) Point of no return
B) Cellular apoptosis threshold
C) Necrotic point
D) Ischemic threshold
Answer: A
The "point of no return" is a key concept where mitochondrial damage becomes so severe that ATP
production ceases entirely, leading to irreversible membrane and DNA damage.
Question 3
Which of the following is a characteristic feature of apoptosis?
A) Elicits a significant inflammatory response
B) Results in cellular swelling and rupture
C) Involves organized cell shrinkage and fragmentation
D) Is always a pathological process
Answer: C
Apoptosis is a programmed, controlled cell death that does not cause inflammation. Necrosis is
characterized by cell swelling, rupture, and inflammation.
Question 4
Ischemia-reperfusion injury causes additional cellular damage primarily due to:
A) Immediate restoration of ATP levels
2|Page
,B) Influx of calcium and generation of oxygen-free radicals
C) Rapid normalization of pH
D) Prevention of inflammatory cell infiltration
Answer: B
When blood flow returns (reperfusion), it brings oxygen which leads to a burst of free radical production
and an influx of calcium, exacerbating the injury caused by the initial ischemia.
Question 5
A client presents with enlargement of the left ventricle due to long-standing hypertension. This is an
example of which type of cellular adaptation?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Answer: B
Hypertrophy is an increase in cell size leading to organ enlargement. The left ventricle enlarges in
response to increased workload (hypertension) because cardiac muscle cells cannot divide (hyperplasia).
Question 6
A client who smokes has a change in the bronchial epithelium from ciliated columnar to stratified
squamous. This is an example of:
3|Page
, A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Answer: D
Metaplasia is the reversible replacement of one differentiated cell type with another. In smokers, the
normal ciliated columnar epithelium of the bronchi transforms into stratified squamous epithelium as a
protective adaptation to chronic irritation.
Question 7
Which type of necrosis is characterized by a cheese-like appearance and is most commonly
associated with tuberculosis?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
Answer: C
Caseous necrosis (cheese-like) is characteristic of tuberculosis. It represents a combination of coagulative
and liquefactive necrosis with a granulomatous inflammatory response.
Question 8
Gangrenous necrosis is most commonly associated with:
4|Page
Advanced Pathophysiology with Verified Questions
& Answers Plus Rationales | Guaranteed A Grade
Latest 2026/2027 Update - (Chamberlain
University)
SECTION 1: CELLULAR ADAPTATION & INJURY
Question 1
A patient with chronic hypertension has an enlarged heart. This increase in muscle mass is
primarily due to which cellular adaptation?
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Dysplasia
Answer: C
Hypertrophy is an increase in the size of cells, leading to an enlarged organ. Cardiac muscle cells are
terminally differentiated and cannot divide, so they adapt to increased workload through hypertrophy, not
hyperplasia (increase in cell number).
Question 2
The irreversible point in cellular injury where cell death is inevitable, even if the stressor is
removed, is known as the:
1|Page
,A) Point of no return
B) Cellular apoptosis threshold
C) Necrotic point
D) Ischemic threshold
Answer: A
The "point of no return" is a key concept where mitochondrial damage becomes so severe that ATP
production ceases entirely, leading to irreversible membrane and DNA damage.
Question 3
Which of the following is a characteristic feature of apoptosis?
A) Elicits a significant inflammatory response
B) Results in cellular swelling and rupture
C) Involves organized cell shrinkage and fragmentation
D) Is always a pathological process
Answer: C
Apoptosis is a programmed, controlled cell death that does not cause inflammation. Necrosis is
characterized by cell swelling, rupture, and inflammation.
Question 4
Ischemia-reperfusion injury causes additional cellular damage primarily due to:
A) Immediate restoration of ATP levels
2|Page
,B) Influx of calcium and generation of oxygen-free radicals
C) Rapid normalization of pH
D) Prevention of inflammatory cell infiltration
Answer: B
When blood flow returns (reperfusion), it brings oxygen which leads to a burst of free radical production
and an influx of calcium, exacerbating the injury caused by the initial ischemia.
Question 5
A client presents with enlargement of the left ventricle due to long-standing hypertension. This is an
example of which type of cellular adaptation?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Answer: B
Hypertrophy is an increase in cell size leading to organ enlargement. The left ventricle enlarges in
response to increased workload (hypertension) because cardiac muscle cells cannot divide (hyperplasia).
Question 6
A client who smokes has a change in the bronchial epithelium from ciliated columnar to stratified
squamous. This is an example of:
3|Page
, A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Answer: D
Metaplasia is the reversible replacement of one differentiated cell type with another. In smokers, the
normal ciliated columnar epithelium of the bronchi transforms into stratified squamous epithelium as a
protective adaptation to chronic irritation.
Question 7
Which type of necrosis is characterized by a cheese-like appearance and is most commonly
associated with tuberculosis?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
Answer: C
Caseous necrosis (cheese-like) is characteristic of tuberculosis. It represents a combination of coagulative
and liquefactive necrosis with a granulomatous inflammatory response.
Question 8
Gangrenous necrosis is most commonly associated with:
4|Page
