NR507 Week 4 Midterm Mastery: 100
Verified Practice Questions & Rationales
for Advanced Pathophysiology (Grade
A+ Examplify Proctored Review, 2026)
---
### Cellular Adaptation, Injury & Neoplasia (Questions 1-20)
**Q1.** A patient with chronic hypertension develops an enlarged left ventricle.
This represents which type of cellular adaptation?
- A) Hyperplasia
- B) Metaplasia
- C) Hypertrophy
- D) Dysplasia
**Answer: C) Hypertrophy**
**Rationale:** Hypertrophy is an increase in the size of cells, leading to an
enlarged organ. Cardiac muscle cells are terminally differentiated and cannot
divide (hyperplasia), so they adapt to increased workload through hypertrophy.
This is the primary mechanism by which the heart compensates for chronic
pressure overload in hypertension.
,---
**Q2.** A chronic smoker develops a change in bronchial epithelium from
ciliated columnar to stratified squamous cells. This process is termed:
- A) Hyperplasia
- B) Hypertrophy
- C) Atrophy
- D) Metaplasia
**Answer: D) Metaplasia**
**Rationale:** Metaplasia is the reversible replacement of one differentiated cell
type with another. In chronic smokers, the normal ciliated columnar epithelium of
the airways is replaced by stratified squamous epithelium as a protective
adaptation to chronic irritation.
---
**Q3.** Which of the following is the primary mechanism of cellular injury in a
patient experiencing a myocardial infarction?
- A) Free radical formation
- B) Hypoxic injury due to ischemia
- C) Chemical toxicity
,- D) Accumulation of calcium
**Answer: B) Hypoxic injury due to ischemia**
**Rationale:** Myocardial infarction results from coronary artery occlusion,
leading to ischemia and subsequent hypoxic injury to cardiac muscle cells. Oxygen
deprivation impairs aerobic metabolism, reducing ATP production and leading to
cellular injury and death.
---
**Q4.** The earliest reversible morphologic sign of cell injury is:
- A) Nuclear pyknosis
- B) Cellular swelling (hydropic change)
- C) Membrane blebbing
- D) Mitochondrial dense bodies
**Answer: B) Cellular swelling (hydropic change)**
**Rationale:** Cellular swelling, or hydropic change, is the earliest and most
reversible morphologic manifestation of cell injury. It results from failure of the
sodium-potassium pump due to ATP depletion, causing sodium accumulation and
water influx into the cell.
---
, **Q5.** Apoptosis is best defined as:
- A) Unregulated cell death causing inflammation
- B) Normal cell self-destruction mechanism
- C) Cell death due to trauma
- D) Pathologic cell swelling
**Answer: B) Normal cell self-destruction mechanism**
**Rationale:** Apoptosis is programmed cell death—a tightly regulated, energy-
dependent process of cellular self-destruction that eliminates unwanted or
damaged cells without triggering an inflammatory response.
---
**Q6.** Which cellular process allows cells to digest their own components for
survival during nutrient deprivation?
- A) Apoptosis
- B) Necrosis
- C) Autophagy
- D) Phagocytosis
**Answer: C) Autophagy**
Verified Practice Questions & Rationales
for Advanced Pathophysiology (Grade
A+ Examplify Proctored Review, 2026)
---
### Cellular Adaptation, Injury & Neoplasia (Questions 1-20)
**Q1.** A patient with chronic hypertension develops an enlarged left ventricle.
This represents which type of cellular adaptation?
- A) Hyperplasia
- B) Metaplasia
- C) Hypertrophy
- D) Dysplasia
**Answer: C) Hypertrophy**
**Rationale:** Hypertrophy is an increase in the size of cells, leading to an
enlarged organ. Cardiac muscle cells are terminally differentiated and cannot
divide (hyperplasia), so they adapt to increased workload through hypertrophy.
This is the primary mechanism by which the heart compensates for chronic
pressure overload in hypertension.
,---
**Q2.** A chronic smoker develops a change in bronchial epithelium from
ciliated columnar to stratified squamous cells. This process is termed:
- A) Hyperplasia
- B) Hypertrophy
- C) Atrophy
- D) Metaplasia
**Answer: D) Metaplasia**
**Rationale:** Metaplasia is the reversible replacement of one differentiated cell
type with another. In chronic smokers, the normal ciliated columnar epithelium of
the airways is replaced by stratified squamous epithelium as a protective
adaptation to chronic irritation.
---
**Q3.** Which of the following is the primary mechanism of cellular injury in a
patient experiencing a myocardial infarction?
- A) Free radical formation
- B) Hypoxic injury due to ischemia
- C) Chemical toxicity
,- D) Accumulation of calcium
**Answer: B) Hypoxic injury due to ischemia**
**Rationale:** Myocardial infarction results from coronary artery occlusion,
leading to ischemia and subsequent hypoxic injury to cardiac muscle cells. Oxygen
deprivation impairs aerobic metabolism, reducing ATP production and leading to
cellular injury and death.
---
**Q4.** The earliest reversible morphologic sign of cell injury is:
- A) Nuclear pyknosis
- B) Cellular swelling (hydropic change)
- C) Membrane blebbing
- D) Mitochondrial dense bodies
**Answer: B) Cellular swelling (hydropic change)**
**Rationale:** Cellular swelling, or hydropic change, is the earliest and most
reversible morphologic manifestation of cell injury. It results from failure of the
sodium-potassium pump due to ATP depletion, causing sodium accumulation and
water influx into the cell.
---
, **Q5.** Apoptosis is best defined as:
- A) Unregulated cell death causing inflammation
- B) Normal cell self-destruction mechanism
- C) Cell death due to trauma
- D) Pathologic cell swelling
**Answer: B) Normal cell self-destruction mechanism**
**Rationale:** Apoptosis is programmed cell death—a tightly regulated, energy-
dependent process of cellular self-destruction that eliminates unwanted or
damaged cells without triggering an inflammatory response.
---
**Q6.** Which cellular process allows cells to digest their own components for
survival during nutrient deprivation?
- A) Apoptosis
- B) Necrosis
- C) Autophagy
- D) Phagocytosis
**Answer: C) Autophagy**
