NSG5140 Week 5 Midterm Exam – Practice
Questions with Verified Answers & Rationales
EXAM OVERVIEW
NSG 5140 Advanced Pathophysiology is a graduate-level course focusing
on pathophysiologic conditions across the lifespan, providing foundation
for advanced practice nursing through knowledge of advanced physiology
and pathophysiologic cellular changes . The midterm exam assesses
advanced knowledge of pharmacotherapeutics, pathophysiology, and
clinical decision-making across major body systems .
SECTION 1: CELLULAR INJURY & HOMEOSTASIS
(Questions 1-50)
QUESTION 1
Which of the following is the primary mechanism of cellular injury in
hypoxic conditions?
A) DNA mutation
B) ATP depletion leading to loss of ion homeostasis
C) Free radical formation
D) Protein misfolding
,Correct Answer: B) ATP depletion leading to loss of ion homeostasis.
Rationale: Hypoxia limits oxidative phosphorylation, leading to decreased
ATP production. ATP depletion causes failure of the Na⁺/K⁺ ATPase pump,
resulting in intracellular sodium accumulation, water influx, and cellular
swelling. This is the hallmark of hypoxic cellular injury .
QUESTION 2
A patient with chronic hypertension develops left ventricular wall
thickening. This is an example of which adaptive cellular response?
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 by hypertrophy (increased cell size), not hyperplasia.
Chronic hypertension causes the myocytes to enlarge, resulting in left
ventricular wall thickening .
QUESTION 3
What is a consequence of plasma membrane damage to the mitochondria?
A) Enzymatic digestion halts DNA synthesis
B) Influx of calcium ions halts ATP production
C) Edema from sodium influx causes reduction in ATP production
D) Potassium shifts out of the mitochondria, destroying infrastructure
,Correct Answer: B) Influx of calcium ions halts ATP production.
Rationale: Plasma membrane damage allows calcium to enter the cell and
accumulate in mitochondria. Excess calcium disrupts oxidative
phosphorylation and ATP production, leading to cell injury and potential
apoptosis .
QUESTION 4
The loss of differentiation that occurs in neoplastic cells is called:
A) Anaplasia
B) Aplasia
C) Dysplasia
D) Metaplasia
Correct Answer: A) Anaplasia.
Rationale: Anaplasia is the loss of differentiation in neoplastic cells. It is a
hallmark of malignant transformation and is associated with rapid,
uncontrolled growth .
QUESTION 5
Programmed cell death that occurs when cell division stops and growth
ceases is called:
A) Apoptosis
B) Necrosis
C) Autophagy
D) Pyroptosis
, Correct Answer: A) Apoptosis.
Rationale: Apoptosis is programmed cell death. It is a regulated process that
eliminates damaged or unnecessary cells without triggering an inflammatory
response. It occurs when cell division stops and growth ceases .
QUESTION 6
A decrease in the size and number of an organ's cells is termed:
A) Atrophy
B) Hyperplasia
C) Hypertrophy
D) Anaplasia
Correct Answer: A) Atrophy.
Rationale: Atrophy is a decrease in the size and number of an organ's cells. It
can result from decreased workload, loss of innervation, or inadequate
nutrition .
QUESTION 7
An increase in the size (but not number) of an organ's cells is termed:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct Answer: B) Hypertrophy.
Rationale: Hypertrophy is an increase in the size of an organ's cells without
Questions with Verified Answers & Rationales
EXAM OVERVIEW
NSG 5140 Advanced Pathophysiology is a graduate-level course focusing
on pathophysiologic conditions across the lifespan, providing foundation
for advanced practice nursing through knowledge of advanced physiology
and pathophysiologic cellular changes . The midterm exam assesses
advanced knowledge of pharmacotherapeutics, pathophysiology, and
clinical decision-making across major body systems .
SECTION 1: CELLULAR INJURY & HOMEOSTASIS
(Questions 1-50)
QUESTION 1
Which of the following is the primary mechanism of cellular injury in
hypoxic conditions?
A) DNA mutation
B) ATP depletion leading to loss of ion homeostasis
C) Free radical formation
D) Protein misfolding
,Correct Answer: B) ATP depletion leading to loss of ion homeostasis.
Rationale: Hypoxia limits oxidative phosphorylation, leading to decreased
ATP production. ATP depletion causes failure of the Na⁺/K⁺ ATPase pump,
resulting in intracellular sodium accumulation, water influx, and cellular
swelling. This is the hallmark of hypoxic cellular injury .
QUESTION 2
A patient with chronic hypertension develops left ventricular wall
thickening. This is an example of which adaptive cellular response?
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 by hypertrophy (increased cell size), not hyperplasia.
Chronic hypertension causes the myocytes to enlarge, resulting in left
ventricular wall thickening .
QUESTION 3
What is a consequence of plasma membrane damage to the mitochondria?
A) Enzymatic digestion halts DNA synthesis
B) Influx of calcium ions halts ATP production
C) Edema from sodium influx causes reduction in ATP production
D) Potassium shifts out of the mitochondria, destroying infrastructure
,Correct Answer: B) Influx of calcium ions halts ATP production.
Rationale: Plasma membrane damage allows calcium to enter the cell and
accumulate in mitochondria. Excess calcium disrupts oxidative
phosphorylation and ATP production, leading to cell injury and potential
apoptosis .
QUESTION 4
The loss of differentiation that occurs in neoplastic cells is called:
A) Anaplasia
B) Aplasia
C) Dysplasia
D) Metaplasia
Correct Answer: A) Anaplasia.
Rationale: Anaplasia is the loss of differentiation in neoplastic cells. It is a
hallmark of malignant transformation and is associated with rapid,
uncontrolled growth .
QUESTION 5
Programmed cell death that occurs when cell division stops and growth
ceases is called:
A) Apoptosis
B) Necrosis
C) Autophagy
D) Pyroptosis
, Correct Answer: A) Apoptosis.
Rationale: Apoptosis is programmed cell death. It is a regulated process that
eliminates damaged or unnecessary cells without triggering an inflammatory
response. It occurs when cell division stops and growth ceases .
QUESTION 6
A decrease in the size and number of an organ's cells is termed:
A) Atrophy
B) Hyperplasia
C) Hypertrophy
D) Anaplasia
Correct Answer: A) Atrophy.
Rationale: Atrophy is a decrease in the size and number of an organ's cells. It
can result from decreased workload, loss of innervation, or inadequate
nutrition .
QUESTION 7
An increase in the size (but not number) of an organ's cells is termed:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct Answer: B) Hypertrophy.
Rationale: Hypertrophy is an increase in the size of an organ's cells without
