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WGU D115 – ADVANCED PATHOPHYSIOLOGY FOR THE APRN Cram Study Guide 1 | Latest
2026/2027 Update Questions with Detailed Rationales | A+ Graded
Question 1
Which of the following is the primary cause of cellular swelling
in reversible cell injury?
A. Increased protein synthesis
B. Failure of the sodium-potassium pump leading to
intracellular sodium and water accumulation
C. Mitochondrial hyperplasia
D. Increased potassium influx
E. Decreased membrane permeability
Answer: B
Rationale: ATP depletion impairs the Na⁺/K⁺-ATPase pump,
causing sodium to accumulate intracellularly. Water follows
sodium, leading to cellular swelling—an early reversible change.
Question 2
A patient with chronic hypertension develops thickening of the
left ventricular wall. This is an example of:
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
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D. Dysplasia
E. Atrophy
Answer: B
Rationale: Hypertrophy is an increase in cell size in response to
increased workload or pressure. Chronic hypertension increases
afterload, causing cardiac myocyte hypertrophy.
Question 3
Which type of necrosis is most characteristic of ischemic injury
in the heart?
A. Liquefactive necrosis
B. Caseous necrosis
C. Coagulative necrosis
D. Fat necrosis
E. Fibrinoid necrosis
Answer: C
Rationale: Coagulative necrosis occurs in most solid organs
(heart, kidney, liver) after ischemic injury. The basic tissue
architecture is preserved initially, but the cells die.
Question 4
A patient with chronic gastroesophageal reflux develops Barrett
esophagus. This is an example of:
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A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
E. Atrophy
Answer: C
Rationale: Barrett esophagus is metaplasia—replacement of
squamous epithelium with columnar epithelium in response to
chronic acid exposure. It is a reversible adaptive change but
carries risk of dysplasia.
Question 5
Which cell type is the first to arrive at the site of acute
inflammation?
A. Macrophages
B. Neutrophils
C. Lymphocytes
D. Plasma cells
E. Eosinophils
Answer: B
Rationale: Neutrophils are the first leukocytes to migrate to the
site of acute inflammation, typically within 6–24 hours.
Macrophages predominate later.
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Question 6
A patient has a chronic inflammatory condition. Which cell type
predominates?
A. Neutrophils
B. Macrophages and lymphocytes
C. Basophils
D. Mast cells only
E. Platelets
Answer: B
Rationale: Chronic inflammation is characterized by infiltration
of macrophages, lymphocytes, and plasma cells, tissue
destruction, and fibrosis.
Question 7
What is the primary immunoglobulin involved in allergic
reactions?
A. IgG
B. IgA
C. IgM
D. IgE
E. IgD
WGU D115 – ADVANCED PATHOPHYSIOLOGY FOR THE APRN Cram Study Guide 1 | Latest
2026/2027 Update Questions with Detailed Rationales | A+ Graded
Question 1
Which of the following is the primary cause of cellular swelling
in reversible cell injury?
A. Increased protein synthesis
B. Failure of the sodium-potassium pump leading to
intracellular sodium and water accumulation
C. Mitochondrial hyperplasia
D. Increased potassium influx
E. Decreased membrane permeability
Answer: B
Rationale: ATP depletion impairs the Na⁺/K⁺-ATPase pump,
causing sodium to accumulate intracellularly. Water follows
sodium, leading to cellular swelling—an early reversible change.
Question 2
A patient with chronic hypertension develops thickening of the
left ventricular wall. This is an example of:
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
, Page |2
D. Dysplasia
E. Atrophy
Answer: B
Rationale: Hypertrophy is an increase in cell size in response to
increased workload or pressure. Chronic hypertension increases
afterload, causing cardiac myocyte hypertrophy.
Question 3
Which type of necrosis is most characteristic of ischemic injury
in the heart?
A. Liquefactive necrosis
B. Caseous necrosis
C. Coagulative necrosis
D. Fat necrosis
E. Fibrinoid necrosis
Answer: C
Rationale: Coagulative necrosis occurs in most solid organs
(heart, kidney, liver) after ischemic injury. The basic tissue
architecture is preserved initially, but the cells die.
Question 4
A patient with chronic gastroesophageal reflux develops Barrett
esophagus. This is an example of:
, Page |3
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
E. Atrophy
Answer: C
Rationale: Barrett esophagus is metaplasia—replacement of
squamous epithelium with columnar epithelium in response to
chronic acid exposure. It is a reversible adaptive change but
carries risk of dysplasia.
Question 5
Which cell type is the first to arrive at the site of acute
inflammation?
A. Macrophages
B. Neutrophils
C. Lymphocytes
D. Plasma cells
E. Eosinophils
Answer: B
Rationale: Neutrophils are the first leukocytes to migrate to the
site of acute inflammation, typically within 6–24 hours.
Macrophages predominate later.
, Page |4
Question 6
A patient has a chronic inflammatory condition. Which cell type
predominates?
A. Neutrophils
B. Macrophages and lymphocytes
C. Basophils
D. Mast cells only
E. Platelets
Answer: B
Rationale: Chronic inflammation is characterized by infiltration
of macrophages, lymphocytes, and plasma cells, tissue
destruction, and fibrosis.
Question 7
What is the primary immunoglobulin involved in allergic
reactions?
A. IgG
B. IgA
C. IgM
D. IgE
E. IgD
