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WGU D115 – ADVANCED PATHOPHYSIOLOGY FOR THE APRN Cram Study Guide 3 |
Latest 2026/2027 Update Questions with Detailed Rationales | A+ Graded
Question 1
A patient experiences a reversible cell injury characterized by
cell swelling and decreased ATP. Which of the following is the
primary cause of cell swelling?
A. Sodium-potassium pump failure leading to intracellular
sodium and water accumulation
B. Increased protein synthesis
C. Mitochondrial hyperplasia
D. Increased potassium influx
E. Decreased membrane permeability
Answer: A
Rationale: ATP depletion impairs the Na⁺/K⁺-ATPase pump,
causing sodium to accumulate inside the cell, drawing water
and causing swelling. This is an early reversible change.
Question 2
Which of the following is an example of physiologic
hyperplasia?
A. Endometrial proliferation during menstrual cycle
B. Barrett esophagus
C. Hepatic regeneration after partial hepatectomy
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D. Cardiac enlargement due to hypertension
E. Bronchial metaplasia in smokers
Answer: A
Rationale: Physiologic hyperplasia is an increase in cell number
in response to normal stimuli, such as endometrial proliferation
under estrogen. Hepatic regeneration is compensatory
hyperplasia; Barrett is metaplasia; cardiac enlargement is
hypertrophy.
Question 3
A patient with chronic hypoxia develops an increase in red
blood cell mass. This adaptive change is best described as:
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
E. Atrophy
Answer: B
Rationale: Chronic hypoxia stimulates erythropoietin, causing
increased proliferation of erythroid precursors in bone
marrow—a physiologic hyperplasia.
Question 4
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Which of the following is a feature of irreversible cell injury?
A. Decreased ATP
B. Mitochondrial swelling
C. Nuclear karyolysis and cell membrane rupture
D. Cellular swelling
E. Ribosomal detachment
Answer: C
Rationale: Irreversible injury is marked by nuclear changes
(pyknosis, karyorrhexis, karyolysis) and membrane rupture;
reversible injury includes decreased ATP, swelling, and
ribosomal detachment.
Question 5
Which type of necrosis is most characteristic of tuberculosis?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
E. Fibrinoid necrosis
Answer: C
Rationale: Caseous necrosis is a distinctive form of necrotic
tissue that appears cheese-like and is typical of granulomatous
inflammation in tuberculosis.
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Question 6
What is the primary mediator of vasodilation in acute
inflammation?
A. Complement C3a
B. Histamine and nitric oxide
C. Thromboxane A2
D. Platelet-activating factor only
E. Bradykinin only
Answer: B
Rationale: Histamine (from mast cells) and nitric oxide (from
endothelium) are key mediators of vasodilation, increasing
blood flow and causing redness/heat.
Question 7
Which leukocyte is most characteristic of a parasitic infection?
A. Neutrophils
B. Eosinophils
C. Basophils
D. Lymphocytes
E. Monocytes
Answer: B
Rationale: Eosinophils are prominent in parasitic infections and
WGU D115 – ADVANCED PATHOPHYSIOLOGY FOR THE APRN Cram Study Guide 3 |
Latest 2026/2027 Update Questions with Detailed Rationales | A+ Graded
Question 1
A patient experiences a reversible cell injury characterized by
cell swelling and decreased ATP. Which of the following is the
primary cause of cell swelling?
A. Sodium-potassium pump failure leading to intracellular
sodium and water accumulation
B. Increased protein synthesis
C. Mitochondrial hyperplasia
D. Increased potassium influx
E. Decreased membrane permeability
Answer: A
Rationale: ATP depletion impairs the Na⁺/K⁺-ATPase pump,
causing sodium to accumulate inside the cell, drawing water
and causing swelling. This is an early reversible change.
Question 2
Which of the following is an example of physiologic
hyperplasia?
A. Endometrial proliferation during menstrual cycle
B. Barrett esophagus
C. Hepatic regeneration after partial hepatectomy
, Page |2
D. Cardiac enlargement due to hypertension
E. Bronchial metaplasia in smokers
Answer: A
Rationale: Physiologic hyperplasia is an increase in cell number
in response to normal stimuli, such as endometrial proliferation
under estrogen. Hepatic regeneration is compensatory
hyperplasia; Barrett is metaplasia; cardiac enlargement is
hypertrophy.
Question 3
A patient with chronic hypoxia develops an increase in red
blood cell mass. This adaptive change is best described as:
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
E. Atrophy
Answer: B
Rationale: Chronic hypoxia stimulates erythropoietin, causing
increased proliferation of erythroid precursors in bone
marrow—a physiologic hyperplasia.
Question 4
, Page |3
Which of the following is a feature of irreversible cell injury?
A. Decreased ATP
B. Mitochondrial swelling
C. Nuclear karyolysis and cell membrane rupture
D. Cellular swelling
E. Ribosomal detachment
Answer: C
Rationale: Irreversible injury is marked by nuclear changes
(pyknosis, karyorrhexis, karyolysis) and membrane rupture;
reversible injury includes decreased ATP, swelling, and
ribosomal detachment.
Question 5
Which type of necrosis is most characteristic of tuberculosis?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
E. Fibrinoid necrosis
Answer: C
Rationale: Caseous necrosis is a distinctive form of necrotic
tissue that appears cheese-like and is typical of granulomatous
inflammation in tuberculosis.
, Page |4
Question 6
What is the primary mediator of vasodilation in acute
inflammation?
A. Complement C3a
B. Histamine and nitric oxide
C. Thromboxane A2
D. Platelet-activating factor only
E. Bradykinin only
Answer: B
Rationale: Histamine (from mast cells) and nitric oxide (from
endothelium) are key mediators of vasodilation, increasing
blood flow and causing redness/heat.
Question 7
Which leukocyte is most characteristic of a parasitic infection?
A. Neutrophils
B. Eosinophils
C. Basophils
D. Lymphocytes
E. Monocytes
Answer: B
Rationale: Eosinophils are prominent in parasitic infections and
