NRSG 2350 FINAL EXAM PRACTICE TEST
Integrated Pathophysiology and Pharmacology
100 Questions with ANSWERs & Rationales
SECTION 1: CELLULAR ADAPTATION & PATHOPHYSIOLOGY (Questions 1–10)
1. A patient's leg muscles have decreased in size after being in a cast for 6 weeks. This cellular change is
best described as:
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
ANSWER: C) Atrophy
Rationale: Atrophy is a decrease in cell size that results from reduced workload, disuse, or decreased
blood supply. After prolonged immobilization in a cast, muscle cells undergo atrophy due to decreased
functional demand. Hypertrophy is an increase in cell size, hyperplasia is an increase in cell number, and
metaplasia is the replacement of one cell type with another.
2. Which of the following cellular adaptations is considered pathologic and is commonly seen in the
respiratory tract of chronic smokers?
A) Hypertrophy
B) Hyperplasia
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 respiratory tract is replaced by
stratified squamous epithelium as a protective response to chronic irritation. This is considered a
pathologic adaptation.
3. Which of the following cell types is more likely to have arisen from a stem cell in an adult?
A) Muscle
B) Bone
C) Epithelial
D) Neural
ANSWER: C) Epithelial
Rationale: Epithelial cells such as skin, organ lining, and vessel lining cells are constantly being replaced
throughout life. These tissues have a high turnover rate and rely on stem cells for continuous
regeneration.
4. What is the primary difference between hyperplasia and hypertrophy?
A) Hyperplasia increases cell size; hypertrophy increases cell number
B) Hyperplasia increases cell number; hypertrophy increases cell size
C) Both involve an increase in cell number
D) Both involve a decrease in cell size
ANSWER: B) Hyperplasia increases cell number; hypertrophy increases cell size
,Rationale: Hyperplasia is an increase in the number of cells in an organ or tissue, while hypertrophy is an
increase in the size of individual cells. Both can be physiologic or pathologic responses to increased
demand.
5. A patient with chronic heart failure develops an enlarged heart. This is best described as:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
ANSWER: B) Hypertrophy
Rationale: Cardiac hypertrophy occurs when the heart muscle works against increased resistance (such
as in hypertension or heart failure). The individual cardiac muscle cells increase in size to meet the
increased workload, but the number of cells does not increase.
6. Which cellular change is characterized by a decrease in cell size and function?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Dysplasia
ANSWER: C) Atrophy
Rationale: Atrophy involves a decrease in cell size and often a decrease in function. This can result from
disuse, denervation, ischemia, malnutrition, or endocrine stimulation loss.
, 7. Dysplasia is best described as:
A) An increase in cell number
B) An increase in cell size
C) Abnormal changes in cell size, shape, and organization
D) Replacement of one cell type with another
ANSWER: C) Abnormal changes in cell size, shape, and organization
Rationale: Dysplasia refers to abnormal changes in the size, shape, and organization of mature cells. It is
often found in epithelial tissues and is considered a precancerous change, though it can be reversible if
the stimulus is removed.
8. A patient's cervical Pap smear shows dysplastic cells. The nurse understands that this finding:
A) Confirms cervical cancer
B) Indicates abnormal cellular changes that may be precancerous
C) Is a normal finding
D) Indicates an infection
ANSWER: B) Indicates abnormal cellular changes that may be precancerous
Rationale: Dysplastic cells show abnormal size, shape, and organization but have not yet invaded
surrounding tissues. Dysplasia is considered a precancerous condition that may progress to cancer if the
underlying cause is not addressed.
9. Which of the following is an example of physiologic hypertrophy?
A) Cardiac enlargement in heart failure
B) Uterine enlargement during pregnancy
Integrated Pathophysiology and Pharmacology
100 Questions with ANSWERs & Rationales
SECTION 1: CELLULAR ADAPTATION & PATHOPHYSIOLOGY (Questions 1–10)
1. A patient's leg muscles have decreased in size after being in a cast for 6 weeks. This cellular change is
best described as:
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
ANSWER: C) Atrophy
Rationale: Atrophy is a decrease in cell size that results from reduced workload, disuse, or decreased
blood supply. After prolonged immobilization in a cast, muscle cells undergo atrophy due to decreased
functional demand. Hypertrophy is an increase in cell size, hyperplasia is an increase in cell number, and
metaplasia is the replacement of one cell type with another.
2. Which of the following cellular adaptations is considered pathologic and is commonly seen in the
respiratory tract of chronic smokers?
A) Hypertrophy
B) Hyperplasia
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 respiratory tract is replaced by
stratified squamous epithelium as a protective response to chronic irritation. This is considered a
pathologic adaptation.
3. Which of the following cell types is more likely to have arisen from a stem cell in an adult?
A) Muscle
B) Bone
C) Epithelial
D) Neural
ANSWER: C) Epithelial
Rationale: Epithelial cells such as skin, organ lining, and vessel lining cells are constantly being replaced
throughout life. These tissues have a high turnover rate and rely on stem cells for continuous
regeneration.
4. What is the primary difference between hyperplasia and hypertrophy?
A) Hyperplasia increases cell size; hypertrophy increases cell number
B) Hyperplasia increases cell number; hypertrophy increases cell size
C) Both involve an increase in cell number
D) Both involve a decrease in cell size
ANSWER: B) Hyperplasia increases cell number; hypertrophy increases cell size
,Rationale: Hyperplasia is an increase in the number of cells in an organ or tissue, while hypertrophy is an
increase in the size of individual cells. Both can be physiologic or pathologic responses to increased
demand.
5. A patient with chronic heart failure develops an enlarged heart. This is best described as:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
ANSWER: B) Hypertrophy
Rationale: Cardiac hypertrophy occurs when the heart muscle works against increased resistance (such
as in hypertension or heart failure). The individual cardiac muscle cells increase in size to meet the
increased workload, but the number of cells does not increase.
6. Which cellular change is characterized by a decrease in cell size and function?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Dysplasia
ANSWER: C) Atrophy
Rationale: Atrophy involves a decrease in cell size and often a decrease in function. This can result from
disuse, denervation, ischemia, malnutrition, or endocrine stimulation loss.
, 7. Dysplasia is best described as:
A) An increase in cell number
B) An increase in cell size
C) Abnormal changes in cell size, shape, and organization
D) Replacement of one cell type with another
ANSWER: C) Abnormal changes in cell size, shape, and organization
Rationale: Dysplasia refers to abnormal changes in the size, shape, and organization of mature cells. It is
often found in epithelial tissues and is considered a precancerous change, though it can be reversible if
the stimulus is removed.
8. A patient's cervical Pap smear shows dysplastic cells. The nurse understands that this finding:
A) Confirms cervical cancer
B) Indicates abnormal cellular changes that may be precancerous
C) Is a normal finding
D) Indicates an infection
ANSWER: B) Indicates abnormal cellular changes that may be precancerous
Rationale: Dysplastic cells show abnormal size, shape, and organization but have not yet invaded
surrounding tissues. Dysplasia is considered a precancerous condition that may progress to cancer if the
underlying cause is not addressed.
9. Which of the following is an example of physiologic hypertrophy?
A) Cardiac enlargement in heart failure
B) Uterine enlargement during pregnancy
