Latest NURS 5315 Advanced Pathophysiology Exams 1–5 With verified
answers plus rationales 2026/2027 instant pdf
1. A patient develops cellular injury after prolonged tissue hypoxia. Which change occurs
first because of decreased oxygen availability?
A. Increased ATP production
B. Decreased oxidative phosphorylation
C. Increased protein synthesis
D. Increased cellular proliferation
Answer: B. Decreased oxidative phosphorylation
Rationale: Hypoxia reduces mitochondrial oxidative phosphorylation, causing decreased ATP
production and disruption of normal cellular functions.
2. Which cellular adaptation is characterized by an increase in cell size?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Answer: B. Hypertrophy
Rationale: Hypertrophy is an increase in the size of individual cells, commonly occurring when
cells experience increased workload.
3. Which cellular adaptation involves an increase in the number of cells?
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
Answer: C. Hyperplasia
Rationale: Hyperplasia occurs when cells increase in number, often because of hormonal
stimulation, compensatory responses, or chronic irritation.
,4. A patient has prolonged immobilization of an extremity. Which cellular adaptation is
most likely to occur in the affected skeletal muscle?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Answer: C. Atrophy
Rationale: Reduced workload or disuse causes cells, particularly skeletal muscle cells, to
decrease in size and functional capacity.
5. Which process describes replacement of one differentiated adult cell type with another
differentiated cell type?
A. Dysplasia
B. Metaplasia
C. Hypertrophy
D. Necrosis
Answer: B. Metaplasia
Rationale: Metaplasia is a potentially reversible adaptation in which one mature cell type is
replaced by another type better able to tolerate the environmental stress.
6. Which finding is most characteristic of irreversible cell injury?
A. Mild cellular swelling
B. Fatty change
C. Severe mitochondrial dysfunction and membrane damage
D. Temporary reduction in ATP
Answer: C. Severe mitochondrial dysfunction and membrane damage
Rationale: Severe mitochondrial damage and loss of membrane integrity are major indicators
that cellular injury has progressed beyond the point of recovery.
7. Which form of cell death typically causes significant inflammation in surrounding
tissue?
,A. Apoptosis
B. Necrosis
C. Physiologic cell turnover
D. Autophagy
Answer: B. Necrosis
Rationale: Necrosis involves cell membrane disruption and release of intracellular contents,
which can trigger an inflammatory response.
8. Which characteristic is associated with apoptosis?
A. Cell swelling
B. Membrane rupture with inflammation
C. Programmed cellular death
D. Extensive tissue destruction
Answer: C. Programmed cellular death
Rationale: Apoptosis is a regulated form of cell death that removes damaged or unnecessary
cells with minimal inflammation.
9. Which organelle is primarily responsible for producing ATP through oxidative
phosphorylation?
A. Lysosome
B. Ribosome
C. Mitochondrion
D. Golgi apparatus
Answer: C. Mitochondrion
Rationale: Mitochondria generate most cellular ATP through oxidative phosphorylation.
10. A patient experiences severe hypoxia. Which cellular consequence is expected because
of ATP depletion?
A. Increased sodium-potassium pump activity
B. Cellular swelling
, C. Increased protein synthesis
D. Increased oxidative phosphorylation
Answer: B. Cellular swelling
Rationale: ATP depletion impairs the sodium-potassium pump, causing sodium and water to
accumulate inside cells and resulting in cellular swelling.
11. Which intracellular change can occur when calcium homeostasis is disrupted during
cell injury?
A. Activation of destructive enzymes
B. Increased ATP production
C. Complete inhibition of proteases
D. Increased membrane stability
Answer: A. Activation of destructive enzymes
Rationale: Increased intracellular calcium activates enzymes such as phospholipases, proteases,
endonucleases, and ATPases that contribute to cellular damage.
12. Which reactive molecule can cause oxidative cellular injury?
A. Free radical
B. Albumin
C. Insulin
D. Hemoglobin only
Answer: A. Free radical
Rationale: Free radicals and reactive oxygen species can damage cellular lipids, proteins, and
DNA.
13. Which antioxidant enzyme helps protect cells from oxidative injury?
A. Amylase
B. Superoxide dismutase
C. Lipase
D. Pepsin
answers plus rationales 2026/2027 instant pdf
1. A patient develops cellular injury after prolonged tissue hypoxia. Which change occurs
first because of decreased oxygen availability?
A. Increased ATP production
B. Decreased oxidative phosphorylation
C. Increased protein synthesis
D. Increased cellular proliferation
Answer: B. Decreased oxidative phosphorylation
Rationale: Hypoxia reduces mitochondrial oxidative phosphorylation, causing decreased ATP
production and disruption of normal cellular functions.
2. Which cellular adaptation is characterized by an increase in cell size?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Answer: B. Hypertrophy
Rationale: Hypertrophy is an increase in the size of individual cells, commonly occurring when
cells experience increased workload.
3. Which cellular adaptation involves an increase in the number of cells?
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
Answer: C. Hyperplasia
Rationale: Hyperplasia occurs when cells increase in number, often because of hormonal
stimulation, compensatory responses, or chronic irritation.
,4. A patient has prolonged immobilization of an extremity. Which cellular adaptation is
most likely to occur in the affected skeletal muscle?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Answer: C. Atrophy
Rationale: Reduced workload or disuse causes cells, particularly skeletal muscle cells, to
decrease in size and functional capacity.
5. Which process describes replacement of one differentiated adult cell type with another
differentiated cell type?
A. Dysplasia
B. Metaplasia
C. Hypertrophy
D. Necrosis
Answer: B. Metaplasia
Rationale: Metaplasia is a potentially reversible adaptation in which one mature cell type is
replaced by another type better able to tolerate the environmental stress.
6. Which finding is most characteristic of irreversible cell injury?
A. Mild cellular swelling
B. Fatty change
C. Severe mitochondrial dysfunction and membrane damage
D. Temporary reduction in ATP
Answer: C. Severe mitochondrial dysfunction and membrane damage
Rationale: Severe mitochondrial damage and loss of membrane integrity are major indicators
that cellular injury has progressed beyond the point of recovery.
7. Which form of cell death typically causes significant inflammation in surrounding
tissue?
,A. Apoptosis
B. Necrosis
C. Physiologic cell turnover
D. Autophagy
Answer: B. Necrosis
Rationale: Necrosis involves cell membrane disruption and release of intracellular contents,
which can trigger an inflammatory response.
8. Which characteristic is associated with apoptosis?
A. Cell swelling
B. Membrane rupture with inflammation
C. Programmed cellular death
D. Extensive tissue destruction
Answer: C. Programmed cellular death
Rationale: Apoptosis is a regulated form of cell death that removes damaged or unnecessary
cells with minimal inflammation.
9. Which organelle is primarily responsible for producing ATP through oxidative
phosphorylation?
A. Lysosome
B. Ribosome
C. Mitochondrion
D. Golgi apparatus
Answer: C. Mitochondrion
Rationale: Mitochondria generate most cellular ATP through oxidative phosphorylation.
10. A patient experiences severe hypoxia. Which cellular consequence is expected because
of ATP depletion?
A. Increased sodium-potassium pump activity
B. Cellular swelling
, C. Increased protein synthesis
D. Increased oxidative phosphorylation
Answer: B. Cellular swelling
Rationale: ATP depletion impairs the sodium-potassium pump, causing sodium and water to
accumulate inside cells and resulting in cellular swelling.
11. Which intracellular change can occur when calcium homeostasis is disrupted during
cell injury?
A. Activation of destructive enzymes
B. Increased ATP production
C. Complete inhibition of proteases
D. Increased membrane stability
Answer: A. Activation of destructive enzymes
Rationale: Increased intracellular calcium activates enzymes such as phospholipases, proteases,
endonucleases, and ATPases that contribute to cellular damage.
12. Which reactive molecule can cause oxidative cellular injury?
A. Free radical
B. Albumin
C. Insulin
D. Hemoglobin only
Answer: A. Free radical
Rationale: Free radicals and reactive oxygen species can damage cellular lipids, proteins, and
DNA.
13. Which antioxidant enzyme helps protect cells from oxidative injury?
A. Amylase
B. Superoxide dismutase
C. Lipase
D. Pepsin
