N212 Pathophysiology Exam 1 Study Guide
Foundational Cellular & Systemic Pathophysiology A+
2026/2027 Official Exam | Grade A | 100% Verified Solutions
Original high-yield examination aligned to the public N212 Pathophysiology Exam 1 blueprint. Application- and analysis-level items
covering cellular adaptation and injury, inflammation and repair, fluid and electrolyte balance, acid-base disorders, and
immunity/hypersensitivity.
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
■ Section 1: Cellular Adaptation, Injury & Death (Q1–10)
■ Section 2: Inflammation & Tissue Repair (Q11–20)
■ Section 3: Fluid & Electrolyte Balance (Q21–30)
■ Section 4: Acid-Base Imbalances (Q31–40)
■ Section 5: Immunity, Hypersensitivity & Host Defense (Q41–50)
Passing Score: 75% · 1 mark per question · Application/Analysis level
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, SECTION: CELLULAR ADAPTATION, INJURY & DEATH
Q1. A patient with long-standing hypertension develops thickening of the left-ventricular wall. The nurse identifies this cellular
adaptation as:
A. Atrophy caused by decreased workload
B. Metaplasia of cardiac myocytes into fibroblasts
C. Hypertrophy caused by increased hemodynamic demand
D. Dysplasia with disordered nuclear architecture
Correct Answer: C
Rationale: Increased afterload forces cardiac myocytes to synthesize additional contractile proteins, enlarging cell size (hypertrophy) without
increasing cell number.
Q2. A long-time smoker’s bronchial epithelium changes from ciliated columnar to stratified squamous cells. This reversible
adaptation is best classified as:
A. Metaplasia in response to chronic irritation
B. Hypertrophy of the bronchial smooth muscle
C. Neoplastic transformation that is irreversible
D. Atrophy of the mucosal glands
Correct Answer: A
Rationale: Metaplasia is the reversible replacement of one differentiated cell type by another better suited to withstand stress. In smokers,
squamous metaplasia replaces the normal respiratory epithelium.
Q3. A patient experiences prolonged ischemia of a skeletal-muscle bed. After restoration of blood flow, the tissue shows
irreversible injury. The organelle whose damage most directly commits the cell to necrosis is the:
A. Rough endoplasmic reticulum
B. Golgi apparatus with impaired protein packaging
C. Nucleolus with temporary cessation of rRNA synthesis
D. Mitochondrion, through opening of the permeability transition pore and loss of ATP generation
Correct Answer: D
Rationale: Severe ATP depletion and mitochondrial membrane permeabilization are central to irreversible injury. Once mitochondria fail,
energy-dependent ion pumps collapse and membrane integrity is lost.
Q4. Apoptosis differs from necrosis in that apoptosis:
A. Produces extensive inflammation and spillage of cellular contents
B. Is a regulated, energy-dependent process that eliminates cells with minimal inflammation
C. Always results from sudden ischemic infarction of large tissue areas
D. Is characterized by cellular swelling and membrane rupture as the primary events
Correct Answer: B
Rationale: Apoptosis is programmed cell death that proceeds through orderly caspase activation, DNA fragmentation, and formation of apoptotic
bodies that are rapidly cleared, limiting inflammation.
Q5. A pathologist examines tissue and notes cells with pyknotic nuclei, karyorrhexis, and karyolysis together with cytoplasmic
eosinophilia. These nuclear changes are classic features of:
A. Necrosis
B. Reversible cellular swelling
C. Purely apoptotic bodies without necrosis
D. Cellular adaptation by hyperplasia
Correct Answer: A
Rationale: Pyknosis (nuclear shrinkage), karyorrhexis (fragmentation), and karyolysis (dissolution) are the sequential nuclear changes of necrosis
and indicate irreversible cell death.
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