,ATI Pathophysiology Assessment Exam Questions And Answers
2026/2027
1.** A client with chronic obstructive pulmonary disease (COPD) has
increased anteroposterior chest diameter and barrel-shaped chest. This
structural change is best described as which type of cellular adaptation?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
**Correct Answer:** B) Hypertrophy
**Rationale:** Hypertrophy is an increase in cell size leading to enlargement
of the organ or tissue. In COPD, chronic airway obstruction causes the lungs
to become hyperinflated, increasing the workload on the respiratory muscles.
This leads to hypertrophy of the diaphragm and intercostal muscles,
contributing to the barrel-chest appearance.
**2.** A nurse is reviewing the concept of cellular adaptation. Which of the
following is an example of pathologic hyperplasia?
A) Breast tissue enlargement during pregnancy
B) Endometrial hyperplasia due to unopposed estrogen
C) Liver regeneration after partial hepatectomy
D) Thickening of the skin on the palms of a manual laborer
**Correct Answer:** B) Endometrial hyperplasia due to unopposed estrogen
,**Rationale:** Pathologic hyperplasia results from abnormal hormonal
stimulation or growth factor production. Unopposed estrogen (without
progesterone) causes excessive proliferation of the endometrial lining, which
can progress to endometrial cancer. Breast enlargement during pregnancy
(A) and liver regeneration (C) are examples of physiologic hyperplasia, and
skin thickening (D) is an example of hypertrophy.
**3.** A client has suffered a myocardial infarction. The death of cardiac
muscle cells due to prolonged ischemia is best described as:
A) Apoptosis
B) Necrosis
C) Atrophy
D) Metaplasia
**Correct Answer:** B) Necrosis
**Rationale:** Necrosis is the unprogrammed, pathologic death of cells or
tissues due to injury such as hypoxia, ischemia, or trauma. In a myocardial
infarction, prolonged ischemia leads to coagulative necrosis of cardiac
muscle cells. Apoptosis (A) is programmed cell death that is often
physiologic.
**4.** A client has a chronic infection that has caused the normal ciliated
columnar epithelium of the bronchi to be replaced by stratified squamous
epithelium. This cellular adaptation is called:
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
, **Correct Answer:** C) Metaplasia
**Rationale:** Metaplasia is the reversible replacement of one differentiated
cell type with another. Chronic irritation (such as from smoking or infection)
can cause the airway epithelium to change from ciliated columnar to
stratified squamous epithelium to better withstand the irritant, but this
change results in loss of protective ciliary function.
**5.** Which of the following is a key characteristic that distinguishes
malignant tumors from benign tumors?
A) Malignant tumors are encapsulated
B) Malignant tumors are well-differentiated
C) Malignant tumors invade surrounding tissues and metastasize
D) Malignant tumors grow slowly
**Correct Answer:** C) Malignant tumors invade surrounding tissues and
metastasize
**Rationale:** Malignant (cancerous) tumors are characterized by invasion of
surrounding tissues, metastasis (spread to distant sites), and lack of
differentiation (anaplasia). Benign tumors are typically encapsulated, well-
differentiated, grow slowly, and do not metastasize.
**6.** A nurse is teaching a client about the risk factors for cancer. Which of
the following is an example of a chemical carcinogen?
A) Ultraviolet radiation
B) Human papillomavirus (HPV)
2026/2027
1.** A client with chronic obstructive pulmonary disease (COPD) has
increased anteroposterior chest diameter and barrel-shaped chest. This
structural change is best described as which type of cellular adaptation?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
**Correct Answer:** B) Hypertrophy
**Rationale:** Hypertrophy is an increase in cell size leading to enlargement
of the organ or tissue. In COPD, chronic airway obstruction causes the lungs
to become hyperinflated, increasing the workload on the respiratory muscles.
This leads to hypertrophy of the diaphragm and intercostal muscles,
contributing to the barrel-chest appearance.
**2.** A nurse is reviewing the concept of cellular adaptation. Which of the
following is an example of pathologic hyperplasia?
A) Breast tissue enlargement during pregnancy
B) Endometrial hyperplasia due to unopposed estrogen
C) Liver regeneration after partial hepatectomy
D) Thickening of the skin on the palms of a manual laborer
**Correct Answer:** B) Endometrial hyperplasia due to unopposed estrogen
,**Rationale:** Pathologic hyperplasia results from abnormal hormonal
stimulation or growth factor production. Unopposed estrogen (without
progesterone) causes excessive proliferation of the endometrial lining, which
can progress to endometrial cancer. Breast enlargement during pregnancy
(A) and liver regeneration (C) are examples of physiologic hyperplasia, and
skin thickening (D) is an example of hypertrophy.
**3.** A client has suffered a myocardial infarction. The death of cardiac
muscle cells due to prolonged ischemia is best described as:
A) Apoptosis
B) Necrosis
C) Atrophy
D) Metaplasia
**Correct Answer:** B) Necrosis
**Rationale:** Necrosis is the unprogrammed, pathologic death of cells or
tissues due to injury such as hypoxia, ischemia, or trauma. In a myocardial
infarction, prolonged ischemia leads to coagulative necrosis of cardiac
muscle cells. Apoptosis (A) is programmed cell death that is often
physiologic.
**4.** A client has a chronic infection that has caused the normal ciliated
columnar epithelium of the bronchi to be replaced by stratified squamous
epithelium. This cellular adaptation is called:
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
, **Correct Answer:** C) Metaplasia
**Rationale:** Metaplasia is the reversible replacement of one differentiated
cell type with another. Chronic irritation (such as from smoking or infection)
can cause the airway epithelium to change from ciliated columnar to
stratified squamous epithelium to better withstand the irritant, but this
change results in loss of protective ciliary function.
**5.** Which of the following is a key characteristic that distinguishes
malignant tumors from benign tumors?
A) Malignant tumors are encapsulated
B) Malignant tumors are well-differentiated
C) Malignant tumors invade surrounding tissues and metastasize
D) Malignant tumors grow slowly
**Correct Answer:** C) Malignant tumors invade surrounding tissues and
metastasize
**Rationale:** Malignant (cancerous) tumors are characterized by invasion of
surrounding tissues, metastasis (spread to distant sites), and lack of
differentiation (anaplasia). Benign tumors are typically encapsulated, well-
differentiated, grow slowly, and do not metastasize.
**6.** A nurse is teaching a client about the risk factors for cancer. Which of
the following is an example of a chemical carcinogen?
A) Ultraviolet radiation
B) Human papillomavirus (HPV)
