WGU D236 OBJECTIVE ASSESSMENT
PATHOPHYSIOLOGY EXAM 2026
QUESTIONS AND ANSWERS
1. A patient with chronic gastroesophageal reflux disease (GERD) undergoes a biopsy showing
that the normal stratified squamous epithelium of the esophagus has been replaced by
simple columnar epithelium. What is this cellular adaptation called?
A. Metaplasia
B. Dysplasia
C. Hyperplasia
D. Hypertrophy
Answer: A
Conceptual Explanation: Metaplasia is the reversible replacement of one mature cell type
by another mature cell type, often as a response to chronic irritation, such as acid reflux in
Barrett’s esophagus.
2. Which of the following processes characterizes programmed cell death without the release
of inflammatory intracellular contents?
A. Autophagy
,B. Apoptosis
C. Liquefactive necrosis
D. Coagulative necrosis
Answer: B
Conceptual Explanation: Apoptosis is a distinct type of programmed cell death that is
highly regulated and does not trigger an inflammatory response, unlike necrosis.
3. An arterial blood gas (ABG) report shows pH 7.25, PaCO2 55 mmHg, and HCO3- 26 mEq/L.
Which acid-base imbalance does this represent?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis, and a PaCO2 above 45
mmHg with a normal or slightly elevated bicarbonate indicates the primary cause is
respiratory retention of CO2.
4. In the Renin-Angiotensin-Aldosterone System (RAAS), what is the primary stimulus for the
release of renin by the juxtaglomerular cells?
A. Increased blood pressure
, B. High sodium intake
C. Hypokalemia
D. Decreased renal perfusion
Answer: D
Conceptual Explanation: Renin is released in response to decreased blood pressure or
decreased renal blood flow (perfusion) to help restore blood volume and pressure.
5. Which electrolyte imbalance is most likely to cause tall, peaked T waves on an
electrocardiogram (ECG)?
A. Hyponatremia
B. Hypocalcemia
C. Hyperkalemia
D. Hypermagnesemia
Answer: C
Conceptual Explanation: Hyperkalemia (high potassium) affects cardiac repolarization,
leading to characteristic tall, peaked T waves, and can progress to fatal arrhythmias.
6. A patient presents with positive Trousseau and Chvostek signs. Which electrolyte
abnormality should the nurse anticipate?
A. Hypercalcemia
B. Hypocalcemia
PATHOPHYSIOLOGY EXAM 2026
QUESTIONS AND ANSWERS
1. A patient with chronic gastroesophageal reflux disease (GERD) undergoes a biopsy showing
that the normal stratified squamous epithelium of the esophagus has been replaced by
simple columnar epithelium. What is this cellular adaptation called?
A. Metaplasia
B. Dysplasia
C. Hyperplasia
D. Hypertrophy
Answer: A
Conceptual Explanation: Metaplasia is the reversible replacement of one mature cell type
by another mature cell type, often as a response to chronic irritation, such as acid reflux in
Barrett’s esophagus.
2. Which of the following processes characterizes programmed cell death without the release
of inflammatory intracellular contents?
A. Autophagy
,B. Apoptosis
C. Liquefactive necrosis
D. Coagulative necrosis
Answer: B
Conceptual Explanation: Apoptosis is a distinct type of programmed cell death that is
highly regulated and does not trigger an inflammatory response, unlike necrosis.
3. An arterial blood gas (ABG) report shows pH 7.25, PaCO2 55 mmHg, and HCO3- 26 mEq/L.
Which acid-base imbalance does this represent?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis, and a PaCO2 above 45
mmHg with a normal or slightly elevated bicarbonate indicates the primary cause is
respiratory retention of CO2.
4. In the Renin-Angiotensin-Aldosterone System (RAAS), what is the primary stimulus for the
release of renin by the juxtaglomerular cells?
A. Increased blood pressure
, B. High sodium intake
C. Hypokalemia
D. Decreased renal perfusion
Answer: D
Conceptual Explanation: Renin is released in response to decreased blood pressure or
decreased renal blood flow (perfusion) to help restore blood volume and pressure.
5. Which electrolyte imbalance is most likely to cause tall, peaked T waves on an
electrocardiogram (ECG)?
A. Hyponatremia
B. Hypocalcemia
C. Hyperkalemia
D. Hypermagnesemia
Answer: C
Conceptual Explanation: Hyperkalemia (high potassium) affects cardiac repolarization,
leading to characteristic tall, peaked T waves, and can progress to fatal arrhythmias.
6. A patient presents with positive Trousseau and Chvostek signs. Which electrolyte
abnormality should the nurse anticipate?
A. Hypercalcemia
B. Hypocalcemia
