Davis Advantage for Pathophysiology 3rd Edition Practice Questions | Nursing Pathophysiology Clinical Judgment & Exam Prep
DAVIS ADVANTAGE FOR PATHOPHYSIOLOGY 3RD EDITION
PRACTICE QUESTIONS | NURSING PATHOPHYSIOLOGY
CLINICAL JUDGMENT & EXAM PREP
UNIT 1: THE CELL
CHAPTER 1: THE CELL IN HEALTH AND ILLNESS
CELL STRUCTURE AND FUNCTION
20 ORIGINAL PRACTICE QUESTIONS
Practice Questions
Question 1 (Multiple Choice)
A nurse is reviewing metabolic processes in hypoxic myocardial tissue. Which pathophysiological
consequence occurs when cells are forced to rely on anaerobic metabolism due to lack of
oxygen?
• A) Increased production of adenosine triphosphate (ATP) via oxidative phosphorylation
• B) Lactic acid accumulation leading to cellular acidosis and membrane damage
• C) Enhanced activity of the active Na⁺/K⁺ ATPase pump
• D) Pyruvate entry into the Krebs cycle within the mitochondria
Answer: B
Rationale: Under hypoxic conditions, oxidative phosphorylation stops, and cells undergo
anaerobic glycolysis. This pathway produces only 2 ATP per glucose molecule (compared to 34–36
1
,Davis Advantage for Pathophysiology 3rd Edition Practice Questions | Nursing Pathophysiology Clinical Judgment & Exam Prep
ATP aerobically) and yields lactic acid as a byproduct, causing intracellular acidosis, lysosomal
enzyme activation, and membrane degradation.
Question 2 (Multiple Choice)
Which organelle contains digestive enzymes responsible for autolysis during cellular degradation
and phagocytosis of foreign pathogens?
• A) Peroxisome
• B) Lysosome
• C) Ribosome
• D) Golgi apparatus
Answer: B
Rationale: Lysosomes contain hydrolytic (digestive) enzymes that degrade cellular waste, foreign
debris, and pathogens ingested by phagocytosis. In severe ischemic cell injury, lysosomal
membranes rupture, releasing enzymes that autolyze the cell.
Question 3 (Multiple Choice)
A client with severe arterial occlusion in the lower extremity experiences profound cellular
hypoxia. Which downstream effect occurs due to failure of the Na⁺/K⁺ ATPase pump?
• A) Sodium leaves the cell, causing cellular shrinkage.
• B) Calcium is actively pumped out into the extracellular fluid.
• C) Sodium and water enter the cell, causing intracellular swelling.
• D) Potassium accumulates intracellularly, lowering resting membrane potential.
Answer: C
Rationale: The Na⁺/K⁺ ATPase pump requires ATP to pump 3 Na⁺ out and 2 K⁺ in. When ATP is
depleted during hypoxia, the pump fails, allowing Na⁺ to flood into the cell. Water passively
follows sodium (osmosis), causing cell swelling (cloudy swelling/hydropic change).
2
,Davis Advantage for Pathophysiology 3rd Edition Practice Questions | Nursing Pathophysiology Clinical Judgment & Exam Prep
Question 4 (Select All That Apply)
Which of the following cellular adaptation patterns represent non-neoplastic responses to
persistent irritation or demand? (Select all that apply.)
• A) Hypertrophy
• B) Hyperplasia
• C) Metaplasia
• D) Anaplasia
• E) Atrophy
Answer: A, B, C, E
Rationale: Hypertrophy (increase in cell size), hyperplasia (increase in cell number), metaplasia
(replacement of one adult cell type by another), and atrophy (decrease in cell size) are adaptive
cellular responses. Anaplasia refers to poorly differentiated, malignant cellular changes and is
NOT an adaptive process.
Question 5 (Multiple Choice)
A long-term cigarette smoker has a bronchial biopsy showing replacement of normal ciliated
pseudostratified columnar epithelium with stratified squamous epithelium. Which adaptive
change does this illustrate?
• A) Dysplasia
• B) Metaplasia
• C) Hyperplasia
• D) Atrophy
Answer: B
3
, Davis Advantage for Pathophysiology 3rd Edition Practice Questions | Nursing Pathophysiology Clinical Judgment & Exam Prep
Rationale: Metaplasia is the reversible replacement of one mature cell type by another that is
better able to withstand chronic irritation/stress. In smokers, fragile ciliated columnar epithelial
cells are replaced by tougher, non-ciliated stratified squamous cells.
Question 6 (Multiple Choice)
What key feature distinguishes apoptosis from necrosis?
• A) Apoptosis induces a profound acute inflammatory reaction.
• B) Necrosis is a programmed, gene-regulated process of cell suicide.
• C) Apoptosis is controlled cell destruction that avoids inflammatory tissue damage.
• D) Necrosis results in intact cellular membranes and phagocytosis without cell lysis.
Answer: C
Rationale: Apoptosis is programmed cell death where apoptotic bodies are neatly phagocytosed
without spilling intracellular contents, avoiding inflammation. Necrosis is unregulated cell death
due to injury, characterized by membrane disruption, cellular lysis, and significant local
inflammation.
Question 7 (Multiple Choice)
Which organelle is primarily responsible for lipid synthesis, steroid hormone production, and
intracellular calcium storage?
• A) Rough Endoplasmic Reticulum
• B) Smooth Endoplasmic Reticulum
• C) Golgi Apparatus
• D) Nucleolus
Answer: B
4
DAVIS ADVANTAGE FOR PATHOPHYSIOLOGY 3RD EDITION
PRACTICE QUESTIONS | NURSING PATHOPHYSIOLOGY
CLINICAL JUDGMENT & EXAM PREP
UNIT 1: THE CELL
CHAPTER 1: THE CELL IN HEALTH AND ILLNESS
CELL STRUCTURE AND FUNCTION
20 ORIGINAL PRACTICE QUESTIONS
Practice Questions
Question 1 (Multiple Choice)
A nurse is reviewing metabolic processes in hypoxic myocardial tissue. Which pathophysiological
consequence occurs when cells are forced to rely on anaerobic metabolism due to lack of
oxygen?
• A) Increased production of adenosine triphosphate (ATP) via oxidative phosphorylation
• B) Lactic acid accumulation leading to cellular acidosis and membrane damage
• C) Enhanced activity of the active Na⁺/K⁺ ATPase pump
• D) Pyruvate entry into the Krebs cycle within the mitochondria
Answer: B
Rationale: Under hypoxic conditions, oxidative phosphorylation stops, and cells undergo
anaerobic glycolysis. This pathway produces only 2 ATP per glucose molecule (compared to 34–36
1
,Davis Advantage for Pathophysiology 3rd Edition Practice Questions | Nursing Pathophysiology Clinical Judgment & Exam Prep
ATP aerobically) and yields lactic acid as a byproduct, causing intracellular acidosis, lysosomal
enzyme activation, and membrane degradation.
Question 2 (Multiple Choice)
Which organelle contains digestive enzymes responsible for autolysis during cellular degradation
and phagocytosis of foreign pathogens?
• A) Peroxisome
• B) Lysosome
• C) Ribosome
• D) Golgi apparatus
Answer: B
Rationale: Lysosomes contain hydrolytic (digestive) enzymes that degrade cellular waste, foreign
debris, and pathogens ingested by phagocytosis. In severe ischemic cell injury, lysosomal
membranes rupture, releasing enzymes that autolyze the cell.
Question 3 (Multiple Choice)
A client with severe arterial occlusion in the lower extremity experiences profound cellular
hypoxia. Which downstream effect occurs due to failure of the Na⁺/K⁺ ATPase pump?
• A) Sodium leaves the cell, causing cellular shrinkage.
• B) Calcium is actively pumped out into the extracellular fluid.
• C) Sodium and water enter the cell, causing intracellular swelling.
• D) Potassium accumulates intracellularly, lowering resting membrane potential.
Answer: C
Rationale: The Na⁺/K⁺ ATPase pump requires ATP to pump 3 Na⁺ out and 2 K⁺ in. When ATP is
depleted during hypoxia, the pump fails, allowing Na⁺ to flood into the cell. Water passively
follows sodium (osmosis), causing cell swelling (cloudy swelling/hydropic change).
2
,Davis Advantage for Pathophysiology 3rd Edition Practice Questions | Nursing Pathophysiology Clinical Judgment & Exam Prep
Question 4 (Select All That Apply)
Which of the following cellular adaptation patterns represent non-neoplastic responses to
persistent irritation or demand? (Select all that apply.)
• A) Hypertrophy
• B) Hyperplasia
• C) Metaplasia
• D) Anaplasia
• E) Atrophy
Answer: A, B, C, E
Rationale: Hypertrophy (increase in cell size), hyperplasia (increase in cell number), metaplasia
(replacement of one adult cell type by another), and atrophy (decrease in cell size) are adaptive
cellular responses. Anaplasia refers to poorly differentiated, malignant cellular changes and is
NOT an adaptive process.
Question 5 (Multiple Choice)
A long-term cigarette smoker has a bronchial biopsy showing replacement of normal ciliated
pseudostratified columnar epithelium with stratified squamous epithelium. Which adaptive
change does this illustrate?
• A) Dysplasia
• B) Metaplasia
• C) Hyperplasia
• D) Atrophy
Answer: B
3
, Davis Advantage for Pathophysiology 3rd Edition Practice Questions | Nursing Pathophysiology Clinical Judgment & Exam Prep
Rationale: Metaplasia is the reversible replacement of one mature cell type by another that is
better able to withstand chronic irritation/stress. In smokers, fragile ciliated columnar epithelial
cells are replaced by tougher, non-ciliated stratified squamous cells.
Question 6 (Multiple Choice)
What key feature distinguishes apoptosis from necrosis?
• A) Apoptosis induces a profound acute inflammatory reaction.
• B) Necrosis is a programmed, gene-regulated process of cell suicide.
• C) Apoptosis is controlled cell destruction that avoids inflammatory tissue damage.
• D) Necrosis results in intact cellular membranes and phagocytosis without cell lysis.
Answer: C
Rationale: Apoptosis is programmed cell death where apoptotic bodies are neatly phagocytosed
without spilling intracellular contents, avoiding inflammation. Necrosis is unregulated cell death
due to injury, characterized by membrane disruption, cellular lysis, and significant local
inflammation.
Question 7 (Multiple Choice)
Which organelle is primarily responsible for lipid synthesis, steroid hormone production, and
intracellular calcium storage?
• A) Rough Endoplasmic Reticulum
• B) Smooth Endoplasmic Reticulum
• C) Golgi Apparatus
• D) Nucleolus
Answer: B
4
