SCI225 Pathophysiology Midterm Exam Comprehensive Guide
2026/2027 UPDATE |Nightingale
SECTION 1: CELLULAR INJURY, ADAPTATION & DEATH
(Questions 1-20)
Question 1
What is the primary mechanism of cellular injury in hypoxia?
A) Increased ATP production
B) Oxidative stress from free radicals
C) Impaired mitochondrial function leading to ATP depletion
D) Excessive calcium influx
Correct Answer: C
Rationale: Hypoxia impairs oxidative phosphorylation in the mitochondria, leading to
ATP depletion. This disrupts cellular functions like ion pumps, causing swelling and
injury . Increased ATP production (A) is incorrect; oxidative stress (B) and calcium influx
(D) are secondary events that occur later in the injury cascade.
Question 2
The early dilation (swelling) of the cell's endoplasmic reticulum results in:
A) Increased protein synthesis
B) Ribosomes detaching from the rough endoplasmic reticulum, reducing protein
synthesis
,C) Enhanced cellular metabolism
D) Increased ATP production
Correct Answer: B
Rationale: Early cell swelling causes ribosomes to detach from the rough endoplasmic
reticulum, reducing protein synthesis. This is a hallmark of reversible cell injury . Protein
synthesis is decreased, not increased (A), and ATP production is impaired, not enhanced
(D).
Question 3
Reversible cell injury means:
A) Permanent damage has occurred
B) Cell death is inevitable
C) Recovery is possible if the cause is removed
D) Genetic mutation has occurred
Correct Answer: C
Rationale: Reversible cell injury occurs when the cell can return to normal function if the
damaging stimulus is removed. With prolonged or severe injury, irreversible injury and
cell death (necrosis) occur . This concept is fundamental to understanding the spectrum
of cellular response to injury.
Question 4
Which organ is most frequently affected by chronic alcohol injury?
,A) Brain
B) Kidney
C) Liver
D) Heart
Correct Answer: C
Rationale: The liver is the primary site of alcohol metabolism and is most vulnerable to
chronic alcohol injury, leading to a spectrum of conditions including fatty liver, alcoholic
hepatitis, and cirrhosis .
Question 5
Pathologic cell death that triggers an inflammatory response is known as:
A) Apoptosis
B) Necrosis
C) Atrophy
D) Metaplasia
Correct Answer: B
Rationale: Necrosis is pathologic cell death that triggers an inflammatory response due
to the release of cellular contents . Apoptosis (A) is programmed cell death that does
not cause inflammation.
Question 6
Programmed cell death that does not cause inflammation is known as:
, A) Necrosis
B) Apoptosis
C) Atrophy
D) Metaplasia
Correct Answer: B
Rationale: Apoptosis is programmed cell death that does not trigger an inflammatory
response. It can be either physiologic (normal tissue turnover) or pathologic .
Question 7
The hallmark feature of apoptosis is:
A) Cellular swelling
B) Chromatin condensation
C) Membrane rupture
D) Lysosomal leakage
Correct Answer: B
Rationale: Chromatin condensation is a hallmark of apoptosis (programmed cell
death) . Cellular swelling (A), membrane rupture (C), and lysosomal leakage (D) are
features of necrosis, not apoptosis.
Question 8
A patient with a myocardial infarction has coagulative necrosis. The nurse expects this
type of necrosis because:
2026/2027 UPDATE |Nightingale
SECTION 1: CELLULAR INJURY, ADAPTATION & DEATH
(Questions 1-20)
Question 1
What is the primary mechanism of cellular injury in hypoxia?
A) Increased ATP production
B) Oxidative stress from free radicals
C) Impaired mitochondrial function leading to ATP depletion
D) Excessive calcium influx
Correct Answer: C
Rationale: Hypoxia impairs oxidative phosphorylation in the mitochondria, leading to
ATP depletion. This disrupts cellular functions like ion pumps, causing swelling and
injury . Increased ATP production (A) is incorrect; oxidative stress (B) and calcium influx
(D) are secondary events that occur later in the injury cascade.
Question 2
The early dilation (swelling) of the cell's endoplasmic reticulum results in:
A) Increased protein synthesis
B) Ribosomes detaching from the rough endoplasmic reticulum, reducing protein
synthesis
,C) Enhanced cellular metabolism
D) Increased ATP production
Correct Answer: B
Rationale: Early cell swelling causes ribosomes to detach from the rough endoplasmic
reticulum, reducing protein synthesis. This is a hallmark of reversible cell injury . Protein
synthesis is decreased, not increased (A), and ATP production is impaired, not enhanced
(D).
Question 3
Reversible cell injury means:
A) Permanent damage has occurred
B) Cell death is inevitable
C) Recovery is possible if the cause is removed
D) Genetic mutation has occurred
Correct Answer: C
Rationale: Reversible cell injury occurs when the cell can return to normal function if the
damaging stimulus is removed. With prolonged or severe injury, irreversible injury and
cell death (necrosis) occur . This concept is fundamental to understanding the spectrum
of cellular response to injury.
Question 4
Which organ is most frequently affected by chronic alcohol injury?
,A) Brain
B) Kidney
C) Liver
D) Heart
Correct Answer: C
Rationale: The liver is the primary site of alcohol metabolism and is most vulnerable to
chronic alcohol injury, leading to a spectrum of conditions including fatty liver, alcoholic
hepatitis, and cirrhosis .
Question 5
Pathologic cell death that triggers an inflammatory response is known as:
A) Apoptosis
B) Necrosis
C) Atrophy
D) Metaplasia
Correct Answer: B
Rationale: Necrosis is pathologic cell death that triggers an inflammatory response due
to the release of cellular contents . Apoptosis (A) is programmed cell death that does
not cause inflammation.
Question 6
Programmed cell death that does not cause inflammation is known as:
, A) Necrosis
B) Apoptosis
C) Atrophy
D) Metaplasia
Correct Answer: B
Rationale: Apoptosis is programmed cell death that does not trigger an inflammatory
response. It can be either physiologic (normal tissue turnover) or pathologic .
Question 7
The hallmark feature of apoptosis is:
A) Cellular swelling
B) Chromatin condensation
C) Membrane rupture
D) Lysosomal leakage
Correct Answer: B
Rationale: Chromatin condensation is a hallmark of apoptosis (programmed cell
death) . Cellular swelling (A), membrane rupture (C), and lysosomal leakage (D) are
features of necrosis, not apoptosis.
Question 8
A patient with a myocardial infarction has coagulative necrosis. The nurse expects this
type of necrosis because:
