Chamberlain NR-
283
Pathophysiology
Nursing Exam
Total questions: 100 | Recommended time: 120 minutes
Section 1: Cellular Adaptation, Injury, and Death (Questions
1–20)
1. Which of the following is the chief function of nerve cells?
A. Movement
B. Conductivity
C. Metabolic absorption
D. Excretion
Rationale: Conductivity is the chief function of nerve cells; they respond to stimuli by
generating and transmitting electrical impulses. Movement is the chief function of
muscle cells, metabolic absorption is a function of many cell types, and excretion refers
to the removal of cellular waste products.
2. Which of the following is the best description of the cellular adaptation that
occurs when a patient with chronic heart failure develops cardiomegaly?
,A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Rationale: Hypertension increases afterload, causing the left ventricle to pump against
higher pressure. Myocardial cells increase in size (hypertrophy) as an adaptive response,
rather than increasing in number (hyperplasia, which occurs in dividing cells). This
initially compensates, but may eventually lead to diastolic dysfunction.
3. When normal columnar ciliated epithelial cells in the bronchial mucosa are
replaced by stratified squamous epithelium, which type of cellular adaptation is
this?
A. Atrophy
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type by another,
usually less mature cell type. In smokers, normal columnar ciliated epithelial cells are
replaced by stratified squamous epithelium (without mucus secretion and cilia). If the
stimulus is removed, this can be reversed, but it may predispose to malignant
transformation.
4. Which statement about dysplasia is correct?
A. Dysplasia is a common normal cellular adaptation
B. Dysplastic changes can be reversible, but more often progress to malignancy
C. Dysplasia refers to a decrease in cell size
D. Dysplasia refers to an increase in cell number
Rationale: Dysplasia refers to disordered cellular growth and is considered a
precancerous lesion. Mild dysplasia can be reversible if the underlying cause is removed,
but moderate to severe dysplasia often progresses to carcinoma in situ and invasive
malignancy.
5. What happens to cells during ischemia due to decreased ATP production?
A. Cells shrink due to calcium influx
B. Cells shrink due to potassium chloride influx
,C. Cells swell due to sodium chloride influx
D. Cells swell due to nitric oxide influx
Rationale: During ischemia, ATP depletion leads to failure of the Na⁺/K⁺-ATPase pump.
Sodium accumulates intracellularly, water follows, causing cellular swelling (hydropic
change). This is an early reversible change of cell injury.
6. What is the consequence of plasma membrane damage to mitochondria?
A. Enzymatic digestion halts DNA synthesis
B. Calcium influx halts ATP production
C. Decreased ATP production due to sodium influx causing edema
D. Potassium efflux from mitochondria destroys infrastructure
Rationale: Mitochondrial damage allows calcium influx, inhibiting ATP production. This
further promotes cellular injury and may trigger apoptosis or necrosis. Mitochondrial
dysfunction is a key event in irreversible cell injury.
7. Which of the following is the most common cause of cellular injury?
A. Physical factors
B. Chemical injury
C. Ischemia
D. Infection
Rationale: Ischemia (deficient oxygen supply to cells) is the most common cause of
cellular injury. It leads to hypoxia, ATP depletion, and disruption of cellular function,
ultimately leading to cell death.
8. A patient who has been immobilized in a cast for several weeks develops muscle
atrophy. Which of the following is the correct term for this decrease in cell size?
A. Atrophy
B. Hyperplasia
C. Hypertrophy
D. Metaplasia
Rationale: Atrophy is a decrease in cell size due to reduced workload, denervation,
ischemia, malnutrition, or hormonal changes. Atrophic cells may have decreased
function but can often recover if the stressor is removed.
9. Which of the following is the primary function of epithelial cells?
, A. Conductivity
B. Movement
C. Protection and absorption
D. Energy storage
Rationale: The primary functions of epithelial cells are protection and absorption. Nerve
cells are responsible for conductivity, muscle cells for movement, and adipose cells for
energy storage.
10. A patient asks why indoor pollution is worse than outdoor pollution. Which of
the following should the nurse identify as the main indoor pollutant source?
A. Fireplace smoke
B. Radon
C. Benzene
D. Chlorine
Rationale: Indoor pollution is considered more harmful than outdoor pollution, mainly
due to cigarette smoke and radon. Radon is a radioactive gas that can accumulate
indoors and is the second leading cause of lung cancer.
11. Which cells are involved in initiating immune responses in the skin?
A. Langerhans cells
B. Merkel cells
C. Keratinocytes
D. Melanocytes
Rationale: Langerhans cells are dendritic cells in the epidermis that initiate immune
responses by capturing and presenting antigens to T lymphocytes.
12. Which type of cell adaptation occurs in the mammary glands during
pregnancy?
A. Atrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
Rationale: During pregnancy, estrogen and progesterone stimulate proliferation of
mammary gland epithelial cells, leading to breast enlargement. This is an example of
physiological hyperplasia.
283
Pathophysiology
Nursing Exam
Total questions: 100 | Recommended time: 120 minutes
Section 1: Cellular Adaptation, Injury, and Death (Questions
1–20)
1. Which of the following is the chief function of nerve cells?
A. Movement
B. Conductivity
C. Metabolic absorption
D. Excretion
Rationale: Conductivity is the chief function of nerve cells; they respond to stimuli by
generating and transmitting electrical impulses. Movement is the chief function of
muscle cells, metabolic absorption is a function of many cell types, and excretion refers
to the removal of cellular waste products.
2. Which of the following is the best description of the cellular adaptation that
occurs when a patient with chronic heart failure develops cardiomegaly?
,A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Rationale: Hypertension increases afterload, causing the left ventricle to pump against
higher pressure. Myocardial cells increase in size (hypertrophy) as an adaptive response,
rather than increasing in number (hyperplasia, which occurs in dividing cells). This
initially compensates, but may eventually lead to diastolic dysfunction.
3. When normal columnar ciliated epithelial cells in the bronchial mucosa are
replaced by stratified squamous epithelium, which type of cellular adaptation is
this?
A. Atrophy
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type by another,
usually less mature cell type. In smokers, normal columnar ciliated epithelial cells are
replaced by stratified squamous epithelium (without mucus secretion and cilia). If the
stimulus is removed, this can be reversed, but it may predispose to malignant
transformation.
4. Which statement about dysplasia is correct?
A. Dysplasia is a common normal cellular adaptation
B. Dysplastic changes can be reversible, but more often progress to malignancy
C. Dysplasia refers to a decrease in cell size
D. Dysplasia refers to an increase in cell number
Rationale: Dysplasia refers to disordered cellular growth and is considered a
precancerous lesion. Mild dysplasia can be reversible if the underlying cause is removed,
but moderate to severe dysplasia often progresses to carcinoma in situ and invasive
malignancy.
5. What happens to cells during ischemia due to decreased ATP production?
A. Cells shrink due to calcium influx
B. Cells shrink due to potassium chloride influx
,C. Cells swell due to sodium chloride influx
D. Cells swell due to nitric oxide influx
Rationale: During ischemia, ATP depletion leads to failure of the Na⁺/K⁺-ATPase pump.
Sodium accumulates intracellularly, water follows, causing cellular swelling (hydropic
change). This is an early reversible change of cell injury.
6. What is the consequence of plasma membrane damage to mitochondria?
A. Enzymatic digestion halts DNA synthesis
B. Calcium influx halts ATP production
C. Decreased ATP production due to sodium influx causing edema
D. Potassium efflux from mitochondria destroys infrastructure
Rationale: Mitochondrial damage allows calcium influx, inhibiting ATP production. This
further promotes cellular injury and may trigger apoptosis or necrosis. Mitochondrial
dysfunction is a key event in irreversible cell injury.
7. Which of the following is the most common cause of cellular injury?
A. Physical factors
B. Chemical injury
C. Ischemia
D. Infection
Rationale: Ischemia (deficient oxygen supply to cells) is the most common cause of
cellular injury. It leads to hypoxia, ATP depletion, and disruption of cellular function,
ultimately leading to cell death.
8. A patient who has been immobilized in a cast for several weeks develops muscle
atrophy. Which of the following is the correct term for this decrease in cell size?
A. Atrophy
B. Hyperplasia
C. Hypertrophy
D. Metaplasia
Rationale: Atrophy is a decrease in cell size due to reduced workload, denervation,
ischemia, malnutrition, or hormonal changes. Atrophic cells may have decreased
function but can often recover if the stressor is removed.
9. Which of the following is the primary function of epithelial cells?
, A. Conductivity
B. Movement
C. Protection and absorption
D. Energy storage
Rationale: The primary functions of epithelial cells are protection and absorption. Nerve
cells are responsible for conductivity, muscle cells for movement, and adipose cells for
energy storage.
10. A patient asks why indoor pollution is worse than outdoor pollution. Which of
the following should the nurse identify as the main indoor pollutant source?
A. Fireplace smoke
B. Radon
C. Benzene
D. Chlorine
Rationale: Indoor pollution is considered more harmful than outdoor pollution, mainly
due to cigarette smoke and radon. Radon is a radioactive gas that can accumulate
indoors and is the second leading cause of lung cancer.
11. Which cells are involved in initiating immune responses in the skin?
A. Langerhans cells
B. Merkel cells
C. Keratinocytes
D. Melanocytes
Rationale: Langerhans cells are dendritic cells in the epidermis that initiate immune
responses by capturing and presenting antigens to T lymphocytes.
12. Which type of cell adaptation occurs in the mammary glands during
pregnancy?
A. Atrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
Rationale: During pregnancy, estrogen and progesterone stimulate proliferation of
mammary gland epithelial cells, leading to breast enlargement. This is an example of
physiological hyperplasia.
