NUR 2063 Pathophysiology
Comprehensive Final Exam with
questions and verified correct
answers updated 2026
Questions 1–25: Cellular Injury, Adaptation, Inflammation, Immunity, and Fluid/Electrolyte/Acid-
Base (Hans)
1. Which cellular adaptation involves an increase in the size of cells in response to increased
workload?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
correct answer: B
Rationale: Hypertrophy is an increase in cell size (e.g., left ventricular hypertrophy in chronic
hypertension). It occurs when cells cannot divide but must accommodate increased demand.
Hyperplasia is increased cell number; atrophy is decreased size; metaplasia is cell type replacement.
2. What is the primary mechanism of cellular injury in ischemia?
A. Increased ATP production
B. Decreased oxygen delivery leading to failure of the sodium-potassium pump
C. Excessive protein synthesis
D. Enhanced lysosomal activity without membrane damage
correct answer: B
Rationale: Ischemia reduces oxygen, impairing oxidative phosphorylation and ATP synthesis. Failure
of the Na+/K+ ATPase pump causes sodium influx, osmotic swelling, calcium influx, and eventual
membrane damage if prolonged.
3. Which of the following best describes apoptosis?
, A. Uncontrolled cell death resulting in inflammation
B. Programmed cell death that is orderly and does not cause inflammation
C. Cellular swelling due to hypotonic solutions
D. Increase in cell number due to hormonal stimulation
correct answer: B
Rationale: Apoptosis is ATP-dependent, genetically programmed cell death characterized by cell
shrinkage, chromatin condensation, and formation of apoptotic bodies that are phagocytosed
without eliciting inflammation. It is physiologic (e.g., embryonic development) or pathologic.
4. A patient with long-term alcohol abuse develops enlarged liver cells filled with fat. This is an
example of:
A. Dysplasia
B. Steatosis (fatty change)
C. Caseous necrosis
D. Liquefactive necrosis
correct answer: B
Rationale: Steatosis is reversible accumulation of fat in cells (especially hepatocytes) due to impaired
lipid metabolism from toxins such as alcohol. It is a form of cellular injury but not necrosis.
5. Which ion accumulation is most closely associated with irreversible cell injury?
A. Potassium
B. Calcium
C. Magnesium
D. Chloride
correct answer: B
Rationale: Massive calcium influx activates destructive enzymes (phospholipases, proteases,
ATPases, endonucleases), causing membrane damage, mitochondrial dysfunction, and nuclear
fragmentation—hallmarks of irreversible injury.
6. Hypoxic cell injury primarily affects which organelle first?
Comprehensive Final Exam with
questions and verified correct
answers updated 2026
Questions 1–25: Cellular Injury, Adaptation, Inflammation, Immunity, and Fluid/Electrolyte/Acid-
Base (Hans)
1. Which cellular adaptation involves an increase in the size of cells in response to increased
workload?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
correct answer: B
Rationale: Hypertrophy is an increase in cell size (e.g., left ventricular hypertrophy in chronic
hypertension). It occurs when cells cannot divide but must accommodate increased demand.
Hyperplasia is increased cell number; atrophy is decreased size; metaplasia is cell type replacement.
2. What is the primary mechanism of cellular injury in ischemia?
A. Increased ATP production
B. Decreased oxygen delivery leading to failure of the sodium-potassium pump
C. Excessive protein synthesis
D. Enhanced lysosomal activity without membrane damage
correct answer: B
Rationale: Ischemia reduces oxygen, impairing oxidative phosphorylation and ATP synthesis. Failure
of the Na+/K+ ATPase pump causes sodium influx, osmotic swelling, calcium influx, and eventual
membrane damage if prolonged.
3. Which of the following best describes apoptosis?
, A. Uncontrolled cell death resulting in inflammation
B. Programmed cell death that is orderly and does not cause inflammation
C. Cellular swelling due to hypotonic solutions
D. Increase in cell number due to hormonal stimulation
correct answer: B
Rationale: Apoptosis is ATP-dependent, genetically programmed cell death characterized by cell
shrinkage, chromatin condensation, and formation of apoptotic bodies that are phagocytosed
without eliciting inflammation. It is physiologic (e.g., embryonic development) or pathologic.
4. A patient with long-term alcohol abuse develops enlarged liver cells filled with fat. This is an
example of:
A. Dysplasia
B. Steatosis (fatty change)
C. Caseous necrosis
D. Liquefactive necrosis
correct answer: B
Rationale: Steatosis is reversible accumulation of fat in cells (especially hepatocytes) due to impaired
lipid metabolism from toxins such as alcohol. It is a form of cellular injury but not necrosis.
5. Which ion accumulation is most closely associated with irreversible cell injury?
A. Potassium
B. Calcium
C. Magnesium
D. Chloride
correct answer: B
Rationale: Massive calcium influx activates destructive enzymes (phospholipases, proteases,
ATPases, endonucleases), causing membrane damage, mitochondrial dysfunction, and nuclear
fragmentation—hallmarks of irreversible injury.
6. Hypoxic cell injury primarily affects which organelle first?
