Walden NURS 3020 Pathophysiology
Midterm Exam Practice Examination
2026–2027 Comprehensive Question
Practice Test with Answers & Rationales
Free Pdf Acces
1. Which cellular adaptation occurs when a tissue increases in cell size rather than cell
number?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Answer: B. Hypertrophy
Rationale: Hypertrophy is an increase in the size of individual cells, resulting in enlargement of
the affected tissue or organ. Hyperplasia involves an increase in cell number.
2. A patient with chronic hypertension develops an enlarged left ventricle. Which cellular
adaptation best explains this finding?
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
Answer: A. Hypertrophy
Rationale: Chronic pressure overload from hypertension increases the workload of cardiac
muscle. Cardiac myocytes enlarge, producing ventricular hypertrophy.
3. Which cellular change is generally considered reversible when the underlying stress is
removed?
,A. Necrosis
B. Apoptosis
C. Cellular adaptation
D. Malignant transformation
Answer: C. Cellular adaptation
Rationale: Cells can adapt to changes in workload or environmental conditions. If the stress is
removed before irreversible injury occurs, the cells may return toward normal function.
4. A patient experiences prolonged tissue ischemia. Which cellular consequence is most likely
to occur first?
A. Increased ATP production
B. Decreased ATP production
C. Increased oxidative phosphorylation
D. Increased protein synthesis
Answer: B. Decreased ATP production
Rationale: Ischemia reduces oxygen delivery to tissues. Because aerobic metabolism requires
oxygen, ATP production falls, impairing energy-dependent cellular processes.
5. Which finding is most characteristic of necrosis?
A. Programmed cell death without inflammation
B. Cell shrinkage with formation of apoptotic bodies
C. Cell swelling and membrane disruption
D. Normal cellular function after cell death
Answer: C. Cell swelling and membrane disruption
Rationale: Necrosis commonly involves cellular swelling, membrane disruption, leakage of
intracellular contents, and an inflammatory response.
6. Apoptosis differs from necrosis because apoptosis is primarily:
A. Uncontrolled cell destruction
B. Programmed cell death
C. Associated with severe inflammation
D. Caused exclusively by infection
Answer: B. Programmed cell death
,Rationale: Apoptosis is a regulated form of cell death used to eliminate damaged, unnecessary,
or aging cells without the extensive inflammatory response typically associated with necrosis.
7. Which laboratory finding is most consistent with an acute inflammatory response?
A. Decreased white blood cell count
B. Increased inflammatory mediators
C. Decreased vascular permeability
D. Reduced blood flow to the affected area
Answer: B. Increased inflammatory mediators
Rationale: Acute inflammation involves mediators such as histamine, prostaglandins,
leukotrienes, and cytokines that promote vasodilation, increased vascular permeability, and
leukocyte recruitment.
8. What is the primary purpose of increased vascular permeability during inflammation?
A. Prevent immune cells from entering tissues
B. Allow plasma proteins and leukocytes to reach injured tissue
C. Reduce delivery of oxygen to the tissue
D. Prevent formation of edema
Answer: B. Allow plasma proteins and leukocytes to reach injured tissue
Rationale: Increased vascular permeability permits fluid, proteins, and immune cells to move
from the circulation into damaged tissue.
9. Which leukocyte is typically the predominant cell during the early phase of acute
inflammation?
A. Neutrophil
B. Lymphocyte
C. Eosinophil
D. Monocyte
Answer: A. Neutrophil
Rationale: Neutrophils are among the first leukocytes recruited to sites of acute inflammation
and are important for phagocytosis and destruction of pathogens.
, 10. A patient develops redness and warmth around a superficial wound. Which process
primarily causes these findings?
A. Vasoconstriction
B. Vasodilation
C. Decreased blood flow
D. Reduced capillary permeability
Answer: B. Vasodilation
Rationale: Vasodilation increases local blood flow, producing the classic inflammatory findings
of redness and warmth.
11. Which immune cell produces antibodies?
A. T lymphocyte
B. Neutrophil
C. Plasma cell
D. Natural killer cell
Answer: C. Plasma cell
Rationale: Activated B lymphocytes differentiate into plasma cells, which produce and secrete
antibodies.
12. Which component of the immune system is primarily responsible for cell-mediated
immunity?
A. T lymphocytes
B. Erythrocytes
C. Platelets
D. Plasma proteins only
Answer: A. T lymphocytes
Rationale: T lymphocytes are central to cell-mediated immunity. Different T-cell subsets
coordinate immune responses or directly destroy infected or abnormal cells.
13. A patient develops wheezing, facial swelling, and hypotension immediately after
exposure to an allergen. Which mechanism is most likely responsible?
A. Type I hypersensitivity
B. Type II hypersensitivity
Midterm Exam Practice Examination
2026–2027 Comprehensive Question
Practice Test with Answers & Rationales
Free Pdf Acces
1. Which cellular adaptation occurs when a tissue increases in cell size rather than cell
number?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Answer: B. Hypertrophy
Rationale: Hypertrophy is an increase in the size of individual cells, resulting in enlargement of
the affected tissue or organ. Hyperplasia involves an increase in cell number.
2. A patient with chronic hypertension develops an enlarged left ventricle. Which cellular
adaptation best explains this finding?
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
Answer: A. Hypertrophy
Rationale: Chronic pressure overload from hypertension increases the workload of cardiac
muscle. Cardiac myocytes enlarge, producing ventricular hypertrophy.
3. Which cellular change is generally considered reversible when the underlying stress is
removed?
,A. Necrosis
B. Apoptosis
C. Cellular adaptation
D. Malignant transformation
Answer: C. Cellular adaptation
Rationale: Cells can adapt to changes in workload or environmental conditions. If the stress is
removed before irreversible injury occurs, the cells may return toward normal function.
4. A patient experiences prolonged tissue ischemia. Which cellular consequence is most likely
to occur first?
A. Increased ATP production
B. Decreased ATP production
C. Increased oxidative phosphorylation
D. Increased protein synthesis
Answer: B. Decreased ATP production
Rationale: Ischemia reduces oxygen delivery to tissues. Because aerobic metabolism requires
oxygen, ATP production falls, impairing energy-dependent cellular processes.
5. Which finding is most characteristic of necrosis?
A. Programmed cell death without inflammation
B. Cell shrinkage with formation of apoptotic bodies
C. Cell swelling and membrane disruption
D. Normal cellular function after cell death
Answer: C. Cell swelling and membrane disruption
Rationale: Necrosis commonly involves cellular swelling, membrane disruption, leakage of
intracellular contents, and an inflammatory response.
6. Apoptosis differs from necrosis because apoptosis is primarily:
A. Uncontrolled cell destruction
B. Programmed cell death
C. Associated with severe inflammation
D. Caused exclusively by infection
Answer: B. Programmed cell death
,Rationale: Apoptosis is a regulated form of cell death used to eliminate damaged, unnecessary,
or aging cells without the extensive inflammatory response typically associated with necrosis.
7. Which laboratory finding is most consistent with an acute inflammatory response?
A. Decreased white blood cell count
B. Increased inflammatory mediators
C. Decreased vascular permeability
D. Reduced blood flow to the affected area
Answer: B. Increased inflammatory mediators
Rationale: Acute inflammation involves mediators such as histamine, prostaglandins,
leukotrienes, and cytokines that promote vasodilation, increased vascular permeability, and
leukocyte recruitment.
8. What is the primary purpose of increased vascular permeability during inflammation?
A. Prevent immune cells from entering tissues
B. Allow plasma proteins and leukocytes to reach injured tissue
C. Reduce delivery of oxygen to the tissue
D. Prevent formation of edema
Answer: B. Allow plasma proteins and leukocytes to reach injured tissue
Rationale: Increased vascular permeability permits fluid, proteins, and immune cells to move
from the circulation into damaged tissue.
9. Which leukocyte is typically the predominant cell during the early phase of acute
inflammation?
A. Neutrophil
B. Lymphocyte
C. Eosinophil
D. Monocyte
Answer: A. Neutrophil
Rationale: Neutrophils are among the first leukocytes recruited to sites of acute inflammation
and are important for phagocytosis and destruction of pathogens.
, 10. A patient develops redness and warmth around a superficial wound. Which process
primarily causes these findings?
A. Vasoconstriction
B. Vasodilation
C. Decreased blood flow
D. Reduced capillary permeability
Answer: B. Vasodilation
Rationale: Vasodilation increases local blood flow, producing the classic inflammatory findings
of redness and warmth.
11. Which immune cell produces antibodies?
A. T lymphocyte
B. Neutrophil
C. Plasma cell
D. Natural killer cell
Answer: C. Plasma cell
Rationale: Activated B lymphocytes differentiate into plasma cells, which produce and secrete
antibodies.
12. Which component of the immune system is primarily responsible for cell-mediated
immunity?
A. T lymphocytes
B. Erythrocytes
C. Platelets
D. Plasma proteins only
Answer: A. T lymphocytes
Rationale: T lymphocytes are central to cell-mediated immunity. Different T-cell subsets
coordinate immune responses or directly destroy infected or abnormal cells.
13. A patient develops wheezing, facial swelling, and hypotension immediately after
exposure to an allergen. Which mechanism is most likely responsible?
A. Type I hypersensitivity
B. Type II hypersensitivity
