Pathophysiology Midterm Exam Actual Exam 2026/2027 |
Complete Exam-Style Questions with Detailed Rationales |
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Cellular Function, Adaptation, and Injury**
Q1: A nursing student is reviewing the functions of cellular organelles. Which organelle is
primarily responsible for generating the majority of the cell’s adenosine triphosphate (ATP)
through oxidative phosphorylation?
A. Golgi apparatus
B. Mitochondria [CORRECT]
C. Rough endoplasmic reticulum
D. Lysosome
Correct Answer: B
Rationale: This choice is correct because the mitochondria are known as the powerhouses of
the cell, specifically housing the electron transport chain where the bulk of ATP is produced.
Q2: A patient with a long-standing history of uncontrolled hypertension is found to have an
enlarged left ventricle on an echocardiogram. This finding is best described as which type of
cellular adaptation?
A. Hyperplasia
B. Metaplasia
C. Hypertrophy [CORRECT]
D. Dysplasia
Correct Answer: C
Rationale: The best answer is C. This matches the principle that increased workload on the
heart muscle causes individual cardiac muscle cells to increase in size, leading to
hypertrophy without an increase in cell number.
Q3: A patient with chronic gastroesophageal reflux disease (GERD) undergoes an endoscopy,
revealing that the normal stratified squamous epithelium of the lower esophagus has been
replaced by columnar epithelium. This process is known as:
A. Dysplasia
B. Metaplasia [CORRECT]
C. Anaplasia
D. Atrophy
Correct Answer: B
Rationale: This choice is correct because metaplasia is the reversible replacement of one
mature cell type by another mature cell type better suited to withstand chronic irritation,
such as stomach acid.
,Q4: Which of the following best describes the fundamental difference between apoptosis
and necrosis?
A. Apoptosis triggers severe inflammation, whereas necrosis does not.
B. Apoptosis is a programmed, controlled cell death, while necrosis is premature,
pathological cell death. [CORRECT]
C. Necrosis is always a physiologic process, while apoptosis is caused by external toxins.
D. Apoptosis results in cellular swelling, whereas necrosis results in cellular shrinkage.
Correct Answer: B
Rationale: This choice is correct because apoptosis is a clean, programmed suicide of the cell
that avoids inflammation, whereas necrosis is accidental cell death that spills cellular
contents and triggers an inflammatory response.
Q5: A patient experiences a temporary blockage of blood flow to a limb. Upon restoration of
blood flow, the cells exhibit cellular swelling and fatty changes but maintain intact plasma
membranes. This represents:
A. Irreversible cell injury
B. Coagulative necrosis
C. Reversible cell injury [CORRECT]
D. Apoptosis
Correct Answer: C
Rationale: The best answer is C. This aligns with the principle that cellular swelling and fatty
change are hallmarks of reversible injury, as the plasma membrane remains intact and the
cell can recover once oxygen is restored.
Q6: During a routine Pap smear, a patient is diagnosed with cervical dysplasia. The nurse
understands that this finding indicates:
A. A decrease in cell size due to lack of use.
B. An abnormal increase in the number of normal cells.
C. Disordered cellular growth with variations in cell size, shape, and organization. [CORRECT]
D. The conversion of one mature cell type to another mature cell type.
Correct Answer: C
Rationale: This choice is correct because dysplasia is characterized by abnormal changes in
the size, shape, and organization of mature cells, often serving as a precursor to malignancy
if the irritant is not removed.
Q7: Which cellular transport mechanism requires the direct expenditure of ATP to move
solutes against their concentration gradient?
A. Facilitated diffusion
B. Osmosis
C. Active transport [CORRECT]
D. Filtration
Correct Answer: C
Rationale: This choice is correct because active transport is the only listed mechanism that
moves substances from an area of lower concentration to higher concentration, which
requires cellular energy in the form of ATP.
, Q8: A patient has been in a full-body cast for eight weeks following a severe fracture. Upon
cast removal, the affected leg appears significantly smaller than the unaffected leg. This is
an example of:
A. Physiologic hyperplasia
B. Disuse atrophy [CORRECT]
C. Pathologic hypertrophy
D. Metaplasia
Correct Answer: B
Rationale: The best answer is B. This matches the principle that a decrease in workload or
physical activity leads to a reduction in cell size and tissue mass, known as disuse atrophy.
Q9: During hypoxic cell injury, the depletion of ATP directly leads to which of the following
early cellular events?
A. Rupture of the lysosomal membrane
B. Failure of the sodium-potassium pump, leading to cellular swelling [CORRECT]
C. Increased protein synthesis
D. Condensation of chromatin
Correct Answer: B
Rationale: This choice is correct because the Na+/K+ ATPase pump requires ATP to function;
without it, sodium and water rush into the cell, causing the classic early sign of reversible
hypoxic injury: cellular swelling.
Q10: A patient donates a portion of their liver for a transplant. Within weeks, the donor’s
remaining liver tissue grows back to its original functional mass. This process is best
described as:
A. Compensatory hyperplasia [CORRECT]
B. Pathologic hypertrophy
C. Metaplasia
D. Dysplasia
Correct Answer: A
Rationale: This choice is correct because compensatory hyperplasia is the increase in the
number of cells in an organ or tissue after partial removal or injury, allowing the organ to
restore its functional capacity.
Q11: Which of the following is a primary mechanism by which free radicals cause cellular
damage?
A. They stimulate excessive ATP production.
B. They initiate lipid peroxidation, damaging cell membranes. [CORRECT]
C. They enhance the function of the sodium-potassium pump.
D. They promote cellular hypertrophy.
Correct Answer: B
Rationale: The best answer is B. This aligns with the principle that free radicals are highly
reactive molecules with unpaired electrons that steal electrons from membrane lipids,
causing destructive lipid peroxidation.