NURS 6202 Advanced Pathophysiology Midterm
Exam — 300 Practice Questions with Answers,
Choices & Detailed Rationales
Course: NURS 6202 – Advanced Pathophysiology (Capella University)
Exam: Midterm Examination
Content Domains: Cellular Injury, Adaptation & Neoplasia (1–40) | Fluid, Electrolyte & Acid-Base
Balance (41–80) | Inflammation & Immunity (81–120) | Genetics & Genetic Diseases (121–150)
| Neurologic System Alterations (151–180) | Endocrine System Alterations (181–210) |
Cardiovascular System Alterations (211–240) | Pulmonary System Alterations (241–260) | Renal
& Urologic System Alterations (261–280) | Hematologic & Gastrointestinal Alterations (281–300)
SECTION 1: CELLULAR INJURY, ADAPTATION & NEOPLASIA (Questions 1–40)
Question 1
Under anaerobic conditions, what process provides energy for the cell?
A) Oxidative phosphorylation
B) Glycolysis
C) Krebs cycle
D) Beta-oxidation
Answer: B) Glycolysis
Rationale: Glycolysis is the anaerobic pathway that produces ATP without oxygen. It yields only
2 ATP per glucose molecule compared to 36 ATP with aerobic metabolism. This pathway
becomes critical during ischemia or hypoxia when oxidative phosphorylation cannot occur.
Question 2
What is the result of lipid peroxidation?
A) Increased ATP production
B) Cell membrane damage
C) Enhanced protein synthesis
D) DNA repair activation
,Answer: B) Cell membrane damage
Rationale: Lipid peroxidation is a free radical-mediated chain reaction that damages cell
membranes by oxidizing polyunsaturated fatty acids. This leads to increased membrane
permeability, loss of membrane integrity, and eventual cell death.
Question 3
How do free radicals cause cell damage?
A) Accepting electrons from cell membranes
B) Giving up an electron, which causes injury to the chemical bonds of the cell membrane
C) Increasing intracellular calcium
D) Activating apoptosis
Answer: B) Giving up an electron, which causes injury to the chemical bonds of the cell
membrane
Rationale: Free radicals are highly reactive molecules with unpaired electrons. They damage
cells by "stealing" electrons from other molecules, initiating chain reactions that damage cell
membranes, proteins, and DNA.
Question 4
Apoptotic cell death is characterized by:
A) Cell swelling and lysis
B) Inflammation and tissue damage
C) Cell shrinkage, membrane blebbing, and caspase activation
D) Necrosis and nuclear dissolution
Answer: C) Cell shrinkage, membrane blebbing, and caspase activation
Rationale: Apoptosis is programmed cell death characterized by cell shrinkage, chromatin
condensation, membrane blebbing, and caspase cascade activation. Unlike necrosis, apoptosis
does not trigger inflammation.
Question 5
Which of the following is a common cause of cellular injury?
,A) Hypoxia
B) Genetic mutations
C) Free radicals
D) All of the above
Answer: D) All of the above
Rationale: Cellular injury can result from multiple causes including hypoxia (oxygen deprivation),
genetic mutations, free radical damage, physical agents, chemical toxins, infectious agents, and
nutritional imbalances.
Question 6
The Hayflick limit refers to:
A) The number of cell divisions before senescence
B) The maximum size a cell can achieve
C) The limit of DNA repair capacity
D) The maximum rate of cellular metabolism
Answer: A) The number of cell divisions before senescence
Rationale: The Hayflick limit describes the finite number of times a normal human cell can divide
before entering senescence. Cancer cells bypass this limit through telomerase activation,
allowing unlimited replication.
Question 7
A bronchial epithelial cell changes from one mature cell type to another after chronic irritation
from cigarette smoke. Which cellular adaptation is occurring?
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Dysplasia
Answer: C) Metaplasia
Rationale: Metaplasia is a reversible adaptation in which one mature cell type is replaced by
another better able to tolerate chronic stress. Chronic cigarette smoke exposure causes
bronchial epithelial cells to change from columnar to squamous epithelium.
, Question 8
Which cellular adaptation involves an increase in cell size rather than cell number?
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Atrophy
Answer: A) Hypertrophy
Rationale: Hypertrophy increases the size of individual cells and commonly occurs when cells
experience increased workload.
Question 9
Which example best illustrates physiologic hypertrophy?
A) Left ventricular enlargement from chronic hypertension
B) Skeletal muscle enlargement after resistance training
C) Shrinkage of skeletal muscle after immobilization
D) Replacement of bronchial cells after smoking
Answer: B) Skeletal muscle enlargement after resistance training
Rationale: Resistance exercise increases workload and produces enlargement of existing
skeletal muscle fibers. This is a normal, physiologic adaptation to exercise.
Question 10
Which cellular adaptation is characterized by an increase in the number of cells?
A) Atrophy
B) Hyperplasia
C) Metaplasia
D) Hypertrophy
Answer: B) Hyperplasia
Rationale: Hyperplasia occurs when cellular proliferation increases the number of cells in a
tissue.
Exam — 300 Practice Questions with Answers,
Choices & Detailed Rationales
Course: NURS 6202 – Advanced Pathophysiology (Capella University)
Exam: Midterm Examination
Content Domains: Cellular Injury, Adaptation & Neoplasia (1–40) | Fluid, Electrolyte & Acid-Base
Balance (41–80) | Inflammation & Immunity (81–120) | Genetics & Genetic Diseases (121–150)
| Neurologic System Alterations (151–180) | Endocrine System Alterations (181–210) |
Cardiovascular System Alterations (211–240) | Pulmonary System Alterations (241–260) | Renal
& Urologic System Alterations (261–280) | Hematologic & Gastrointestinal Alterations (281–300)
SECTION 1: CELLULAR INJURY, ADAPTATION & NEOPLASIA (Questions 1–40)
Question 1
Under anaerobic conditions, what process provides energy for the cell?
A) Oxidative phosphorylation
B) Glycolysis
C) Krebs cycle
D) Beta-oxidation
Answer: B) Glycolysis
Rationale: Glycolysis is the anaerobic pathway that produces ATP without oxygen. It yields only
2 ATP per glucose molecule compared to 36 ATP with aerobic metabolism. This pathway
becomes critical during ischemia or hypoxia when oxidative phosphorylation cannot occur.
Question 2
What is the result of lipid peroxidation?
A) Increased ATP production
B) Cell membrane damage
C) Enhanced protein synthesis
D) DNA repair activation
,Answer: B) Cell membrane damage
Rationale: Lipid peroxidation is a free radical-mediated chain reaction that damages cell
membranes by oxidizing polyunsaturated fatty acids. This leads to increased membrane
permeability, loss of membrane integrity, and eventual cell death.
Question 3
How do free radicals cause cell damage?
A) Accepting electrons from cell membranes
B) Giving up an electron, which causes injury to the chemical bonds of the cell membrane
C) Increasing intracellular calcium
D) Activating apoptosis
Answer: B) Giving up an electron, which causes injury to the chemical bonds of the cell
membrane
Rationale: Free radicals are highly reactive molecules with unpaired electrons. They damage
cells by "stealing" electrons from other molecules, initiating chain reactions that damage cell
membranes, proteins, and DNA.
Question 4
Apoptotic cell death is characterized by:
A) Cell swelling and lysis
B) Inflammation and tissue damage
C) Cell shrinkage, membrane blebbing, and caspase activation
D) Necrosis and nuclear dissolution
Answer: C) Cell shrinkage, membrane blebbing, and caspase activation
Rationale: Apoptosis is programmed cell death characterized by cell shrinkage, chromatin
condensation, membrane blebbing, and caspase cascade activation. Unlike necrosis, apoptosis
does not trigger inflammation.
Question 5
Which of the following is a common cause of cellular injury?
,A) Hypoxia
B) Genetic mutations
C) Free radicals
D) All of the above
Answer: D) All of the above
Rationale: Cellular injury can result from multiple causes including hypoxia (oxygen deprivation),
genetic mutations, free radical damage, physical agents, chemical toxins, infectious agents, and
nutritional imbalances.
Question 6
The Hayflick limit refers to:
A) The number of cell divisions before senescence
B) The maximum size a cell can achieve
C) The limit of DNA repair capacity
D) The maximum rate of cellular metabolism
Answer: A) The number of cell divisions before senescence
Rationale: The Hayflick limit describes the finite number of times a normal human cell can divide
before entering senescence. Cancer cells bypass this limit through telomerase activation,
allowing unlimited replication.
Question 7
A bronchial epithelial cell changes from one mature cell type to another after chronic irritation
from cigarette smoke. Which cellular adaptation is occurring?
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Dysplasia
Answer: C) Metaplasia
Rationale: Metaplasia is a reversible adaptation in which one mature cell type is replaced by
another better able to tolerate chronic stress. Chronic cigarette smoke exposure causes
bronchial epithelial cells to change from columnar to squamous epithelium.
, Question 8
Which cellular adaptation involves an increase in cell size rather than cell number?
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Atrophy
Answer: A) Hypertrophy
Rationale: Hypertrophy increases the size of individual cells and commonly occurs when cells
experience increased workload.
Question 9
Which example best illustrates physiologic hypertrophy?
A) Left ventricular enlargement from chronic hypertension
B) Skeletal muscle enlargement after resistance training
C) Shrinkage of skeletal muscle after immobilization
D) Replacement of bronchial cells after smoking
Answer: B) Skeletal muscle enlargement after resistance training
Rationale: Resistance exercise increases workload and produces enlargement of existing
skeletal muscle fibers. This is a normal, physiologic adaptation to exercise.
Question 10
Which cellular adaptation is characterized by an increase in the number of cells?
A) Atrophy
B) Hyperplasia
C) Metaplasia
D) Hypertrophy
Answer: B) Hyperplasia
Rationale: Hyperplasia occurs when cellular proliferation increases the number of cells in a
tissue.
