NUR 631 ADVANCED
PATHOPHYSIOLOGY MIDTERM EXAM
STUDY GUIDE QUESTIONS AND
ANSWERS 100% VERIFIED BY
EXPERTS. 2026/2027
1. A 55-year-old male smoker presents with a persistent cough. A biopsy of his bronchial
epithelium reveals a change from ciliated columnar cells to stratified squamous cells. What is
this cellular adaptation called?
A. Metaplasia
B. Hyperplasia
C. Dysplasia
D. Atrophy
Answer: A
Conceptual Explanation: Metaplasia is the reversible replacement of one mature cell type
by another, often as a response to chronic irritation like smoking.
2. During reperfusion injury, what is the primary mechanism that causes further damage to
the cell membrane?
A. Calcium overload
,B. Oxidative stress from free radicals
C. Lactic acid accumulation
D. Decreased ATP production
Answer: B
Conceptual Explanation: Reperfusion injury is primarily caused by the generation of
reactive oxygen species (free radicals) when oxygen is reintroduced to ischemic tissue.
3. Which type of necrosis is most commonly associated with hypoxic injury in the brain?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
Answer: B
Conceptual Explanation: Liquefactive necrosis occurs in the brain because brain cells are
rich in digestive hydrolytic enzymes and lipids.
4. A patient is diagnosed with Klinefelter syndrome. Which of the following karyotypes is
consistent with this diagnosis?
A. 45, X
B. 47, XXY
, C. 47, XY, +21
D. 47, XYY
Answer: B
Conceptual Explanation: Klinefelter syndrome is characterized by the presence of at least
one extra X chromosome in a male (47, XXY).
5. Which force is primarily responsible for moving water from the interstitial space into the
intravascular space?
A. Capillary hydrostatic pressure
B. Interstitial hydrostatic pressure
C. Interstitial oncotic pressure
D. Plasma oncotic pressure
Answer: D
Conceptual Explanation: Plasma oncotic (colloid osmotic) pressure, primarily exerted by
albumin, pulls water into the capillaries.
6. A patient presents with a serum sodium level of 120 mEq/L and confusion. Which fluid shift
is occurring in the brain?
A. Water moves from the ECF to the ICF, causing cell swelling
B. Water moves from the ICF to the ECF, causing cell shrinkage
C. Sodium moves into the cells, pulling water with it
PATHOPHYSIOLOGY MIDTERM EXAM
STUDY GUIDE QUESTIONS AND
ANSWERS 100% VERIFIED BY
EXPERTS. 2026/2027
1. A 55-year-old male smoker presents with a persistent cough. A biopsy of his bronchial
epithelium reveals a change from ciliated columnar cells to stratified squamous cells. What is
this cellular adaptation called?
A. Metaplasia
B. Hyperplasia
C. Dysplasia
D. Atrophy
Answer: A
Conceptual Explanation: Metaplasia is the reversible replacement of one mature cell type
by another, often as a response to chronic irritation like smoking.
2. During reperfusion injury, what is the primary mechanism that causes further damage to
the cell membrane?
A. Calcium overload
,B. Oxidative stress from free radicals
C. Lactic acid accumulation
D. Decreased ATP production
Answer: B
Conceptual Explanation: Reperfusion injury is primarily caused by the generation of
reactive oxygen species (free radicals) when oxygen is reintroduced to ischemic tissue.
3. Which type of necrosis is most commonly associated with hypoxic injury in the brain?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
Answer: B
Conceptual Explanation: Liquefactive necrosis occurs in the brain because brain cells are
rich in digestive hydrolytic enzymes and lipids.
4. A patient is diagnosed with Klinefelter syndrome. Which of the following karyotypes is
consistent with this diagnosis?
A. 45, X
B. 47, XXY
, C. 47, XY, +21
D. 47, XYY
Answer: B
Conceptual Explanation: Klinefelter syndrome is characterized by the presence of at least
one extra X chromosome in a male (47, XXY).
5. Which force is primarily responsible for moving water from the interstitial space into the
intravascular space?
A. Capillary hydrostatic pressure
B. Interstitial hydrostatic pressure
C. Interstitial oncotic pressure
D. Plasma oncotic pressure
Answer: D
Conceptual Explanation: Plasma oncotic (colloid osmotic) pressure, primarily exerted by
albumin, pulls water into the capillaries.
6. A patient presents with a serum sodium level of 120 mEq/L and confusion. Which fluid shift
is occurring in the brain?
A. Water moves from the ECF to the ICF, causing cell swelling
B. Water moves from the ICF to the ECF, causing cell shrinkage
C. Sodium moves into the cells, pulling water with it
