NURS 6501 • Advanced Pathophysiology • Week 1–4 Review
NURS 6501 Advanced Pathophysiology Week 1–4 Review 2026–
2027 | Pathophysiology Concepts & Practice Questions
Week 1 — Cellular Biology, Adaptation, Injury & Genetics
Question 1. A patient develops increased workload on the left ventricle because of chronic
hypertension. Which cellular adaptation is most likely to occur in the ventricular myocardium?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Correct Answer: B. Hypertrophy
Detailed Rationale:
Cardiac myocytes have limited capacity for cell division. In response to chronic increased workload,
individual myocardial cells enlarge by increasing their structural proteins and organelles. This produces
hypertrophy, which initially helps the heart generate greater force. Persistent hypertrophy can
eventually increase myocardial oxygen demand and contribute to diastolic dysfunction and heart
failure.
Why the other options are incorrect:
A. Hyperplasia: Involves an increase in cell number and is not the principal adaptation of adult cardiac
myocytes to chronic pressure overload.
C. Atrophy: Represents decreased cell size and functional capacity, which is opposite of the expected
response.
D. Metaplasia: Involves replacement of one differentiated cell type by another and is not the typical
response to increased cardiac workload.
──────────────────────────────────────────────────────────────────────
Question 2. Which cellular change is most directly associated with reversible cellular injury caused by
ATP depletion?
A. Cellular swelling
B. Nuclear fragmentation
C. Membrane rupture
D. Enzymatic digestion of the nucleus
Correct Answer: A. Cellular swelling
Advanced Pathophysiology Review 2026–2027
, NURS 6501 • Advanced Pathophysiology • Week 1–4 Review
Detailed Rationale:
ATP depletion impairs the sodium-potassium ATPase pump. Sodium accumulates intracellularly,
causing water to move into the cell and producing cellular swelling. This is a classic manifestation of
potentially reversible injury when the underlying insult is corrected.
Why the other options are incorrect:
B. Nuclear fragmentation: More characteristic of irreversible cell injury and apoptosis or necrotic
processes.
C. Membrane rupture: Indicates severe, usually irreversible cellular injury.
D. Enzymatic digestion of the nucleus: Associated with advanced nuclear destruction during cell death
rather than early reversible injury.
──────────────────────────────────────────────────────────────────────
Question 3. Which organelle is primarily responsible for generating ATP through oxidative
phosphorylation?
A. Lysosome
B. Golgi apparatus
C. Mitochondrion
D. Ribosome
Correct Answer: C. Mitochondrion
Detailed Rationale:
Mitochondria produce most cellular ATP through oxidative phosphorylation. Cells with high energy
requirements, such as cardiac and skeletal muscle cells, contain abundant mitochondria.
Why the other options are incorrect:
A. Lysosome: Contains enzymes responsible for intracellular digestion.
B. Golgi apparatus: Modifies, sorts, and packages proteins and lipids.
D. Ribosome: Responsible for protein synthesis.
──────────────────────────────────────────────────────────────────────
Question 4. A patient experiences prolonged tissue hypoxia. Which metabolic response occurs when
oxygen-dependent ATP production becomes inadequate?
A. Increased oxidative phosphorylation
B. Increased anaerobic glycolysis
C. Complete cessation of glucose metabolism
D. Increased mitochondrial ATP production
Advanced Pathophysiology Review 2026–2027
, NURS 6501 • Advanced Pathophysiology • Week 1–4 Review
Correct Answer: B. Increased anaerobic glycolysis
Detailed Rationale:
When oxygen availability decreases, oxidative phosphorylation becomes impaired. Cells compensate
by increasing anaerobic glycolysis, which generates ATP without requiring oxygen but produces lactate.
Accumulation of lactate can contribute to intracellular acidosis.
Why the other options are incorrect:
A. Increased oxidative phosphorylation: Requires adequate oxygen.
C. Complete cessation of glucose metabolism: Cells can continue glycolysis anaerobically.
D. Increased mitochondrial ATP production: Mitochondrial oxidative ATP generation decreases during
significant hypoxia.
──────────────────────────────────────────────────────────────────────
Question 5. Which characteristic best distinguishes apoptosis from necrosis?
A. Apoptosis always produces extensive inflammation.
B. Apoptosis generally involves programmed cellular death.
C. Necrosis is always physiologic.
D. Necrosis preserves cellular membrane integrity.
Correct Answer: B. Apoptosis generally involves programmed cellular death.
Detailed Rationale:
Apoptosis is a regulated form of cell death that removes unwanted or damaged cells. Cellular contents
are generally packaged into apoptotic bodies, limiting inflammation. Necrosis, in contrast, commonly
follows severe cellular injury and can involve membrane disruption and inflammation.
Why the other options are incorrect:
A. Apoptosis generally produces little surrounding inflammation.
C. Necrosis is typically associated with pathologic injury.
D. Necrosis commonly involves loss of membrane integrity.
──────────────────────────────────────────────────────────────────────
Question 6. A patient has a mutation that changes a single nucleotide and results in substitution of one
amino acid for another in a protein. Which type of mutation is this?
A. Missense mutation
B. Nonsense mutation
C. Silent mutation
Advanced Pathophysiology Review 2026–2027
, NURS 6501 • Advanced Pathophysiology • Week 1–4 Review
D. Frameshift mutation
Correct Answer: A. Missense mutation
Detailed Rationale:
A missense mutation changes a nucleotide in a way that results in substitution of one amino acid for
another. Depending on the affected amino acid and its location, this may alter protein structure or
function.
Why the other options are incorrect:
B. Nonsense mutation: Creates a premature stop codon.
C. Silent mutation: Changes the DNA sequence without changing the encoded amino acid.
D. Frameshift mutation: Results from insertion or deletion of nucleotides that alters the reading frame.
──────────────────────────────────────────────────────────────────────
Question 7. Which process allows a cell to increase its size in response to increased functional
demand?
A. Hypertrophy
B. Hyperplasia
C. Dysplasia
D. Apoptosis
Correct Answer: A. Hypertrophy
Detailed Rationale:
Hypertrophy refers to enlargement of individual cells. It commonly occurs when cells respond to
increased workload by synthesizing additional structural proteins and organelles.
Why the other options are incorrect:
B. Hyperplasia: Increases the number of cells.
C. Dysplasia: Refers to abnormal cellular growth and organization.
D. Apoptosis: Represents programmed cell death.
──────────────────────────────────────────────────────────────────────
Question 8. A patient with chronic gastroesophageal irritation develops replacement of normal
esophageal squamous epithelium with columnar-type epithelium. Which process is illustrated?
A. Hypertrophy
B. Atrophy
C. Metaplasia
Advanced Pathophysiology Review 2026–2027
NURS 6501 Advanced Pathophysiology Week 1–4 Review 2026–
2027 | Pathophysiology Concepts & Practice Questions
Week 1 — Cellular Biology, Adaptation, Injury & Genetics
Question 1. A patient develops increased workload on the left ventricle because of chronic
hypertension. Which cellular adaptation is most likely to occur in the ventricular myocardium?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Correct Answer: B. Hypertrophy
Detailed Rationale:
Cardiac myocytes have limited capacity for cell division. In response to chronic increased workload,
individual myocardial cells enlarge by increasing their structural proteins and organelles. This produces
hypertrophy, which initially helps the heart generate greater force. Persistent hypertrophy can
eventually increase myocardial oxygen demand and contribute to diastolic dysfunction and heart
failure.
Why the other options are incorrect:
A. Hyperplasia: Involves an increase in cell number and is not the principal adaptation of adult cardiac
myocytes to chronic pressure overload.
C. Atrophy: Represents decreased cell size and functional capacity, which is opposite of the expected
response.
D. Metaplasia: Involves replacement of one differentiated cell type by another and is not the typical
response to increased cardiac workload.
──────────────────────────────────────────────────────────────────────
Question 2. Which cellular change is most directly associated with reversible cellular injury caused by
ATP depletion?
A. Cellular swelling
B. Nuclear fragmentation
C. Membrane rupture
D. Enzymatic digestion of the nucleus
Correct Answer: A. Cellular swelling
Advanced Pathophysiology Review 2026–2027
, NURS 6501 • Advanced Pathophysiology • Week 1–4 Review
Detailed Rationale:
ATP depletion impairs the sodium-potassium ATPase pump. Sodium accumulates intracellularly,
causing water to move into the cell and producing cellular swelling. This is a classic manifestation of
potentially reversible injury when the underlying insult is corrected.
Why the other options are incorrect:
B. Nuclear fragmentation: More characteristic of irreversible cell injury and apoptosis or necrotic
processes.
C. Membrane rupture: Indicates severe, usually irreversible cellular injury.
D. Enzymatic digestion of the nucleus: Associated with advanced nuclear destruction during cell death
rather than early reversible injury.
──────────────────────────────────────────────────────────────────────
Question 3. Which organelle is primarily responsible for generating ATP through oxidative
phosphorylation?
A. Lysosome
B. Golgi apparatus
C. Mitochondrion
D. Ribosome
Correct Answer: C. Mitochondrion
Detailed Rationale:
Mitochondria produce most cellular ATP through oxidative phosphorylation. Cells with high energy
requirements, such as cardiac and skeletal muscle cells, contain abundant mitochondria.
Why the other options are incorrect:
A. Lysosome: Contains enzymes responsible for intracellular digestion.
B. Golgi apparatus: Modifies, sorts, and packages proteins and lipids.
D. Ribosome: Responsible for protein synthesis.
──────────────────────────────────────────────────────────────────────
Question 4. A patient experiences prolonged tissue hypoxia. Which metabolic response occurs when
oxygen-dependent ATP production becomes inadequate?
A. Increased oxidative phosphorylation
B. Increased anaerobic glycolysis
C. Complete cessation of glucose metabolism
D. Increased mitochondrial ATP production
Advanced Pathophysiology Review 2026–2027
, NURS 6501 • Advanced Pathophysiology • Week 1–4 Review
Correct Answer: B. Increased anaerobic glycolysis
Detailed Rationale:
When oxygen availability decreases, oxidative phosphorylation becomes impaired. Cells compensate
by increasing anaerobic glycolysis, which generates ATP without requiring oxygen but produces lactate.
Accumulation of lactate can contribute to intracellular acidosis.
Why the other options are incorrect:
A. Increased oxidative phosphorylation: Requires adequate oxygen.
C. Complete cessation of glucose metabolism: Cells can continue glycolysis anaerobically.
D. Increased mitochondrial ATP production: Mitochondrial oxidative ATP generation decreases during
significant hypoxia.
──────────────────────────────────────────────────────────────────────
Question 5. Which characteristic best distinguishes apoptosis from necrosis?
A. Apoptosis always produces extensive inflammation.
B. Apoptosis generally involves programmed cellular death.
C. Necrosis is always physiologic.
D. Necrosis preserves cellular membrane integrity.
Correct Answer: B. Apoptosis generally involves programmed cellular death.
Detailed Rationale:
Apoptosis is a regulated form of cell death that removes unwanted or damaged cells. Cellular contents
are generally packaged into apoptotic bodies, limiting inflammation. Necrosis, in contrast, commonly
follows severe cellular injury and can involve membrane disruption and inflammation.
Why the other options are incorrect:
A. Apoptosis generally produces little surrounding inflammation.
C. Necrosis is typically associated with pathologic injury.
D. Necrosis commonly involves loss of membrane integrity.
──────────────────────────────────────────────────────────────────────
Question 6. A patient has a mutation that changes a single nucleotide and results in substitution of one
amino acid for another in a protein. Which type of mutation is this?
A. Missense mutation
B. Nonsense mutation
C. Silent mutation
Advanced Pathophysiology Review 2026–2027
, NURS 6501 • Advanced Pathophysiology • Week 1–4 Review
D. Frameshift mutation
Correct Answer: A. Missense mutation
Detailed Rationale:
A missense mutation changes a nucleotide in a way that results in substitution of one amino acid for
another. Depending on the affected amino acid and its location, this may alter protein structure or
function.
Why the other options are incorrect:
B. Nonsense mutation: Creates a premature stop codon.
C. Silent mutation: Changes the DNA sequence without changing the encoded amino acid.
D. Frameshift mutation: Results from insertion or deletion of nucleotides that alters the reading frame.
──────────────────────────────────────────────────────────────────────
Question 7. Which process allows a cell to increase its size in response to increased functional
demand?
A. Hypertrophy
B. Hyperplasia
C. Dysplasia
D. Apoptosis
Correct Answer: A. Hypertrophy
Detailed Rationale:
Hypertrophy refers to enlargement of individual cells. It commonly occurs when cells respond to
increased workload by synthesizing additional structural proteins and organelles.
Why the other options are incorrect:
B. Hyperplasia: Increases the number of cells.
C. Dysplasia: Refers to abnormal cellular growth and organization.
D. Apoptosis: Represents programmed cell death.
──────────────────────────────────────────────────────────────────────
Question 8. A patient with chronic gastroesophageal irritation develops replacement of normal
esophageal squamous epithelium with columnar-type epithelium. Which process is illustrated?
A. Hypertrophy
B. Atrophy
C. Metaplasia
Advanced Pathophysiology Review 2026–2027
