NUR 6130 Advanced Practice Nursing III
Exam 1 Latest 2026 – 150 Questions with
Correct Answers & Detailed Rationales |
William Paterson University (WPU) | Stuvia
Study Guide PDF
Section 1: Cellular Adaptation & Injury (Questions 1–30)
1. A patient with chronic heart failure develops an enlarged heart. This represents
which type of cellular adaptation?
A. Hyperplasia
B. Metaplasia
C. Hypertrophy
D. Dysplasia
Correct Answer: C
Rationale: Hypertrophy is an increase in cell size leading to organ enlargement, often due to
increased workload (e.g., cardiac myocytes in heart failure). Hyperplasia is increased cell
number, metaplasia is one cell type replacing another, and dysplasia is disordered cell
growth .
2. Which cellular change is considered reversible?
,A. Necrosis
B. Apoptosis
C. Fatty change (steatosis)
D. Karyorrhexis
Correct Answer: C
Rationale: Fatty change is a reversible adaptation to injury (e.g., alcohol or hypoxia).
Necrosis and karyorrhexis (nuclear fragmentation) are irreversible. Apoptosis is
programmed cell death, often physiological .
3. A pathologist notes "liquefactive necrosis" in a brain specimen. This is most likely
due to:
A. Ischemic infarction of the kidney
B. Tuberculosis infection
C. Stroke with enzymatic digestion
D. Pancreatitis
Correct Answer: C
Rationale: Liquefactive necrosis occurs in the brain following stroke, where dead tissue is
digested by enzymes. Caseous necrosis (TB) is cheese-like; coagulative necrosis (kidney)
preserves tissue architecture; fat necrosis occurs in pancreatitis .
4. Which of the following is a hallmark of irreversible cell injury?
A. Decreased ATP synthesis
B. Mitochondrial swelling
C. Loss of membrane integrity
D. Cellular swelling
,Correct Answer: C
Rationale: Irreversible injury is marked by severe membrane damage (lysosomal and
plasma membranes), leading to enzyme leakage and inability to restore homeostasis. ATP
decrease and swelling are reversible if the cause is removed .
5. A 60-year-old smoker develops columnar cells in the esophagus replacing
squamous epithelium. This is termed:
A. Dysplasia
B. Metaplasia
C. Anaplasia
D. Neoplasia
Correct Answer: B
Rationale: Metaplasia is a reversible change where one differentiated cell type replaces
another (e.g., Barrett's esophagus: squamous to columnar). Dysplasia is disordered growth;
anaplasia is loss of differentiation in cancer .
6. Apoptosis is characterized by:
A. Cell swelling and lysis
B. Inflammation of surrounding tissue
C. Caspase activation and cellular shrinkage
D. Random DNA fragmentation
Correct Answer: C
Rationale: Apoptosis is programmed cell death mediated by caspases, leading to cell
shrinkage, chromatin condensation, and formation of apoptotic bodies without inflammation.
Necrosis involves swelling and inflammation .
, 7. A patient with a pulmonary embolism develops a wedge-shaped, pale area of dead
lung tissue. This is an example of:
A. Fat necrosis
B. Coagulative necrosis
C. Liquefactive necrosis
D. Caseous necrosis
Correct Answer: B
Rationale: Coagulative necrosis occurs in ischemic injury to most tissues except the brain
(e.g., heart, kidney, lung), where tissue architecture is preserved for days. Liquefactive
necrosis occurs in the brain; fat necrosis occurs in pancreatitis; caseous necrosis occurs in
TB .
8. Which of the following is an example of physiological hyperplasia?
A. Endometrial hyperplasia due to estrogen excess
B. Compensatory liver regeneration after partial hepatectomy
C. Breast hyperplasia during pregnancy
D. Prostate hyperplasia in older men
Correct Answer: C
Rationale: Breast hyperplasia during pregnancy is physiological (hormonal) hyperplasia.
Endometrial hyperplasia, compensatory liver regeneration, and prostate hyperplasia are
examples of pathological hyperplasia .
9. A biopsy of the cervix shows disordered growth with varying cell sizes and
shapes, but the basement membrane is intact. This is:
Exam 1 Latest 2026 – 150 Questions with
Correct Answers & Detailed Rationales |
William Paterson University (WPU) | Stuvia
Study Guide PDF
Section 1: Cellular Adaptation & Injury (Questions 1–30)
1. A patient with chronic heart failure develops an enlarged heart. This represents
which type of cellular adaptation?
A. Hyperplasia
B. Metaplasia
C. Hypertrophy
D. Dysplasia
Correct Answer: C
Rationale: Hypertrophy is an increase in cell size leading to organ enlargement, often due to
increased workload (e.g., cardiac myocytes in heart failure). Hyperplasia is increased cell
number, metaplasia is one cell type replacing another, and dysplasia is disordered cell
growth .
2. Which cellular change is considered reversible?
,A. Necrosis
B. Apoptosis
C. Fatty change (steatosis)
D. Karyorrhexis
Correct Answer: C
Rationale: Fatty change is a reversible adaptation to injury (e.g., alcohol or hypoxia).
Necrosis and karyorrhexis (nuclear fragmentation) are irreversible. Apoptosis is
programmed cell death, often physiological .
3. A pathologist notes "liquefactive necrosis" in a brain specimen. This is most likely
due to:
A. Ischemic infarction of the kidney
B. Tuberculosis infection
C. Stroke with enzymatic digestion
D. Pancreatitis
Correct Answer: C
Rationale: Liquefactive necrosis occurs in the brain following stroke, where dead tissue is
digested by enzymes. Caseous necrosis (TB) is cheese-like; coagulative necrosis (kidney)
preserves tissue architecture; fat necrosis occurs in pancreatitis .
4. Which of the following is a hallmark of irreversible cell injury?
A. Decreased ATP synthesis
B. Mitochondrial swelling
C. Loss of membrane integrity
D. Cellular swelling
,Correct Answer: C
Rationale: Irreversible injury is marked by severe membrane damage (lysosomal and
plasma membranes), leading to enzyme leakage and inability to restore homeostasis. ATP
decrease and swelling are reversible if the cause is removed .
5. A 60-year-old smoker develops columnar cells in the esophagus replacing
squamous epithelium. This is termed:
A. Dysplasia
B. Metaplasia
C. Anaplasia
D. Neoplasia
Correct Answer: B
Rationale: Metaplasia is a reversible change where one differentiated cell type replaces
another (e.g., Barrett's esophagus: squamous to columnar). Dysplasia is disordered growth;
anaplasia is loss of differentiation in cancer .
6. Apoptosis is characterized by:
A. Cell swelling and lysis
B. Inflammation of surrounding tissue
C. Caspase activation and cellular shrinkage
D. Random DNA fragmentation
Correct Answer: C
Rationale: Apoptosis is programmed cell death mediated by caspases, leading to cell
shrinkage, chromatin condensation, and formation of apoptotic bodies without inflammation.
Necrosis involves swelling and inflammation .
, 7. A patient with a pulmonary embolism develops a wedge-shaped, pale area of dead
lung tissue. This is an example of:
A. Fat necrosis
B. Coagulative necrosis
C. Liquefactive necrosis
D. Caseous necrosis
Correct Answer: B
Rationale: Coagulative necrosis occurs in ischemic injury to most tissues except the brain
(e.g., heart, kidney, lung), where tissue architecture is preserved for days. Liquefactive
necrosis occurs in the brain; fat necrosis occurs in pancreatitis; caseous necrosis occurs in
TB .
8. Which of the following is an example of physiological hyperplasia?
A. Endometrial hyperplasia due to estrogen excess
B. Compensatory liver regeneration after partial hepatectomy
C. Breast hyperplasia during pregnancy
D. Prostate hyperplasia in older men
Correct Answer: C
Rationale: Breast hyperplasia during pregnancy is physiological (hormonal) hyperplasia.
Endometrial hyperplasia, compensatory liver regeneration, and prostate hyperplasia are
examples of pathological hyperplasia .
9. A biopsy of the cervix shows disordered growth with varying cell sizes and
shapes, but the basement membrane is intact. This is:
