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WGU D236 Pathophysiology Pre-Assessment
2025–2026 200 Multiple Choice Questions with
Verified Answers and Detailed Rationales for
Nursing Exam Success Graded A+
SECTION 1: HOMEOSTASIS AND CELLULAR ADAPTATION (Questions 1–40)
Question 1
A patient with chronic hypertension exhibits thickening of the left ventricular wall. Which
cellular adaptation is this?
A) Atrophy
B) Hyperplasia
C) Metaplasia
D) Hypertrophy
ANS: D
Rationale: Hypertrophy is an increase in cell size in response to increased workload. Chronic
hypertension increases afterload on the left ventricle, causing myocardial cells to enlarge
(hypertrophy) to maintain cardiac output. Atrophy is a decrease in cell size. Hyperplasia is an
increase in cell number. Metaplasia is replacement of one mature cell type with another .
Question 2
Which process describes the replacement of one mature cell type by another, often due to
chronic irritation like smoking?
, 2
A) Dysplasia
B) Metaplasia
C) Anaplasia
D) Hyperplasia
ANS: B
Rationale: Metaplasia is a reversible replacement of one mature cell type by another less
mature cell type to better withstand an adverse environment. In smokers, normal ciliated
columnar epithelium of the bronchi may be replaced by stratified squamous epithelium.
Dysplasia involves abnormal cell growth. Anaplasia is loss of differentiation in malignant cells .
Question 3
What term describes programmed cell death that is a normal part of development?
A) Autolysis
B) Apoptosis
C) Necrosis
D) Sclerosis
ANS: B
Rationale: Apoptosis is "programmed" cell death that is neat, regulated, and does not trigger
inflammation. It is a normal part of development and tissue homeostasis. Necrosis is
unregulated cell death that causes inflammation .
Question 4
A patient with chronic kidney disease presents with anemia. This is due to a deficiency of which
substance?
, 3
A) Erythropoietin
B) Platelets
C) Albumin
D) Renin
ANS: A
Rationale: Erythropoietin is produced by the kidneys and stimulates red blood cell production in
the bone marrow. In chronic kidney disease, damaged kidneys produce insufficient
erythropoietin, leading to anemia .
Question 5
A patient receiving chemotherapy has widespread programmed cell death without
inflammation. This process is:
A) Liquefactive necrosis
B) Apoptosis
C) Caseous necrosis
D) Gangrenous necrosis
ANS: B
Rationale: Apoptosis is energy-dependent programmed cell death characterized by cell
shrinkage, chromatin condensation, and formation of apoptotic bodies without inflammation—
common in chemotherapy-induced cell death. Necrosis involves cell swelling, membrane
rupture, and inflammatory response .
Question 6
A patient with an acute myocardial infarction shows preserved tissue architecture with loss of
nuclei and eosinophilic cytoplasm. This pattern is:
, 4
A) Liquefactive necrosis
B) Coagulative necrosis
C) Fat necrosis
D) Fibrinoid necrosis
ANS: B
Rationale: Coagulative necrosis is characteristic of ischemic injury in solid organs (heart, kidney,
spleen) where tissue architecture is preserved but cells lose nuclei and stain eosinophilic .
Question 7
A patient with tuberculosis has granulomas containing amorphous granular debris with no
preserved architecture. This describes:
A) Coagulative necrosis
B) Caseous necrosis
C) Liquefactive necrosis
D) Fat necrosis
ANS: B
Rationale: Caseous necrosis is characteristic of tuberculosis, presenting as amorphous granular
debris with no preserved tissue architecture, often within granulomas .
Question 8
A 25-year-old female athlete has enlarged skeletal muscle mass in her quadriceps after 6
months of resistance training. This adaptation results from:
A) Hyperplasia of muscle fibers
B) Hypertrophy of individual muscle cells
WGU D236 Pathophysiology Pre-Assessment
2025–2026 200 Multiple Choice Questions with
Verified Answers and Detailed Rationales for
Nursing Exam Success Graded A+
SECTION 1: HOMEOSTASIS AND CELLULAR ADAPTATION (Questions 1–40)
Question 1
A patient with chronic hypertension exhibits thickening of the left ventricular wall. Which
cellular adaptation is this?
A) Atrophy
B) Hyperplasia
C) Metaplasia
D) Hypertrophy
ANS: D
Rationale: Hypertrophy is an increase in cell size in response to increased workload. Chronic
hypertension increases afterload on the left ventricle, causing myocardial cells to enlarge
(hypertrophy) to maintain cardiac output. Atrophy is a decrease in cell size. Hyperplasia is an
increase in cell number. Metaplasia is replacement of one mature cell type with another .
Question 2
Which process describes the replacement of one mature cell type by another, often due to
chronic irritation like smoking?
, 2
A) Dysplasia
B) Metaplasia
C) Anaplasia
D) Hyperplasia
ANS: B
Rationale: Metaplasia is a reversible replacement of one mature cell type by another less
mature cell type to better withstand an adverse environment. In smokers, normal ciliated
columnar epithelium of the bronchi may be replaced by stratified squamous epithelium.
Dysplasia involves abnormal cell growth. Anaplasia is loss of differentiation in malignant cells .
Question 3
What term describes programmed cell death that is a normal part of development?
A) Autolysis
B) Apoptosis
C) Necrosis
D) Sclerosis
ANS: B
Rationale: Apoptosis is "programmed" cell death that is neat, regulated, and does not trigger
inflammation. It is a normal part of development and tissue homeostasis. Necrosis is
unregulated cell death that causes inflammation .
Question 4
A patient with chronic kidney disease presents with anemia. This is due to a deficiency of which
substance?
, 3
A) Erythropoietin
B) Platelets
C) Albumin
D) Renin
ANS: A
Rationale: Erythropoietin is produced by the kidneys and stimulates red blood cell production in
the bone marrow. In chronic kidney disease, damaged kidneys produce insufficient
erythropoietin, leading to anemia .
Question 5
A patient receiving chemotherapy has widespread programmed cell death without
inflammation. This process is:
A) Liquefactive necrosis
B) Apoptosis
C) Caseous necrosis
D) Gangrenous necrosis
ANS: B
Rationale: Apoptosis is energy-dependent programmed cell death characterized by cell
shrinkage, chromatin condensation, and formation of apoptotic bodies without inflammation—
common in chemotherapy-induced cell death. Necrosis involves cell swelling, membrane
rupture, and inflammatory response .
Question 6
A patient with an acute myocardial infarction shows preserved tissue architecture with loss of
nuclei and eosinophilic cytoplasm. This pattern is:
, 4
A) Liquefactive necrosis
B) Coagulative necrosis
C) Fat necrosis
D) Fibrinoid necrosis
ANS: B
Rationale: Coagulative necrosis is characteristic of ischemic injury in solid organs (heart, kidney,
spleen) where tissue architecture is preserved but cells lose nuclei and stain eosinophilic .
Question 7
A patient with tuberculosis has granulomas containing amorphous granular debris with no
preserved architecture. This describes:
A) Coagulative necrosis
B) Caseous necrosis
C) Liquefactive necrosis
D) Fat necrosis
ANS: B
Rationale: Caseous necrosis is characteristic of tuberculosis, presenting as amorphous granular
debris with no preserved tissue architecture, often within granulomas .
Question 8
A 25-year-old female athlete has enlarged skeletal muscle mass in her quadriceps after 6
months of resistance training. This adaptation results from:
A) Hyperplasia of muscle fibers
B) Hypertrophy of individual muscle cells
