Galen NSG 3280 Pathophysiology for Nurses I: Exam 1 -
Questions with Correct Answers
100 questions
1. A patient with chronic alcohol use disorder has damage to the liver, brain, and heart. Alcohol
injures cells in part because its metabolism:
A. Increases glutathione stores
B. Improves fatty acid oxidation
C. Produces acetaldehyde and free radicals and alters the NADH/NAD ratio
D. Has no effect on the liver
Correct Answer: C. Produces acetaldehyde and free radicals and alters the NADH/NAD ratio
Rationale: Ethanol is metabolized to toxic acetaldehyde, generates free radicals, and increases NADH,
which promotes fat accumulation. It depletes glutathione and impairs fat oxidation, leading to steatosis,
hepatitis and cirrhosis.
2. Hypoxia may result from all of the following EXCEPT:
A. Decreased hemoglobin
B. Reduced blood flow from arterial obstruction
C. Increased hemoglobin levels
D. Lung disease that impairs oxygen exchange
Correct Answer: C. Increased hemoglobin levels
Rationale: Hypoxia results from low oxygen in the air, poor ventilation or diffusion, reduced
oxygen-carrying capacity (anemia, CO), ischemia or inability to use oxygen. An increased hemoglobin
level raises oxygen-carrying capacity rather than causing hypoxia.
3. Which protein is known as the guardian of the genome because it halts the cell cycle and
triggers apoptosis when DNA damage is severe?
A. Insulin
B. p53
C. Albumin
D. Hemoglobin
Correct Answer: B. p53
Rationale: The p53 tumor suppressor stops division to allow DNA repair or initiates apoptosis if damage
is irreparable; mutated p53 is found in about half of cancers. Insulin, albumin and hemoglobin are not cell
cycle regulators.
,4. A biomarker released into the blood when myocardial cells die is:
A. Albumin
B. Troponin
C. Hemoglobin A1c
D. Bilirubin
Correct Answer: B. Troponin
Rationale: Cell death ruptures membranes and releases intracellular proteins; cardiac troponin is highly
specific for myocyte injury and rises within hours of MI. Albumin is a plasma protein, A1c reflects glucose,
and bilirubin reflects heme breakdown.
5. Blunt force injury that tears the skin and underlying tissue with irregular edges is a:
A. Abrasion
B. Laceration
C. Contusion
D. Incised wound
Correct Answer: B. Laceration
Rationale: A laceration is a tear from blunt force, with irregular edges and tissue bridges. An abrasion
scrapes off the epidermis, a contusion is bleeding under intact skin, and an incised wound is a clean cut
from a sharp object.
6. A muscle cell increases in size in response to resistance training, without an increase in cell
number. This adaptation is:
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
Correct Answer: A. Hypertrophy
Rationale: Hypertrophy is an increase in cell size from added structural proteins, typical of skeletal and
cardiac muscle that cannot divide much. Hyperplasia is an increase in cell number, metaplasia is
replacement of one mature cell type by another, and dysplasia is disordered growth with atypical cells.
,7. In a long-term smoker, the ciliated columnar epithelium of the bronchi is replaced by stratified
squamous epithelium. This change is called:
A. Dysplasia
B. Hyperplasia
C. Metaplasia
D. Necrosis
Correct Answer: C. Metaplasia
Rationale: Metaplasia is a reversible substitution of one adult cell type for another better able to withstand
stress; squamous cells resist smoke but lose ciliary clearance. Dysplasia shows atypical cells and is
considered precancerous. Hyperplasia does not change cell type, and necrosis is cell death.
8. The most common cause of cellular injury is:
A. Genetic mutation
B. Hypoxia
C. Radiation
D. Bacterial toxins
Correct Answer: B. Hypoxia
Rationale: Hypoxia, often from ischemia, is the leading cause of cell injury because cells depend on
oxygen for aerobic ATP production. Genetic defects, radiation and toxins also injure cells but far less
often. Ischemia injures tissue faster than hypoxemia alone because nutrients and waste removal are also
disrupted.
9. A tall male with small testes, gynecomastia, and infertility most likely has:
A. Turner syndrome
B. Marfan syndrome
C. Fragile X syndrome
D. Klinefelter syndrome (47,XXY)
Correct Answer: D. Klinefelter syndrome (47,XXY)
Rationale: The extra X chromosome causes testicular failure with low testosterone, tall stature,
gynecomastia and infertility. Marfan syndrome causes tall stature with lens dislocation and aortic dilation
but normal gonads. Turner syndrome affects females.
, 10. An X-linked recessive disorder most commonly affects males because:
A. Males have two X chromosomes
B. Males have only one X chromosome, so a single mutated allele causes disease
C. Females cannot inherit the gene
D. The gene is on the Y chromosome
Correct Answer: B. Males have only one X chromosome, so a single mutated allele causes
disease
Rationale: Males are hemizygous for X-linked genes, so one defective allele expresses the disorder;
carrier females usually have a normal second X. Affected fathers pass the allele to all daughters but no
sons. Hemophilia A and Duchenne muscular dystrophy follow this pattern.
11. Wilson disease results in:
A. Iron accumulation
B. Glycogen buildup in muscle
C. Copper accumulation in the liver and brain, with Kayser-Fleischer rings in the cornea
D. Low copper levels in tissues
Correct Answer: C. Copper accumulation in the liver and brain, with Kayser-Fleischer rings in
the cornea
Rationale: Defective copper excretion into bile causes liver disease, neuropsychiatric symptoms and
corneal rings; it is autosomal recessive and treated with chelation. Iron overload is hemochromatosis.
12. A karyotype is used to detect:
A. Single base pair mutations
B. Enzyme deficiencies
C. Chromosomal number and large structural abnormalities
D. Viral infections
Correct Answer: C. Chromosomal number and large structural abnormalities
Rationale: A karyotype arranges stained chromosomes to identify aneuploidy, translocations and large
deletions. Point mutations need DNA sequencing, enzyme deficiencies need biochemical tests, and viral
infections are detected by other methods.
Questions with Correct Answers
100 questions
1. A patient with chronic alcohol use disorder has damage to the liver, brain, and heart. Alcohol
injures cells in part because its metabolism:
A. Increases glutathione stores
B. Improves fatty acid oxidation
C. Produces acetaldehyde and free radicals and alters the NADH/NAD ratio
D. Has no effect on the liver
Correct Answer: C. Produces acetaldehyde and free radicals and alters the NADH/NAD ratio
Rationale: Ethanol is metabolized to toxic acetaldehyde, generates free radicals, and increases NADH,
which promotes fat accumulation. It depletes glutathione and impairs fat oxidation, leading to steatosis,
hepatitis and cirrhosis.
2. Hypoxia may result from all of the following EXCEPT:
A. Decreased hemoglobin
B. Reduced blood flow from arterial obstruction
C. Increased hemoglobin levels
D. Lung disease that impairs oxygen exchange
Correct Answer: C. Increased hemoglobin levels
Rationale: Hypoxia results from low oxygen in the air, poor ventilation or diffusion, reduced
oxygen-carrying capacity (anemia, CO), ischemia or inability to use oxygen. An increased hemoglobin
level raises oxygen-carrying capacity rather than causing hypoxia.
3. Which protein is known as the guardian of the genome because it halts the cell cycle and
triggers apoptosis when DNA damage is severe?
A. Insulin
B. p53
C. Albumin
D. Hemoglobin
Correct Answer: B. p53
Rationale: The p53 tumor suppressor stops division to allow DNA repair or initiates apoptosis if damage
is irreparable; mutated p53 is found in about half of cancers. Insulin, albumin and hemoglobin are not cell
cycle regulators.
,4. A biomarker released into the blood when myocardial cells die is:
A. Albumin
B. Troponin
C. Hemoglobin A1c
D. Bilirubin
Correct Answer: B. Troponin
Rationale: Cell death ruptures membranes and releases intracellular proteins; cardiac troponin is highly
specific for myocyte injury and rises within hours of MI. Albumin is a plasma protein, A1c reflects glucose,
and bilirubin reflects heme breakdown.
5. Blunt force injury that tears the skin and underlying tissue with irregular edges is a:
A. Abrasion
B. Laceration
C. Contusion
D. Incised wound
Correct Answer: B. Laceration
Rationale: A laceration is a tear from blunt force, with irregular edges and tissue bridges. An abrasion
scrapes off the epidermis, a contusion is bleeding under intact skin, and an incised wound is a clean cut
from a sharp object.
6. A muscle cell increases in size in response to resistance training, without an increase in cell
number. This adaptation is:
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
Correct Answer: A. Hypertrophy
Rationale: Hypertrophy is an increase in cell size from added structural proteins, typical of skeletal and
cardiac muscle that cannot divide much. Hyperplasia is an increase in cell number, metaplasia is
replacement of one mature cell type by another, and dysplasia is disordered growth with atypical cells.
,7. In a long-term smoker, the ciliated columnar epithelium of the bronchi is replaced by stratified
squamous epithelium. This change is called:
A. Dysplasia
B. Hyperplasia
C. Metaplasia
D. Necrosis
Correct Answer: C. Metaplasia
Rationale: Metaplasia is a reversible substitution of one adult cell type for another better able to withstand
stress; squamous cells resist smoke but lose ciliary clearance. Dysplasia shows atypical cells and is
considered precancerous. Hyperplasia does not change cell type, and necrosis is cell death.
8. The most common cause of cellular injury is:
A. Genetic mutation
B. Hypoxia
C. Radiation
D. Bacterial toxins
Correct Answer: B. Hypoxia
Rationale: Hypoxia, often from ischemia, is the leading cause of cell injury because cells depend on
oxygen for aerobic ATP production. Genetic defects, radiation and toxins also injure cells but far less
often. Ischemia injures tissue faster than hypoxemia alone because nutrients and waste removal are also
disrupted.
9. A tall male with small testes, gynecomastia, and infertility most likely has:
A. Turner syndrome
B. Marfan syndrome
C. Fragile X syndrome
D. Klinefelter syndrome (47,XXY)
Correct Answer: D. Klinefelter syndrome (47,XXY)
Rationale: The extra X chromosome causes testicular failure with low testosterone, tall stature,
gynecomastia and infertility. Marfan syndrome causes tall stature with lens dislocation and aortic dilation
but normal gonads. Turner syndrome affects females.
, 10. An X-linked recessive disorder most commonly affects males because:
A. Males have two X chromosomes
B. Males have only one X chromosome, so a single mutated allele causes disease
C. Females cannot inherit the gene
D. The gene is on the Y chromosome
Correct Answer: B. Males have only one X chromosome, so a single mutated allele causes
disease
Rationale: Males are hemizygous for X-linked genes, so one defective allele expresses the disorder;
carrier females usually have a normal second X. Affected fathers pass the allele to all daughters but no
sons. Hemophilia A and Duchenne muscular dystrophy follow this pattern.
11. Wilson disease results in:
A. Iron accumulation
B. Glycogen buildup in muscle
C. Copper accumulation in the liver and brain, with Kayser-Fleischer rings in the cornea
D. Low copper levels in tissues
Correct Answer: C. Copper accumulation in the liver and brain, with Kayser-Fleischer rings in
the cornea
Rationale: Defective copper excretion into bile causes liver disease, neuropsychiatric symptoms and
corneal rings; it is autosomal recessive and treated with chelation. Iron overload is hemochromatosis.
12. A karyotype is used to detect:
A. Single base pair mutations
B. Enzyme deficiencies
C. Chromosomal number and large structural abnormalities
D. Viral infections
Correct Answer: C. Chromosomal number and large structural abnormalities
Rationale: A karyotype arranges stained chromosomes to identify aneuploidy, translocations and large
deletions. Point mutations need DNA sequencing, enzyme deficiencies need biochemical tests, and viral
infections are detected by other methods.
