NUR 2063 — Essentials of
Pathophysiology — Exam 1 (Original, 200
exam-style questions with answers & brief
rationales)
Covers common Exam-1 topics: cellular function & injury, inflammation, tissue repair,
fluid/electrolyte balance, acid–base balance, and basic immunity/infection. All items are
original and formatted multiple-choice with correct answer and a short rationale.
1. Which cellular change is reversible when the injurious stimulus is removed?
A. Necrosis
B. Apoptosis
C. Atrophy
D. Metaplasia
Answer: C. Atrophy.
Rationale: Atrophy (decreased cell size) can be reversed if stressors resolve; necrosis is
irreversible cell death.
2. A cell exposed to mild hypoxia will first demonstrate:
A. Karyolysis
B. Increased anaerobic glycolysis and lactic acid production
C. Complete membrane rupture
D. Organelles disappearing immediately
Answer: B. Increased anaerobic glycolysis and lactic acid production.
Rationale: Hypoxia causes decrease in ATP leading to anaerobic glycolysis and lactic
acid; structural changes follow if prolonged.
3. Which ion shift is characteristic of early ischemic cell injury?
A. Increased intracellular potassium
B. Increased intracellular sodium and water
C. Increased extracellular calcium
D. Decreased intracellular sodium
Answer: B. Increased intracellular sodium and water.
Rationale: Na⁺/K⁺ ATPase fails → Na⁺ accumulates intracellularly → water influx and
cellular swelling.
,4. Which term describes the replacement of one mature cell type by another mature cell
type better suited to stress?
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Anaplasia
Answer: B. Metaplasia.
Rationale: Metaplasia is adaptive replacement (e.g., columnar → squamous in
smokers).
5. Which process is programmed cell death used for normal tissue turnover?
A. Necrosis
B. Autolysis
C. Apoptosis
D. Coagulation
Answer: C. Apoptosis.
Rationale: Apoptosis is energy-dependent programmed cell death for homeostasis.
6. A hallmark of irreversible cell injury is:
A. Mitochondrial swelling and decreased ATP reversible with oxygen
B. Karyorrhexis and karyolysis
C. Cellular swelling only
D. Increased protein synthesis
Answer: B. Karyorrhexis and karyolysis.
Rationale: Nuclear fragmentation (karyorrhexis) and fading (karyolysis) indicate
irreversible damage.
7. Free radical injury commonly damages cells by:
A. Stabilizing DNA
B. Reducing membrane lipid peroxidation
C. Causing lipid peroxidation of membranes
D. Increasing ATP synthesis
Answer: C. Causing lipid peroxidation of membranes.
Rationale: Free radicals attack lipids, proteins, DNA → membrane disruption.
8. Which intracellular organelle is primarily responsible for ATP production and is damaged
early in ischemia?
A. Golgi apparatus
B. Mitochondrion
C. Lysosome
D. Endoplasmic reticulum
Answer: B. Mitochondrion.
Rationale: Mitochondria produce ATP; ischemia damages them leading to energy
, failure.
9. Steatosis (fatty change) in hepatocytes is most often due to:
A. Hypocalcemia
B. Disturbance in lipid metabolism due to toxins or hypoxia
C. Viral infection exclusively
D. Increased protein synthesis
Answer: B. Disturbance in lipid metabolism due to toxins or hypoxia.
Rationale: Alcohol, hypoxia, toxins disrupt lipid handling → fat accumulation.
10.Liquefactive necrosis is most commonly seen in:
A. Myocardial infarct (coagulative)
B. Brain infarct (liquefactive)
C. Gangrenous tissue only
D. Fat necrosis only
Answer: B. Brain infarct (liquefactive).
Rationale: CNS has high lipid and lysosomal content → enzymatic digestion →
liquefaction.
11.Caseous necrosis is characteristic of:
A. Staphylococcal abscesses
B. Tuberculosis infection
C. Ischemic heart tissue
D. Fat necrosis from pancreatitis
Answer: B. Tuberculosis infection.
Rationale: TB causes granulomatous inflammation with caseating (cheesy) necrosis.
12.Which cell type is the principal phagocyte in acute inflammation?
A. Lymphocyte
B. Eosinophil
C. Neutrophil
D. Basophil
Answer: C. Neutrophil.
Rationale: Neutrophils are first responders in acute inflammation and major phagocytes.
13.The cardinal signs of acute inflammation do NOT include:
A. Redness
B. Heat
C. Paralysis
D. Swelling
Answer: C. Paralysis.
Rationale: Cardinal signs: rubor, calor, tumor, dolor, functio laesa (loss of function), not
paralysis.
Pathophysiology — Exam 1 (Original, 200
exam-style questions with answers & brief
rationales)
Covers common Exam-1 topics: cellular function & injury, inflammation, tissue repair,
fluid/electrolyte balance, acid–base balance, and basic immunity/infection. All items are
original and formatted multiple-choice with correct answer and a short rationale.
1. Which cellular change is reversible when the injurious stimulus is removed?
A. Necrosis
B. Apoptosis
C. Atrophy
D. Metaplasia
Answer: C. Atrophy.
Rationale: Atrophy (decreased cell size) can be reversed if stressors resolve; necrosis is
irreversible cell death.
2. A cell exposed to mild hypoxia will first demonstrate:
A. Karyolysis
B. Increased anaerobic glycolysis and lactic acid production
C. Complete membrane rupture
D. Organelles disappearing immediately
Answer: B. Increased anaerobic glycolysis and lactic acid production.
Rationale: Hypoxia causes decrease in ATP leading to anaerobic glycolysis and lactic
acid; structural changes follow if prolonged.
3. Which ion shift is characteristic of early ischemic cell injury?
A. Increased intracellular potassium
B. Increased intracellular sodium and water
C. Increased extracellular calcium
D. Decreased intracellular sodium
Answer: B. Increased intracellular sodium and water.
Rationale: Na⁺/K⁺ ATPase fails → Na⁺ accumulates intracellularly → water influx and
cellular swelling.
,4. Which term describes the replacement of one mature cell type by another mature cell
type better suited to stress?
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Anaplasia
Answer: B. Metaplasia.
Rationale: Metaplasia is adaptive replacement (e.g., columnar → squamous in
smokers).
5. Which process is programmed cell death used for normal tissue turnover?
A. Necrosis
B. Autolysis
C. Apoptosis
D. Coagulation
Answer: C. Apoptosis.
Rationale: Apoptosis is energy-dependent programmed cell death for homeostasis.
6. A hallmark of irreversible cell injury is:
A. Mitochondrial swelling and decreased ATP reversible with oxygen
B. Karyorrhexis and karyolysis
C. Cellular swelling only
D. Increased protein synthesis
Answer: B. Karyorrhexis and karyolysis.
Rationale: Nuclear fragmentation (karyorrhexis) and fading (karyolysis) indicate
irreversible damage.
7. Free radical injury commonly damages cells by:
A. Stabilizing DNA
B. Reducing membrane lipid peroxidation
C. Causing lipid peroxidation of membranes
D. Increasing ATP synthesis
Answer: C. Causing lipid peroxidation of membranes.
Rationale: Free radicals attack lipids, proteins, DNA → membrane disruption.
8. Which intracellular organelle is primarily responsible for ATP production and is damaged
early in ischemia?
A. Golgi apparatus
B. Mitochondrion
C. Lysosome
D. Endoplasmic reticulum
Answer: B. Mitochondrion.
Rationale: Mitochondria produce ATP; ischemia damages them leading to energy
, failure.
9. Steatosis (fatty change) in hepatocytes is most often due to:
A. Hypocalcemia
B. Disturbance in lipid metabolism due to toxins or hypoxia
C. Viral infection exclusively
D. Increased protein synthesis
Answer: B. Disturbance in lipid metabolism due to toxins or hypoxia.
Rationale: Alcohol, hypoxia, toxins disrupt lipid handling → fat accumulation.
10.Liquefactive necrosis is most commonly seen in:
A. Myocardial infarct (coagulative)
B. Brain infarct (liquefactive)
C. Gangrenous tissue only
D. Fat necrosis only
Answer: B. Brain infarct (liquefactive).
Rationale: CNS has high lipid and lysosomal content → enzymatic digestion →
liquefaction.
11.Caseous necrosis is characteristic of:
A. Staphylococcal abscesses
B. Tuberculosis infection
C. Ischemic heart tissue
D. Fat necrosis from pancreatitis
Answer: B. Tuberculosis infection.
Rationale: TB causes granulomatous inflammation with caseating (cheesy) necrosis.
12.Which cell type is the principal phagocyte in acute inflammation?
A. Lymphocyte
B. Eosinophil
C. Neutrophil
D. Basophil
Answer: C. Neutrophil.
Rationale: Neutrophils are first responders in acute inflammation and major phagocytes.
13.The cardinal signs of acute inflammation do NOT include:
A. Redness
B. Heat
C. Paralysis
D. Swelling
Answer: C. Paralysis.
Rationale: Cardinal signs: rubor, calor, tumor, dolor, functio laesa (loss of function), not
paralysis.
