Page 1 of 246
WGU D115 ADVANCED PATHOPHYSIOLOGY
COMPLETE EXAM BANK & STUDY GUIDE
300+ PRACTICE QUESTIONS WITH VERIFIED
ANSWERS & DETAILED RATIONALES
UPDATED FOR 2026–2027 ACADEMIC YEAR |
GRADED A+
# TABLE OF CONTENTS
| **UNIT 1** | Cellular Pathophysiology: Adaptation, Injury & Death | 1–45 | 15% |
| **UNIT 2** | Genetics & Genomics | 46–75 | 10% |
| **UNIT 3** | Immunology & Inflammation | 76–115 | 13% |
| **UNIT 4** | Fluid, Electrolyte & Acid-Base Balance | 116–155 | 13% |
| **UNIT 5** | Cardiovascular Pathophysiology | 156–200 | 15% |
| **UNIT 6** | Respiratory Pathophysiology | 201–235 | 10% |
| **UNIT 7** | Renal Pathophysiology | 236–260 | 8% |
| **UNIT 8** | Endocrine Pathophysiology | 261–295 | 13% |
| **UNIT 9** | Neurologic Pathophysiology | 296–320 | 8% |
| **UNIT 10** | Hematologic & Neoplastic Pathophysiology | 321–345 | 10% |
| **UNIT 11** | Gastrointestinal & Hepatic Pathophysiology | 346–370 | 5% |
| **UNIT 12** | Musculoskeletal & Integumentary Pathophysiology | 371–390 | 5% |
| **UNIT 13** | Shock & Hemodynamics | 391–410 | 5% |
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UNIT 1: CELLULAR PATHOPHYSIOLOGY — ADAPTATION, INJURY & DEATH
## Questions 1–45
### Question 1
A patient with chronic hypertension develops left ventricular hypertrophy. Which cellular
adaptation best describes this change?
A) Hyperplasia
B) Atrophy
C) Hypertrophy
D) Metaplasia
**Correct Answer: C) Hypertrophy**
**Rationale:** Hypertrophy is an increase in cell size in response to increased workload.
Cardiac myocytes have limited capacity for division, so the heart compensates for increased
afterload from hypertension by enlarging existing cells rather than increasing cell number.
Hyperplasia (A) involves an increase in cell number, which does not occur in cardiac muscle.
Atrophy (B) is a decrease in cell size. Metaplasia (D) is the replacement of one cell type with
another.
---
### Question 2
A patient with chronic obstructive pulmonary disease (COPD) develops squamous metaplasia in
the bronchial epithelium. Which of the following best describes this cellular change?
A) An increase in cell size
B) A reversible replacement of one differentiated cell type with another
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C) An increase in the number of cells
D) A decrease in cell size
**Correct Answer: B) A reversible replacement of one differentiated cell type with another**
**Rationale:** Metaplasia is a reversible change in which one differentiated cell type is replaced
by another cell type. In COPD, the normal ciliated columnar epithelium of the bronchi is
replaced by stratified squamous epithelium due to chronic irritation from smoking. This change
is protective against the irritant but results in loss of ciliary function. Hypertrophy (A) is
increased cell size; hyperplasia (C) is increased cell number; atrophy (D) is decreased cell size.
---
### Question 3
A 55-year-old patient with a history of gastroesophageal reflux disease (GERD) develops
Barrett's esophagus. This is an example of which cellular adaptation?
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Dysplasia
**Correct Answer: C) Metaplasia**
**Rationale:** Barrett's esophagus is a metaplastic change in which the normal stratified
squamous epithelium of the esophagus is replaced by columnar epithelium similar to that of the
stomach or intestines in response to chronic acid exposure. This is a premalignant condition.
Hypertrophy (A) involves increased cell size; hyperplasia (B) involves increased cell number;
dysplasia (D) involves disordered cellular growth with atypical cells.
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### Question 4
Which feature distinguishes apoptosis from necrosis?
A) Apoptosis causes significant inflammation
B) Apoptosis is an uncontrolled process
C) Apoptosis is energy-dependent programmed cell death
D) Necrosis involves cell shrinkage without membrane disruption
**Correct Answer: C) Apoptosis is energy-dependent programmed cell death**
**Rationale:** Apoptosis is a controlled, energy-dependent (ATP-requiring) process of
programmed cell death characterized by cell shrinkage, membrane blebbing, and formation of
apoptotic bodies that are phagocytosed without eliciting inflammation. Necrosis is an
uncontrolled process caused by injury that results in cell swelling, membrane rupture, and
inflammation. Apoptosis does NOT cause significant inflammation (A) — that is a feature of
necrosis. Apoptosis is a controlled process, not uncontrolled (B). Necrosis involves cell swelling
and membrane rupture, not shrinkage (D).
---
### Question 5
A patient experiences a myocardial infarction. The type of necrosis that occurs in the heart
muscle is:
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
WGU D115 ADVANCED PATHOPHYSIOLOGY
COMPLETE EXAM BANK & STUDY GUIDE
300+ PRACTICE QUESTIONS WITH VERIFIED
ANSWERS & DETAILED RATIONALES
UPDATED FOR 2026–2027 ACADEMIC YEAR |
GRADED A+
# TABLE OF CONTENTS
| **UNIT 1** | Cellular Pathophysiology: Adaptation, Injury & Death | 1–45 | 15% |
| **UNIT 2** | Genetics & Genomics | 46–75 | 10% |
| **UNIT 3** | Immunology & Inflammation | 76–115 | 13% |
| **UNIT 4** | Fluid, Electrolyte & Acid-Base Balance | 116–155 | 13% |
| **UNIT 5** | Cardiovascular Pathophysiology | 156–200 | 15% |
| **UNIT 6** | Respiratory Pathophysiology | 201–235 | 10% |
| **UNIT 7** | Renal Pathophysiology | 236–260 | 8% |
| **UNIT 8** | Endocrine Pathophysiology | 261–295 | 13% |
| **UNIT 9** | Neurologic Pathophysiology | 296–320 | 8% |
| **UNIT 10** | Hematologic & Neoplastic Pathophysiology | 321–345 | 10% |
| **UNIT 11** | Gastrointestinal & Hepatic Pathophysiology | 346–370 | 5% |
| **UNIT 12** | Musculoskeletal & Integumentary Pathophysiology | 371–390 | 5% |
| **UNIT 13** | Shock & Hemodynamics | 391–410 | 5% |
,Page 2 of 246
UNIT 1: CELLULAR PATHOPHYSIOLOGY — ADAPTATION, INJURY & DEATH
## Questions 1–45
### Question 1
A patient with chronic hypertension develops left ventricular hypertrophy. Which cellular
adaptation best describes this change?
A) Hyperplasia
B) Atrophy
C) Hypertrophy
D) Metaplasia
**Correct Answer: C) Hypertrophy**
**Rationale:** Hypertrophy is an increase in cell size in response to increased workload.
Cardiac myocytes have limited capacity for division, so the heart compensates for increased
afterload from hypertension by enlarging existing cells rather than increasing cell number.
Hyperplasia (A) involves an increase in cell number, which does not occur in cardiac muscle.
Atrophy (B) is a decrease in cell size. Metaplasia (D) is the replacement of one cell type with
another.
---
### Question 2
A patient with chronic obstructive pulmonary disease (COPD) develops squamous metaplasia in
the bronchial epithelium. Which of the following best describes this cellular change?
A) An increase in cell size
B) A reversible replacement of one differentiated cell type with another
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C) An increase in the number of cells
D) A decrease in cell size
**Correct Answer: B) A reversible replacement of one differentiated cell type with another**
**Rationale:** Metaplasia is a reversible change in which one differentiated cell type is replaced
by another cell type. In COPD, the normal ciliated columnar epithelium of the bronchi is
replaced by stratified squamous epithelium due to chronic irritation from smoking. This change
is protective against the irritant but results in loss of ciliary function. Hypertrophy (A) is
increased cell size; hyperplasia (C) is increased cell number; atrophy (D) is decreased cell size.
---
### Question 3
A 55-year-old patient with a history of gastroesophageal reflux disease (GERD) develops
Barrett's esophagus. This is an example of which cellular adaptation?
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Dysplasia
**Correct Answer: C) Metaplasia**
**Rationale:** Barrett's esophagus is a metaplastic change in which the normal stratified
squamous epithelium of the esophagus is replaced by columnar epithelium similar to that of the
stomach or intestines in response to chronic acid exposure. This is a premalignant condition.
Hypertrophy (A) involves increased cell size; hyperplasia (B) involves increased cell number;
dysplasia (D) involves disordered cellular growth with atypical cells.
, Page 4 of 246
### Question 4
Which feature distinguishes apoptosis from necrosis?
A) Apoptosis causes significant inflammation
B) Apoptosis is an uncontrolled process
C) Apoptosis is energy-dependent programmed cell death
D) Necrosis involves cell shrinkage without membrane disruption
**Correct Answer: C) Apoptosis is energy-dependent programmed cell death**
**Rationale:** Apoptosis is a controlled, energy-dependent (ATP-requiring) process of
programmed cell death characterized by cell shrinkage, membrane blebbing, and formation of
apoptotic bodies that are phagocytosed without eliciting inflammation. Necrosis is an
uncontrolled process caused by injury that results in cell swelling, membrane rupture, and
inflammation. Apoptosis does NOT cause significant inflammation (A) — that is a feature of
necrosis. Apoptosis is a controlled process, not uncontrolled (B). Necrosis involves cell swelling
and membrane rupture, not shrinkage (D).
---
### Question 5
A patient experiences a myocardial infarction. The type of necrosis that occurs in the heart
muscle is:
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
