GOULD'S PATHOPHYSIOLOGY FOR THE
HEALTH PROFESSIONS
7TH EDITION
• AUTHOR(S)KARIN C. VANMETER;
ROBERT J. HUBERT
TEST BANK
Ch. 1 — Introduction to Pathophysiology — Homeostasis and
Feedback Control
Stem: A 58-year-old patient presents with fatigue and
orthostatic lightheadedness after starting a new
antihypertensive medication. The nurse recalls that the body
normally maintains steady-state physiologic variables via
feedback systems. Which description best explains how
negative feedback maintains homeostasis when blood pressure
falls?
A. A sensor detects decreased blood pressure and activates
effector responses that amplify the initial change.
B. A sensor detects decreased blood pressure and triggers
,effectors that oppose the change, restoring baseline.
C. The effector organs function independently of sensors and
reset the set point to a new steady state.
D. Positive feedback loops are engaged to rapidly restore blood
pressure to baseline.
Correct Answer: B
Rationale — Correct (B): Negative feedback involves sensors
(baroreceptors) detecting a deviation (lowered blood pressure)
and activating effectors (sympathetic vasoconstriction,
increased heart rate) that oppose the change to return the
variable toward baseline. This mechanism is central to
physiologic homeostasis described in Gould’s introduction to
pathophysiology.
Rationale — Incorrect (A): Amplification of the initial change
describes positive—not negative—feedback and would worsen
hypotension.
Rationale — Incorrect (C): Effectors require input from sensors
and typically act to restore, not independently choose a new set
point.
Rationale — Incorrect (D): Positive feedback accelerates change
(e.g., labor) rather than restoring a variable to baseline.
Teaching Point: Negative feedback opposes deviations to
restore physiologic set points.
Citation: VanMeter, K. C., & Hubert, R. J. (2024). Gould’s
Pathophysiology for the Health Professions (7th ed.). Ch. 1.
,Ch. 1 — Introduction to Pathophysiology — Allostasis and
Adaptation
Stem: A marathon runner develops an enlarged left ventricle
with increased stroke volume over months of training. Which
cellular/tissue adaptation best explains this physiologic change?
A. Atrophy due to reduced workload on myocardial fibers
B. Hypertrophy resulting from increased functional demand and
protein synthesis
C. Hyperplasia caused by increased myocyte cell division
D. Metaplasia with transformation of myocardial cells to a more
fatigue-resistant cell type
Correct Answer: B
Rationale — Correct (B): Hypertrophy occurs when cells
increase in size (and contractile protein content) to meet
increased workload; the heart’s left ventricle enlarges by
hypertrophy rather than by cell division. Gould emphasizes
hypertrophy as an adaptive response to increased functional
demand.
Rationale — Incorrect (A): Atrophy is shrinkage from decreased
workload or nutrition—opposite of what occurs with increased
demand.
Rationale — Incorrect (C): Hyperplasia requires cell
proliferation; cardiac myocytes are terminally differentiated and
expand primarily by hypertrophy.
, Rationale — Incorrect (D): Metaplasia is replacement of one
differentiated cell type by another (e.g., epithelial) and does not
describe myocyte adaptation.
Teaching Point: Increased workload generally causes
hypertrophy, not hyperplasia, in nonproliferative tissues.
Citation: VanMeter, K. C., & Hubert, R. J. (2024). Gould’s
Pathophysiology for the Health Professions (7th ed.). Ch. 1.
Ch. 1 — Introduction to Pathophysiology — Types of Cellular
Adaptation
Stem: A chronic smoker develops replacement of
pseudostratified ciliated columnar epithelium in the bronchi
with stratified squamous epithelium. Which mechanism best
accounts for this change?
A. Hypertrophy due to increased mucociliary demand
B. Dysplasia reflecting irreversible neoplastic change
C. Metaplasia as reversible reprogramming of stem cells to a
different phenotype
D. Apoptosis of ciliated cells with no compensatory proliferation
Correct Answer: C
Rationale — Correct (C): Metaplasia is an adaptive, reversible
change in which one adult cell type (ciliated columnar) is
replaced by another (squamous) better suited to withstand
chronic irritants; Gould identifies epithelial metaplasia in
HEALTH PROFESSIONS
7TH EDITION
• AUTHOR(S)KARIN C. VANMETER;
ROBERT J. HUBERT
TEST BANK
Ch. 1 — Introduction to Pathophysiology — Homeostasis and
Feedback Control
Stem: A 58-year-old patient presents with fatigue and
orthostatic lightheadedness after starting a new
antihypertensive medication. The nurse recalls that the body
normally maintains steady-state physiologic variables via
feedback systems. Which description best explains how
negative feedback maintains homeostasis when blood pressure
falls?
A. A sensor detects decreased blood pressure and activates
effector responses that amplify the initial change.
B. A sensor detects decreased blood pressure and triggers
,effectors that oppose the change, restoring baseline.
C. The effector organs function independently of sensors and
reset the set point to a new steady state.
D. Positive feedback loops are engaged to rapidly restore blood
pressure to baseline.
Correct Answer: B
Rationale — Correct (B): Negative feedback involves sensors
(baroreceptors) detecting a deviation (lowered blood pressure)
and activating effectors (sympathetic vasoconstriction,
increased heart rate) that oppose the change to return the
variable toward baseline. This mechanism is central to
physiologic homeostasis described in Gould’s introduction to
pathophysiology.
Rationale — Incorrect (A): Amplification of the initial change
describes positive—not negative—feedback and would worsen
hypotension.
Rationale — Incorrect (C): Effectors require input from sensors
and typically act to restore, not independently choose a new set
point.
Rationale — Incorrect (D): Positive feedback accelerates change
(e.g., labor) rather than restoring a variable to baseline.
Teaching Point: Negative feedback opposes deviations to
restore physiologic set points.
Citation: VanMeter, K. C., & Hubert, R. J. (2024). Gould’s
Pathophysiology for the Health Professions (7th ed.). Ch. 1.
,Ch. 1 — Introduction to Pathophysiology — Allostasis and
Adaptation
Stem: A marathon runner develops an enlarged left ventricle
with increased stroke volume over months of training. Which
cellular/tissue adaptation best explains this physiologic change?
A. Atrophy due to reduced workload on myocardial fibers
B. Hypertrophy resulting from increased functional demand and
protein synthesis
C. Hyperplasia caused by increased myocyte cell division
D. Metaplasia with transformation of myocardial cells to a more
fatigue-resistant cell type
Correct Answer: B
Rationale — Correct (B): Hypertrophy occurs when cells
increase in size (and contractile protein content) to meet
increased workload; the heart’s left ventricle enlarges by
hypertrophy rather than by cell division. Gould emphasizes
hypertrophy as an adaptive response to increased functional
demand.
Rationale — Incorrect (A): Atrophy is shrinkage from decreased
workload or nutrition—opposite of what occurs with increased
demand.
Rationale — Incorrect (C): Hyperplasia requires cell
proliferation; cardiac myocytes are terminally differentiated and
expand primarily by hypertrophy.
, Rationale — Incorrect (D): Metaplasia is replacement of one
differentiated cell type by another (e.g., epithelial) and does not
describe myocyte adaptation.
Teaching Point: Increased workload generally causes
hypertrophy, not hyperplasia, in nonproliferative tissues.
Citation: VanMeter, K. C., & Hubert, R. J. (2024). Gould’s
Pathophysiology for the Health Professions (7th ed.). Ch. 1.
Ch. 1 — Introduction to Pathophysiology — Types of Cellular
Adaptation
Stem: A chronic smoker develops replacement of
pseudostratified ciliated columnar epithelium in the bronchi
with stratified squamous epithelium. Which mechanism best
accounts for this change?
A. Hypertrophy due to increased mucociliary demand
B. Dysplasia reflecting irreversible neoplastic change
C. Metaplasia as reversible reprogramming of stem cells to a
different phenotype
D. Apoptosis of ciliated cells with no compensatory proliferation
Correct Answer: C
Rationale — Correct (C): Metaplasia is an adaptive, reversible
change in which one adult cell type (ciliated columnar) is
replaced by another (squamous) better suited to withstand
chronic irritants; Gould identifies epithelial metaplasia in
