NUR 631/NUR631 Exam 1 V2 | Advanced
Physiology and Pathophysiology Q&A with
Rationale | Grand Canyon University
1. A patient with chronic hypertension presents with an enlarged heart. Which cellular
adaptation is primarily responsible for the increased size of the left ventricle?
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Atrophy
Correct Answer: B
Expert Explanation: Hypertrophy is defined as an increase in the size of individual cells,
which leads to an increase in the size of the organ. In the heart, this occurs because cardiac
muscle cells are unable to divide and must increase their protein synthesis to handle the
increased workload. This is a common compensatory mechanism in patients with long-
standing high blood pressure.
2. Which of the following processes is a normal physiological example of apoptosis?
A. Cell death due to myocardial infarction
B. Necrosis of liver tissue due to toxin exposure
C. Cellular swelling following a chemical burn
,D. The shedding of the endometrial lining during menstruation
Correct Answer: D
Expert Explanation: Apoptosis is a programmed, organized process of cell death that does
not trigger an inflammatory response. The monthly breakdown of the endometrium is a
classic physiological example of this controlled cellular suicide. Unlike necrosis, apoptosis
involves the shrinkage of cells and the fragmentation of DNA.
3. A smoker’s biopsy of the bronchial lining shows that columnar ciliated epithelial cells have
been replaced by stratified squamous epithelial cells. What is this process called?
A. Metaplasia
B. Anaplasia
C. Dysplasia
D. Hyperplasia
Correct Answer: A
Expert Explanation: Metaplasia is the reversible replacement of one mature cell type by
another mature cell type. In smokers, the fragile columnar cells are replaced by tougher
squamous cells to withstand the irritation of smoke. While this provides protection, the
loss of cilia impairs the clearance of mucus and debris from the lungs.
4. Which cellular injury mechanism is most associated with the formation of reactive oxygen
species (ROS)?
A. Hypoxic injury
, B. Mechanical trauma
C. Reperfusion injury
D. Chemical asphyxiation
Correct Answer: C
Expert Explanation: Reperfusion injury occurs when oxygen is restored to ischemic
tissues, leading to the sudden generation of free radicals. These reactive oxygen species
damage cell membranes and mitochondria through lipid peroxidation. This paradox of
healing explains why tissue damage can worsen after blood flow is restored to an area.
5. What is the primary cause of cellular swelling during hypoxic injury?
A. Increased protein synthesis
B. Decreased ATP leading to failure of the sodium-potassium pump
C. Increased extracellular osmotic pressure
D. Rupture of the lysosomes
Correct Answer: B
Expert Explanation: Hypoxia leads to a decrease in mitochondrial ATP production.
Without ATP, the Na+/K+ ATPase pump fails, causing sodium to accumulate inside the cell.
Water follows the sodium into the cell by osmosis, resulting in cellular swelling or oncosis.
Physiology and Pathophysiology Q&A with
Rationale | Grand Canyon University
1. A patient with chronic hypertension presents with an enlarged heart. Which cellular
adaptation is primarily responsible for the increased size of the left ventricle?
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Atrophy
Correct Answer: B
Expert Explanation: Hypertrophy is defined as an increase in the size of individual cells,
which leads to an increase in the size of the organ. In the heart, this occurs because cardiac
muscle cells are unable to divide and must increase their protein synthesis to handle the
increased workload. This is a common compensatory mechanism in patients with long-
standing high blood pressure.
2. Which of the following processes is a normal physiological example of apoptosis?
A. Cell death due to myocardial infarction
B. Necrosis of liver tissue due to toxin exposure
C. Cellular swelling following a chemical burn
,D. The shedding of the endometrial lining during menstruation
Correct Answer: D
Expert Explanation: Apoptosis is a programmed, organized process of cell death that does
not trigger an inflammatory response. The monthly breakdown of the endometrium is a
classic physiological example of this controlled cellular suicide. Unlike necrosis, apoptosis
involves the shrinkage of cells and the fragmentation of DNA.
3. A smoker’s biopsy of the bronchial lining shows that columnar ciliated epithelial cells have
been replaced by stratified squamous epithelial cells. What is this process called?
A. Metaplasia
B. Anaplasia
C. Dysplasia
D. Hyperplasia
Correct Answer: A
Expert Explanation: Metaplasia is the reversible replacement of one mature cell type by
another mature cell type. In smokers, the fragile columnar cells are replaced by tougher
squamous cells to withstand the irritation of smoke. While this provides protection, the
loss of cilia impairs the clearance of mucus and debris from the lungs.
4. Which cellular injury mechanism is most associated with the formation of reactive oxygen
species (ROS)?
A. Hypoxic injury
, B. Mechanical trauma
C. Reperfusion injury
D. Chemical asphyxiation
Correct Answer: C
Expert Explanation: Reperfusion injury occurs when oxygen is restored to ischemic
tissues, leading to the sudden generation of free radicals. These reactive oxygen species
damage cell membranes and mitochondria through lipid peroxidation. This paradox of
healing explains why tissue damage can worsen after blood flow is restored to an area.
5. What is the primary cause of cellular swelling during hypoxic injury?
A. Increased protein synthesis
B. Decreased ATP leading to failure of the sodium-potassium pump
C. Increased extracellular osmotic pressure
D. Rupture of the lysosomes
Correct Answer: B
Expert Explanation: Hypoxia leads to a decrease in mitochondrial ATP production.
Without ATP, the Na+/K+ ATPase pump fails, causing sodium to accumulate inside the cell.
Water follows the sodium into the cell by osmosis, resulting in cellular swelling or oncosis.
