2026/2027
Wilkes University NSG 530 Exam II
Advanced Pathophysiology
2026/2027 Test Bank and Clinical
Concept Study Manual
Question 1:
A 3-day-old infant is noted to have mild jaundice and elevated unconjugated bilirubin
levels. The nurse recognizes that this presentation is most consistent with:
A. Physiologic jaundice
B. Kernicterus
C. Glucose-6-phosphate dehydrogenase (G6PD) deficiency
D. Pathologic jaundice
Correct Answer: A. Physiologic jaundice
Rationale: Physiologic jaundice typically appears after 24 hours of life, peaks around
day 3–5 in term infants, and is characterized by mild unconjugated hyperbilirubinemia
due to immature hepatic conjugation systems. Kernicterus is a severe complication of
untreated hyperbilirubinemia leading to neurological damage. G6PD deficiency
causes hemolytic jaundice, often more severe and associated with oxidative stress.
Pathologic jaundice appears within the first 24 hours or rises rapidly, indicating an
underlying disease process.
Question 2:
Which cell organelle is responsible for autodigestion when released during cellular
injury?
A. Lysosomes
B. Ribosomes
C. Smooth endoplasmic reticulum
D. Golgi apparatus
Correct Answer: A. Lysosomes
Rationale: Lysosomes contain hydrolytic enzymes capable of breaking down cellular
components, and when released during cell injury, they can cause autodigestion of the
cell. Ribosomes are responsible for protein synthesis, the smooth endoplasmic
reticulum is involved in lipid metabolism, and the Golgi apparatus modifies and
packages proteins.
,2026/2027
Question 3:
Which organelle produces hydrogen peroxide (H₂O₂) through oxidative reactions
involving oxygen?
A. Lysosomes
B. Peroxisomes
C. Ribosomes
D. Mitochondria
Correct Answer: B. Peroxisomes
Rationale: Peroxisomes contain enzymes such as oxidases and catalase that generate
and break down hydrogen peroxide during oxidative metabolism. Lysosomes digest
cellular waste, ribosomes synthesize proteins, and mitochondria generate ATP
through oxidative phosphorylation.
Question 4:
A key difference between eukaryotic and prokaryotic cells is that eukaryotic cells:
A. Are smaller in size
B. Contain membrane-bound organelles
C. Have no nuclear membrane
D. Lack internal structures
Correct Answer: B. Contain membrane-bound organelles
Rationale: Eukaryotic cells are characterized by the presence of membrane-bound
organelles such as mitochondria, nucleus, and endoplasmic reticulum. Prokaryotic
cells lack these structures and are generally smaller. Eukaryotic cells also possess a
true nucleus.
Question 5:
A disruption of the plasma membrane leads to calcium influx into the mitochondria.
What is the primary consequence?
A. DNA synthesis is halted
B. ATP production is impaired
C. Protein synthesis increases
D. Sodium-potassium pump activation increases
Correct Answer: B. ATP production is impaired
Rationale: Calcium overload in mitochondria disrupts oxidative phosphorylation,
leading to decreased ATP production. This energy failure contributes to cell injury.
,2026/2027
DNA synthesis and protein synthesis are not the primary immediate effects of
mitochondrial calcium overload.
Question 6:
Which organelle is responsible for packaging proteins for secretion outside the cell?
A. Lysosome
B. Golgi apparatus
C. Ribosome
D. Mitochondrion
Correct Answer: B. Golgi apparatus
Rationale: The Golgi apparatus modifies, sorts, and packages proteins into vesicles
for secretion. Ribosomes synthesize proteins, lysosomes digest materials, and
mitochondria produce ATP.
Question 7:
Which statement best describes apoptosis?
A. Programmed cell death of scattered single cells
B. Swelling of cells and organelles
C. Random and uncontrolled cell death
D. Formation of malignant tumors
Correct Answer: A. Programmed cell death of scattered single cells
Rationale: Apoptosis is a controlled, energy-dependent process of programmed cell
death that removes damaged or unnecessary cells. It differs from necrosis, which
involves uncontrolled cell swelling and rupture.
Question 8:
During hypoxic cell injury, sodium and water enter the cell primarily because:
A. Oxygen binds sodium to keep it outside the cell
B. Osmotic pressure decreases inside the cell
C. Failure of ATP-dependent sodium-potassium pumps leads to osmotic imbalance
D. Chloride actively transports sodium into the cell
Correct Answer: C. Failure of ATP-dependent sodium-potassium pumps leads to
osmotic imbalance
Rationale: ATP depletion impairs the sodium-potassium pump, leading to intracellular
sodium accumulation. Water follows sodium osmotically, causing cellular swelling.
, 2026/2027
Question 9:
Which organelle is the primary site of protein synthesis?
A. Lysosome
B. Rough endoplasmic reticulum
C. Golgi apparatus
D. Mitochondria
Correct Answer: B. Rough endoplasmic reticulum
Rationale: The rough endoplasmic reticulum is studded with ribosomes that
synthesize proteins destined for secretion or membrane insertion. The Golgi modifies
proteins, lysosomes digest materials, and mitochondria produce ATP.
Question 10:
Obesity increases dehydration risk because:
A. Fat cells contain little water content
B. Obese individuals urinate more frequently
C. Thirst receptors are absent
D. Metabolic rate is increased
Correct Answer: A. Fat cells contain little water content
Rationale: Adipose tissue contains relatively low water content compared to lean
tissue, reducing total body water percentage and increasing susceptibility to
dehydration.
Question 11:
Which mechanism explains asthma development in only one identical twin?
A. Genomic imprinting
B. Epigenetic modifications
C. Chromosomal deletion
D. Gene duplication
Correct Answer: B. Epigenetic modifications
Rationale: Epigenetic changes alter gene expression without changing DNA sequence
and can explain differences in disease expression between genetically identical
individuals.
Wilkes University NSG 530 Exam II
Advanced Pathophysiology
2026/2027 Test Bank and Clinical
Concept Study Manual
Question 1:
A 3-day-old infant is noted to have mild jaundice and elevated unconjugated bilirubin
levels. The nurse recognizes that this presentation is most consistent with:
A. Physiologic jaundice
B. Kernicterus
C. Glucose-6-phosphate dehydrogenase (G6PD) deficiency
D. Pathologic jaundice
Correct Answer: A. Physiologic jaundice
Rationale: Physiologic jaundice typically appears after 24 hours of life, peaks around
day 3–5 in term infants, and is characterized by mild unconjugated hyperbilirubinemia
due to immature hepatic conjugation systems. Kernicterus is a severe complication of
untreated hyperbilirubinemia leading to neurological damage. G6PD deficiency
causes hemolytic jaundice, often more severe and associated with oxidative stress.
Pathologic jaundice appears within the first 24 hours or rises rapidly, indicating an
underlying disease process.
Question 2:
Which cell organelle is responsible for autodigestion when released during cellular
injury?
A. Lysosomes
B. Ribosomes
C. Smooth endoplasmic reticulum
D. Golgi apparatus
Correct Answer: A. Lysosomes
Rationale: Lysosomes contain hydrolytic enzymes capable of breaking down cellular
components, and when released during cell injury, they can cause autodigestion of the
cell. Ribosomes are responsible for protein synthesis, the smooth endoplasmic
reticulum is involved in lipid metabolism, and the Golgi apparatus modifies and
packages proteins.
,2026/2027
Question 3:
Which organelle produces hydrogen peroxide (H₂O₂) through oxidative reactions
involving oxygen?
A. Lysosomes
B. Peroxisomes
C. Ribosomes
D. Mitochondria
Correct Answer: B. Peroxisomes
Rationale: Peroxisomes contain enzymes such as oxidases and catalase that generate
and break down hydrogen peroxide during oxidative metabolism. Lysosomes digest
cellular waste, ribosomes synthesize proteins, and mitochondria generate ATP
through oxidative phosphorylation.
Question 4:
A key difference between eukaryotic and prokaryotic cells is that eukaryotic cells:
A. Are smaller in size
B. Contain membrane-bound organelles
C. Have no nuclear membrane
D. Lack internal structures
Correct Answer: B. Contain membrane-bound organelles
Rationale: Eukaryotic cells are characterized by the presence of membrane-bound
organelles such as mitochondria, nucleus, and endoplasmic reticulum. Prokaryotic
cells lack these structures and are generally smaller. Eukaryotic cells also possess a
true nucleus.
Question 5:
A disruption of the plasma membrane leads to calcium influx into the mitochondria.
What is the primary consequence?
A. DNA synthesis is halted
B. ATP production is impaired
C. Protein synthesis increases
D. Sodium-potassium pump activation increases
Correct Answer: B. ATP production is impaired
Rationale: Calcium overload in mitochondria disrupts oxidative phosphorylation,
leading to decreased ATP production. This energy failure contributes to cell injury.
,2026/2027
DNA synthesis and protein synthesis are not the primary immediate effects of
mitochondrial calcium overload.
Question 6:
Which organelle is responsible for packaging proteins for secretion outside the cell?
A. Lysosome
B. Golgi apparatus
C. Ribosome
D. Mitochondrion
Correct Answer: B. Golgi apparatus
Rationale: The Golgi apparatus modifies, sorts, and packages proteins into vesicles
for secretion. Ribosomes synthesize proteins, lysosomes digest materials, and
mitochondria produce ATP.
Question 7:
Which statement best describes apoptosis?
A. Programmed cell death of scattered single cells
B. Swelling of cells and organelles
C. Random and uncontrolled cell death
D. Formation of malignant tumors
Correct Answer: A. Programmed cell death of scattered single cells
Rationale: Apoptosis is a controlled, energy-dependent process of programmed cell
death that removes damaged or unnecessary cells. It differs from necrosis, which
involves uncontrolled cell swelling and rupture.
Question 8:
During hypoxic cell injury, sodium and water enter the cell primarily because:
A. Oxygen binds sodium to keep it outside the cell
B. Osmotic pressure decreases inside the cell
C. Failure of ATP-dependent sodium-potassium pumps leads to osmotic imbalance
D. Chloride actively transports sodium into the cell
Correct Answer: C. Failure of ATP-dependent sodium-potassium pumps leads to
osmotic imbalance
Rationale: ATP depletion impairs the sodium-potassium pump, leading to intracellular
sodium accumulation. Water follows sodium osmotically, causing cellular swelling.
, 2026/2027
Question 9:
Which organelle is the primary site of protein synthesis?
A. Lysosome
B. Rough endoplasmic reticulum
C. Golgi apparatus
D. Mitochondria
Correct Answer: B. Rough endoplasmic reticulum
Rationale: The rough endoplasmic reticulum is studded with ribosomes that
synthesize proteins destined for secretion or membrane insertion. The Golgi modifies
proteins, lysosomes digest materials, and mitochondria produce ATP.
Question 10:
Obesity increases dehydration risk because:
A. Fat cells contain little water content
B. Obese individuals urinate more frequently
C. Thirst receptors are absent
D. Metabolic rate is increased
Correct Answer: A. Fat cells contain little water content
Rationale: Adipose tissue contains relatively low water content compared to lean
tissue, reducing total body water percentage and increasing susceptibility to
dehydration.
Question 11:
Which mechanism explains asthma development in only one identical twin?
A. Genomic imprinting
B. Epigenetic modifications
C. Chromosomal deletion
D. Gene duplication
Correct Answer: B. Epigenetic modifications
Rationale: Epigenetic changes alter gene expression without changing DNA sequence
and can explain differences in disease expression between genetically identical
individuals.
