NUR 2063 Final Exam Essentials of Pathophysiology Rasmussen
University Question Bank (Latest 2026/2027 Edition) – 100%
Correct Questions, Answers & Detailed Rationales
Total Questions: 50
Time Allowed: 90 Minutes
Passing Score: 80%
Instructions: Select the BEST answer for each question based on pathophysiology
principles, disease mechanisms, clinical manifestations, and evidence-based practice.
For SATA questions, select all that apply.
SECTION 1: CELLULAR ADAPTATION, INJURY & TISSUE REPAIR
Questions 1–7
1. A 45-year-old male weightlifter has significantly enlarged skeletal muscle mass in his
arms and legs compared to baseline measurements. Which cellular adaptation best
describes this change?
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
,Correct Answer: B
Rationale: Hypertrophy is an increase in cell size resulting in enlargement of the tissue
or organ. In skeletal muscle, hypertrophy occurs in response to increased workload or
hormonal stimulation (e.g., testosterone, growth hormone), as seen in weightlifting.
Atrophy is a decrease in cell size. Hyperplasia is an increase in cell number. Metaplasia
is the replacement of one mature cell type by another.
2. A patient with chronic gastroesophageal reflux disease (GERD) undergoes
endoscopy, which reveals Barrett esophagus. Which statements about this cellular
adaptation are correct? Select all that apply.
A. This represents metaplasia.
B. Normal squamous epithelium is replaced by columnar epithelium.
C. This adaptation can be reversible if the stimulus is removed.
D. This condition increases the risk of esophageal adenocarcinoma.
E. This is an example of dysplasia.
Correct Answers: A, B, C, D
Rationale: Barrett esophagus is metaplasia—replacement of normal stratified
squamous epithelium by intestinal-type columnar epithelium due to chronic acid
exposure. Metaplasia is generally considered a reversible adaptation if the inciting
stimulus is removed. It is a premalignant condition that increases the risk of esophageal
adenocarcinoma. Dysplasia refers to disordered, dysfunctional cellular growth with
nuclear atypia and loss of tissue architecture, which is distinct from metaplasia.
,3. A 65-year-old smoker with a 40 pack-year history has a lung biopsy showing cells of
varying sizes and shapes, nuclear hyperchromasia, and loss of normal tissue
architecture. Which term best describes these histological findings?
A. Hyperplasia
B. Metaplasia
C. Dysplasia
D. Anaplasia
Correct Answer: C
Rationale: Dysplasia is characterized by cells that vary in size and shape
(pleomorphism), exhibit nuclear hyperchromasia, and show loss of normal tissue
architecture. It is often a precursor to neoplasia and is commonly seen in epithelial
tissues exposed to chronic irritation or carcinogens, such as in the respiratory tract of
smokers. Hyperplasia is increased cell number. Metaplasia is cell type replacement.
Anaplasia is a more severe loss of differentiation seen in malignant neoplasms.
4. A patient with atherosclerosis suffers a myocardial infarction. Postmortem
examination reveals myocardial tissue that is pale, firm, and retains cellular outlines for
several days. Which type of necrosis is present?
A. Liquefactive necrosis
B. Caseous necrosis
C. Coagulative necrosis
D. Fat necrosis
, Correct Answer: C
Rationale: Coagulative necrosis occurs when ischemia denatures cell proteins and
enzymes, preventing autolysis and maintaining cellular outlines for a period of time. It is
characteristic of ischemic injury in solid organs such as the heart, kidney, and spleen.
Liquefactive necrosis occurs in the brain and with bacterial infections. Caseous
necrosis is associated with tuberculosis. Fat necrosis occurs in adipose tissue, typically
in acute pancreatitis or breast trauma.
5. A patient with acute pancreatitis has peripancreatic tissue that appears chalky white
and firm. Microscopic examination reveals calcium deposits within necrotic fat cells.
Which type of necrosis is this?
A. Liquefactive necrosis
B. Coagulative necrosis
C. Caseous necrosis
D. Fat necrosis
Correct Answer: D
Rationale: Fat necrosis occurs when lipases (released during pancreatitis or from
trauma) break down triglycerides in adipose tissue into fatty acids. These fatty acids
combine with calcium to form soaps (saponification), producing chalky white deposits.
This is characteristic of acute pancreatitis and traumatic fat injury. The other necrosis
types do not involve saponification of fatty tissue.
University Question Bank (Latest 2026/2027 Edition) – 100%
Correct Questions, Answers & Detailed Rationales
Total Questions: 50
Time Allowed: 90 Minutes
Passing Score: 80%
Instructions: Select the BEST answer for each question based on pathophysiology
principles, disease mechanisms, clinical manifestations, and evidence-based practice.
For SATA questions, select all that apply.
SECTION 1: CELLULAR ADAPTATION, INJURY & TISSUE REPAIR
Questions 1–7
1. A 45-year-old male weightlifter has significantly enlarged skeletal muscle mass in his
arms and legs compared to baseline measurements. Which cellular adaptation best
describes this change?
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
,Correct Answer: B
Rationale: Hypertrophy is an increase in cell size resulting in enlargement of the tissue
or organ. In skeletal muscle, hypertrophy occurs in response to increased workload or
hormonal stimulation (e.g., testosterone, growth hormone), as seen in weightlifting.
Atrophy is a decrease in cell size. Hyperplasia is an increase in cell number. Metaplasia
is the replacement of one mature cell type by another.
2. A patient with chronic gastroesophageal reflux disease (GERD) undergoes
endoscopy, which reveals Barrett esophagus. Which statements about this cellular
adaptation are correct? Select all that apply.
A. This represents metaplasia.
B. Normal squamous epithelium is replaced by columnar epithelium.
C. This adaptation can be reversible if the stimulus is removed.
D. This condition increases the risk of esophageal adenocarcinoma.
E. This is an example of dysplasia.
Correct Answers: A, B, C, D
Rationale: Barrett esophagus is metaplasia—replacement of normal stratified
squamous epithelium by intestinal-type columnar epithelium due to chronic acid
exposure. Metaplasia is generally considered a reversible adaptation if the inciting
stimulus is removed. It is a premalignant condition that increases the risk of esophageal
adenocarcinoma. Dysplasia refers to disordered, dysfunctional cellular growth with
nuclear atypia and loss of tissue architecture, which is distinct from metaplasia.
,3. A 65-year-old smoker with a 40 pack-year history has a lung biopsy showing cells of
varying sizes and shapes, nuclear hyperchromasia, and loss of normal tissue
architecture. Which term best describes these histological findings?
A. Hyperplasia
B. Metaplasia
C. Dysplasia
D. Anaplasia
Correct Answer: C
Rationale: Dysplasia is characterized by cells that vary in size and shape
(pleomorphism), exhibit nuclear hyperchromasia, and show loss of normal tissue
architecture. It is often a precursor to neoplasia and is commonly seen in epithelial
tissues exposed to chronic irritation or carcinogens, such as in the respiratory tract of
smokers. Hyperplasia is increased cell number. Metaplasia is cell type replacement.
Anaplasia is a more severe loss of differentiation seen in malignant neoplasms.
4. A patient with atherosclerosis suffers a myocardial infarction. Postmortem
examination reveals myocardial tissue that is pale, firm, and retains cellular outlines for
several days. Which type of necrosis is present?
A. Liquefactive necrosis
B. Caseous necrosis
C. Coagulative necrosis
D. Fat necrosis
, Correct Answer: C
Rationale: Coagulative necrosis occurs when ischemia denatures cell proteins and
enzymes, preventing autolysis and maintaining cellular outlines for a period of time. It is
characteristic of ischemic injury in solid organs such as the heart, kidney, and spleen.
Liquefactive necrosis occurs in the brain and with bacterial infections. Caseous
necrosis is associated with tuberculosis. Fat necrosis occurs in adipose tissue, typically
in acute pancreatitis or breast trauma.
5. A patient with acute pancreatitis has peripancreatic tissue that appears chalky white
and firm. Microscopic examination reveals calcium deposits within necrotic fat cells.
Which type of necrosis is this?
A. Liquefactive necrosis
B. Coagulative necrosis
C. Caseous necrosis
D. Fat necrosis
Correct Answer: D
Rationale: Fat necrosis occurs when lipases (released during pancreatitis or from
trauma) break down triglycerides in adipose tissue into fatty acids. These fatty acids
combine with calcium to form soaps (saponification), producing chalky white deposits.
This is characteristic of acute pancreatitis and traumatic fat injury. The other necrosis
types do not involve saponification of fatty tissue.
