NUR 113 – Pathophysiology for Nursing Disease
Process Study Guide, Clinical Manifestations,
Nursing Applications, Physiological Disorders,
and Comprehensive Review
Question 1
A nursing student is studying cellular adaptation. A patient with chronic
obstructive pulmonary disease (COPD) develops an increase in the size of alveolar
cells due to prolonged hypoxia. This process is best described as:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Answer: B) Hypertrophy
Rationale: Hypertrophy is an increase in the size of individual cells in response to
increased demand or stimulation. In COPD, chronic hypoxia and increased work of
breathing lead to hypertrophy of smooth muscle cells in the airways. Hyperplasia
(Option A) is an increase in the number of cells. Atrophy (Option C) is a decrease
in cell size. Metaplasia (Option D) is a change from one cell type to another.
Question 2
A patient with chronic acid reflux develops a change in the epithelial lining of the
esophagus from stratified squamous epithelium to columnar epithelium. This
adaptive response is known as:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Answer: D) Metaplasia
,Rationale: Metaplasia is the reversible replacement of one differentiated cell type
with another. In Barrett's esophagus, the squamous epithelium of the esophagus is
replaced by columnar epithelium in response to chronic acid exposure. This is an
adaptive change that can increase the risk of malignancy. Hyperplasia (Option A)
is an increase in cell number. Hypertrophy (Option B) is an increase in cell size.
Atrophy (Option C) is a decrease in cell size.
Question 3
A patient experiences an acute myocardial infarction (heart attack). The death of
cardiac muscle cells due to ischemia is classified as which type of cell death?
A) Apoptosis
B) Necrosis
C) Autophagy
D) Pyroptosis
Answer: B) Necrosis
Rationale: Necrosis is unprogrammed cell death resulting from cellular injury,
such as ischemia, trauma, or toxins. It is characterized by cell swelling, membrane
rupture, and inflammation. Apoptosis (Option A) is programmed cell death that is
orderly and does not cause inflammation. Autophagy (Option C) is the process of
cellular self-digestion. Pyroptosis (Option D) is a form of programmed cell death
associated with inflammation.
Question 4
A nursing student is studying the effects of ischemia on cellular function. Which of
the following is the earliest change that occurs in a cell during ischemia?
A) Decreased intracellular calcium
B) Increased ATP production
C) Decreased ATP production
D) Increased pH
Answer: C) Decreased ATP production
Rationale: During ischemia, oxygen supply to the cell is reduced, leading to
decreased ATP production (anaerobic metabolism). This results in failure of the
,sodium-potassium pump, accumulation of sodium and water in the cell, and
cellular swelling. Increased intracellular calcium (Option A) occurs later. ATP
production is decreased, not increased (Option B). pH decreases (Option D) due to
lactic acid accumulation.
Question 5
A patient presents with edema, pain, and erythema at the site of a wound infection.
The nurse understands that these signs are primarily due to which
pathophysiological process?
A) Cellular necrosis
B) Inflammation
C) Apoptosis
D) Metaplasia
Answer: B) Inflammation
Rationale: Inflammation is the body's response to injury or infection. The classic
signs of inflammation are rubor (redness), calor (heat), tumor (swelling), dolor
(pain), and loss of function. These are caused by vasodilation, increased vascular
permeability, and the migration of leukocytes to the site of injury. Cellular necrosis
(Option A) may occur as a result of inflammation but is not the primary cause of
the signs.
Question 6
A patient with a malignant tumor has cells that are characterized by uncontrolled
division and the ability to invade surrounding tissues. Which of the following
terms best describes these cellular characteristics?
A) Dysplasia
B) Metaplasia
C) Anaplasia
D) Hyperplasia
Answer: C) Anaplasia
Rationale: Anaplasia refers to the loss of differentiation and cellular organization
characteristic of malignant tumors. Anaplastic cells are poorly differentiated, have
, abnormal morphology, and exhibit uncontrolled growth and invasion. Dysplasia
(Option A) is abnormal cell growth that is not necessarily malignant. Metaplasia
(Option B) is the replacement of one cell type with another. Hyperplasia (Option
D) is an increase in cell number.
Question 7
A nursing student is studying the mechanisms of cellular injury. Which of the
following is a cause of cellular injury due to free radical formation?
A) Ischemia
B) Reperfusion injury
C) Inflammation
D) All of the above
Answer: D) All of the above
Rationale: Free radicals are highly reactive molecules that can cause cellular
injury. They are produced during ischemia (when oxygen returns to tissues),
reperfusion injury, and inflammation. Free radicals damage cell membranes,
proteins, and DNA, leading to cell injury and death.
Question 8
A patient with a long history of alcohol abuse has a decreased liver size and
impaired liver function. The nurse recognizes this as which type of cellular
adaptation?
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Answer: C) Atrophy
Rationale: Atrophy is a decrease in cell size, which can result in a decrease in
organ size. Chronic alcohol abuse can lead to liver atrophy due to decreased
demand and toxic injury. Hypertrophy (Option A) is an increase in cell size.
Hyperplasia (Option B) is an increase in cell number. Metaplasia (Option D) is a
change in cell type.
Process Study Guide, Clinical Manifestations,
Nursing Applications, Physiological Disorders,
and Comprehensive Review
Question 1
A nursing student is studying cellular adaptation. A patient with chronic
obstructive pulmonary disease (COPD) develops an increase in the size of alveolar
cells due to prolonged hypoxia. This process is best described as:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Answer: B) Hypertrophy
Rationale: Hypertrophy is an increase in the size of individual cells in response to
increased demand or stimulation. In COPD, chronic hypoxia and increased work of
breathing lead to hypertrophy of smooth muscle cells in the airways. Hyperplasia
(Option A) is an increase in the number of cells. Atrophy (Option C) is a decrease
in cell size. Metaplasia (Option D) is a change from one cell type to another.
Question 2
A patient with chronic acid reflux develops a change in the epithelial lining of the
esophagus from stratified squamous epithelium to columnar epithelium. This
adaptive response is known as:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Answer: D) Metaplasia
,Rationale: Metaplasia is the reversible replacement of one differentiated cell type
with another. In Barrett's esophagus, the squamous epithelium of the esophagus is
replaced by columnar epithelium in response to chronic acid exposure. This is an
adaptive change that can increase the risk of malignancy. Hyperplasia (Option A)
is an increase in cell number. Hypertrophy (Option B) is an increase in cell size.
Atrophy (Option C) is a decrease in cell size.
Question 3
A patient experiences an acute myocardial infarction (heart attack). The death of
cardiac muscle cells due to ischemia is classified as which type of cell death?
A) Apoptosis
B) Necrosis
C) Autophagy
D) Pyroptosis
Answer: B) Necrosis
Rationale: Necrosis is unprogrammed cell death resulting from cellular injury,
such as ischemia, trauma, or toxins. It is characterized by cell swelling, membrane
rupture, and inflammation. Apoptosis (Option A) is programmed cell death that is
orderly and does not cause inflammation. Autophagy (Option C) is the process of
cellular self-digestion. Pyroptosis (Option D) is a form of programmed cell death
associated with inflammation.
Question 4
A nursing student is studying the effects of ischemia on cellular function. Which of
the following is the earliest change that occurs in a cell during ischemia?
A) Decreased intracellular calcium
B) Increased ATP production
C) Decreased ATP production
D) Increased pH
Answer: C) Decreased ATP production
Rationale: During ischemia, oxygen supply to the cell is reduced, leading to
decreased ATP production (anaerobic metabolism). This results in failure of the
,sodium-potassium pump, accumulation of sodium and water in the cell, and
cellular swelling. Increased intracellular calcium (Option A) occurs later. ATP
production is decreased, not increased (Option B). pH decreases (Option D) due to
lactic acid accumulation.
Question 5
A patient presents with edema, pain, and erythema at the site of a wound infection.
The nurse understands that these signs are primarily due to which
pathophysiological process?
A) Cellular necrosis
B) Inflammation
C) Apoptosis
D) Metaplasia
Answer: B) Inflammation
Rationale: Inflammation is the body's response to injury or infection. The classic
signs of inflammation are rubor (redness), calor (heat), tumor (swelling), dolor
(pain), and loss of function. These are caused by vasodilation, increased vascular
permeability, and the migration of leukocytes to the site of injury. Cellular necrosis
(Option A) may occur as a result of inflammation but is not the primary cause of
the signs.
Question 6
A patient with a malignant tumor has cells that are characterized by uncontrolled
division and the ability to invade surrounding tissues. Which of the following
terms best describes these cellular characteristics?
A) Dysplasia
B) Metaplasia
C) Anaplasia
D) Hyperplasia
Answer: C) Anaplasia
Rationale: Anaplasia refers to the loss of differentiation and cellular organization
characteristic of malignant tumors. Anaplastic cells are poorly differentiated, have
, abnormal morphology, and exhibit uncontrolled growth and invasion. Dysplasia
(Option A) is abnormal cell growth that is not necessarily malignant. Metaplasia
(Option B) is the replacement of one cell type with another. Hyperplasia (Option
D) is an increase in cell number.
Question 7
A nursing student is studying the mechanisms of cellular injury. Which of the
following is a cause of cellular injury due to free radical formation?
A) Ischemia
B) Reperfusion injury
C) Inflammation
D) All of the above
Answer: D) All of the above
Rationale: Free radicals are highly reactive molecules that can cause cellular
injury. They are produced during ischemia (when oxygen returns to tissues),
reperfusion injury, and inflammation. Free radicals damage cell membranes,
proteins, and DNA, leading to cell injury and death.
Question 8
A patient with a long history of alcohol abuse has a decreased liver size and
impaired liver function. The nurse recognizes this as which type of cellular
adaptation?
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Answer: C) Atrophy
Rationale: Atrophy is a decrease in cell size, which can result in a decrease in
organ size. Chronic alcohol abuse can lead to liver atrophy due to decreased
demand and toxic injury. Hypertrophy (Option A) is an increase in cell size.
Hyperplasia (Option B) is an increase in cell number. Metaplasia (Option D) is a
change in cell type.
