NUR 611 Final Exam Review | Questions
and Answers | 2026 Updated | 100%
Correct - Utica College.
Pathophysiology & Cellular Concepts
1. Which of the following best describes cellular adaptation in which one adult
cell type is replaced by another adult cell type?
• A) Hyperplasia
• B) Metaplasia
• C) Dysplasia
• D) Hypertrophy
Correct Answer: B) Metaplasia
Rationale: Metaplasia is a reversible change where one differentiated cell type is
replaced by another, often in response to chronic irritation, such as Barrett
esophagus (squamous to columnar). Hyperplasia is an increase in cell number,
hypertrophy is an increase in cell size, and dysplasia is abnormal cell growth .
2. What is the primary mechanism of injury in reperfusion injury?
• A) Increased ATP production
• B) Reduced calcium influx
• C) Oxidative stress from reactive oxygen species
• D) Decreased inflammatory response
Correct Answer: C) Oxidative stress from reactive oxygen species
Rationale: When blood flow is restored to ischemic tissue, a burst of reactive
oxygen species (ROS) is generated, overwhelming antioxidant defenses. This leads
,to lipid peroxidation, protein damage, and mitochondrial dysfunction, worsening
cellular injury .
3. Which immunoglobulin is primarily involved in anaphylaxis?
• A) IgA
• B) IgG
• C) IgM
• D) IgE
Correct Answer: D) IgE
Rationale: Anaphylaxis is a type I hypersensitivity reaction mediated by IgE
antibodies bound to mast cells and basophils. Cross-linking by allergen leads to
mast cell degranulation and release of histamine and other mediators .
4. What is the primary pathophysiologic defect in Type 1 Diabetes Mellitus?
• A) Insulin resistance
• B) Autoimmune destruction of pancreatic beta cells
• C) Increased hepatic glucose production
• D) Impaired incretin effect
Correct Answer: B) Autoimmune destruction of pancreatic beta cells
Rationale: Type 1 diabetes is caused by T-cell-mediated autoimmune destruction
of insulin-producing beta cells in the islets of Langerhans, leading to absolute
insulin deficiency. Type 2 involves insulin resistance and relative deficiency .
5. Which laboratory finding indicates a high risk for atherosclerosis?
• A) Low HDL cholesterol
• B) High HDL cholesterol
, • C) Low LDL cholesterol
• D) Low triglycerides
Correct Answer: A) Low HDL cholesterol
Rationale: HDL (high-density lipoprotein) is atheroprotective due to its role in
reverse cholesterol transport. Low HDL is an independent risk factor for coronary
artery disease. High LDL and high triglycerides also increase risk .
6. What is the primary cause of symptoms in Parkinson disease?
• A) Degeneration of motor neurons in the spinal cord
• B) Loss of dopaminergic neurons in the substantia nigra
• C) Demyelination in the central nervous system
• D) Autoimmune attack on acetylcholine receptors
Correct Answer: B) Loss of dopaminergic neurons in the substantia nigra
Rationale: Parkinson disease results from degeneration of dopamine-producing
neurons in the substantia nigra pars compacta, leading to an imbalance between
dopamine and acetylcholine in the basal ganglia, causing bradykinesia, rigidity,
and tremor .
7. A patient with chronic obstructive pulmonary disease has chronic hypoxemia.
Over time, this leads to which compensatory mechanism?
• A) Decreased erythropoietin production
• B) Increased erythropoietin production leading to polycythemia
• C) Decreased red blood cell production
• D) Increased platelet destruction
Correct Answer: B) Increased erythropoietin production leading to polycythemia
, Rationale: Chronic hypoxemia stimulates the kidneys to release erythropoietin,
which increases red blood cell production (polycythemia). While this increases
oxygen-carrying capacity, it also increases blood viscosity, leading to increased
risk of thromboembolic events .
8. A patient with liver failure has prolonged prothrombin time (PT) and INR. This
is most likely due to impaired synthesis of which clotting factors?
• A) Factors I, II, V, VII, and X
• B) Factors II, VII, IX, and X
• C) Factors VIII, IX, XI, and XII
• D) Factors V, VIII, and XIII
Correct Answer: B) Factors II, VII, IX, and X
Rationale: The liver synthesizes all clotting factors except Factor VIII. However,
Factors II, VII, IX, and X are vitamin K-dependent clotting factors synthesized in
the liver. Liver failure impairs synthesis of these factors, leading to prolonged
PT/INR and bleeding risk .
9. What is the most common cause of acute pancreatitis?
• A) Gallstones and alcohol abuse
• B) Hyperlipidemia and trauma
• C) Medications and infections
• D) Genetic mutations
Correct Answer: A) Gallstones and alcohol abuse
Rationale: Gallstones and alcohol abuse are the two most common causes of
acute pancreatitis. Gallstones cause obstruction of the pancreatic duct, while
alcohol has direct toxic effects on pancreatic acinar cells. Together, these account
for approximately 80% of cases .
and Answers | 2026 Updated | 100%
Correct - Utica College.
Pathophysiology & Cellular Concepts
1. Which of the following best describes cellular adaptation in which one adult
cell type is replaced by another adult cell type?
• A) Hyperplasia
• B) Metaplasia
• C) Dysplasia
• D) Hypertrophy
Correct Answer: B) Metaplasia
Rationale: Metaplasia is a reversible change where one differentiated cell type is
replaced by another, often in response to chronic irritation, such as Barrett
esophagus (squamous to columnar). Hyperplasia is an increase in cell number,
hypertrophy is an increase in cell size, and dysplasia is abnormal cell growth .
2. What is the primary mechanism of injury in reperfusion injury?
• A) Increased ATP production
• B) Reduced calcium influx
• C) Oxidative stress from reactive oxygen species
• D) Decreased inflammatory response
Correct Answer: C) Oxidative stress from reactive oxygen species
Rationale: When blood flow is restored to ischemic tissue, a burst of reactive
oxygen species (ROS) is generated, overwhelming antioxidant defenses. This leads
,to lipid peroxidation, protein damage, and mitochondrial dysfunction, worsening
cellular injury .
3. Which immunoglobulin is primarily involved in anaphylaxis?
• A) IgA
• B) IgG
• C) IgM
• D) IgE
Correct Answer: D) IgE
Rationale: Anaphylaxis is a type I hypersensitivity reaction mediated by IgE
antibodies bound to mast cells and basophils. Cross-linking by allergen leads to
mast cell degranulation and release of histamine and other mediators .
4. What is the primary pathophysiologic defect in Type 1 Diabetes Mellitus?
• A) Insulin resistance
• B) Autoimmune destruction of pancreatic beta cells
• C) Increased hepatic glucose production
• D) Impaired incretin effect
Correct Answer: B) Autoimmune destruction of pancreatic beta cells
Rationale: Type 1 diabetes is caused by T-cell-mediated autoimmune destruction
of insulin-producing beta cells in the islets of Langerhans, leading to absolute
insulin deficiency. Type 2 involves insulin resistance and relative deficiency .
5. Which laboratory finding indicates a high risk for atherosclerosis?
• A) Low HDL cholesterol
• B) High HDL cholesterol
, • C) Low LDL cholesterol
• D) Low triglycerides
Correct Answer: A) Low HDL cholesterol
Rationale: HDL (high-density lipoprotein) is atheroprotective due to its role in
reverse cholesterol transport. Low HDL is an independent risk factor for coronary
artery disease. High LDL and high triglycerides also increase risk .
6. What is the primary cause of symptoms in Parkinson disease?
• A) Degeneration of motor neurons in the spinal cord
• B) Loss of dopaminergic neurons in the substantia nigra
• C) Demyelination in the central nervous system
• D) Autoimmune attack on acetylcholine receptors
Correct Answer: B) Loss of dopaminergic neurons in the substantia nigra
Rationale: Parkinson disease results from degeneration of dopamine-producing
neurons in the substantia nigra pars compacta, leading to an imbalance between
dopamine and acetylcholine in the basal ganglia, causing bradykinesia, rigidity,
and tremor .
7. A patient with chronic obstructive pulmonary disease has chronic hypoxemia.
Over time, this leads to which compensatory mechanism?
• A) Decreased erythropoietin production
• B) Increased erythropoietin production leading to polycythemia
• C) Decreased red blood cell production
• D) Increased platelet destruction
Correct Answer: B) Increased erythropoietin production leading to polycythemia
, Rationale: Chronic hypoxemia stimulates the kidneys to release erythropoietin,
which increases red blood cell production (polycythemia). While this increases
oxygen-carrying capacity, it also increases blood viscosity, leading to increased
risk of thromboembolic events .
8. A patient with liver failure has prolonged prothrombin time (PT) and INR. This
is most likely due to impaired synthesis of which clotting factors?
• A) Factors I, II, V, VII, and X
• B) Factors II, VII, IX, and X
• C) Factors VIII, IX, XI, and XII
• D) Factors V, VIII, and XIII
Correct Answer: B) Factors II, VII, IX, and X
Rationale: The liver synthesizes all clotting factors except Factor VIII. However,
Factors II, VII, IX, and X are vitamin K-dependent clotting factors synthesized in
the liver. Liver failure impairs synthesis of these factors, leading to prolonged
PT/INR and bleeding risk .
9. What is the most common cause of acute pancreatitis?
• A) Gallstones and alcohol abuse
• B) Hyperlipidemia and trauma
• C) Medications and infections
• D) Genetic mutations
Correct Answer: A) Gallstones and alcohol abuse
Rationale: Gallstones and alcohol abuse are the two most common causes of
acute pancreatitis. Gallstones cause obstruction of the pancreatic duct, while
alcohol has direct toxic effects on pancreatic acinar cells. Together, these account
for approximately 80% of cases .
