NUR 376 Exam 4 – Applied
Pathophysiology – Comprehensive Final –
Official Blueprint Replica
Cellular & Tissue Injury (Cumulative Review)
Q1: A patient with chronic hypertension develops left ventricular hypertrophy. The primary
cellular adaptation responsible for this change is:
A. Hyperplasia
B. Hypertrophy [CORRECT]
C. Metaplasia
D. Dysplasia
Correct Answer: B
Rationale: Correct because hypertrophy is an increase in cell size in response to increased
workload, such as the chronic pressure overload from hypertension.
Q2: A patient experiences prolonged tissue hypoxia. The earliest cellular change observed is:
A. Nuclear fragmentation
B. Cellular swelling due to sodium and water influx [CORRECT]
C. Lysosomal enzyme release
D. Apoptotic body formation
Correct Answer: B
Rationale: Correct because hypoxia impairs ATP production, causing failure of the sodium-
potassium pump and resulting in cellular swelling.
Q3: A patient with Barrett's esophagus has columnar epithelium replacing normal squamous
epithelium. This process is known as:
A. Dysplasia
B. Metaplasia [CORRECT]
C. Anaplasia
,D. Hyperplasia
Correct Answer: B
Rationale: Correct because metaplasia is the reversible replacement of one mature cell type
by another in response to chronic irritation.
Q4: A patient suffers a myocardial infarction. The type of necrosis most commonly associated
with ischemic injury to the heart is:
A. Liquefactive necrosis
B. Coagulative necrosis [CORRECT]
C. Caseous necrosis
D. Fat necrosis
Correct Answer: B
Rationale: Correct because coagulative necrosis is the hallmark of ischemic injury in solid
organs like the heart, preserving tissue architecture temporarily.
Q5: A patient undergoes chemotherapy, which triggers programmed cell death in malignant
cells. This process is termed:
A. Necrosis
B. Apoptosis [CORRECT]
C. Autophagy
D. Metaplasia
Correct Answer: B
Rationale: Correct because apoptosis is a controlled, programmed cell death pathway that
eliminates damaged or unwanted cells without causing inflammation.
Q6: A patient with acetaminophen toxicity develops liver damage. The primary mechanism of
cellular injury in this scenario is:
A. ATP depletion
B. Free radical injury and lipid peroxidation [CORRECT]
C. Calcium influx
D. Osmotic swelling
,Correct Answer: B
Rationale: Correct because acetaminophen metabolism produces a toxic metabolite (NAPQI)
that depletes glutathione and causes free radical-mediated lipid peroxidation.
Q7: A patient with chronic alcohol use develops a fatty liver. The intracellular accumulation of
triglycerides is primarily due to:
A. Increased fatty acid oxidation
B. Impaired lipoprotein export from the liver [CORRECT]
C. Enhanced protein synthesis
D. Increased cellular ATP production
Correct Answer: B
Rationale: Correct because alcohol metabolism impairs the liver's ability to synthesize and
export lipoproteins, leading to intracellular triglyceride accumulation.
Q8: A patient has a Pap smear showing cervical dysplasia. This finding indicates:
A. Reversible replacement of cell types
B. Disordered cellular growth with loss of uniformity [CORRECT]
C. Benign increase in cell number
D. Programmed cell death
Correct Answer: B
Rationale: Correct because dysplasia is characterized by disordered cellular growth, variation
in cell size and shape, and loss of tissue architecture.
Q9: A patient with severe peripheral artery disease develops dry gangrene of the toes. This is
a form of:
A. Liquefactive necrosis
B. Coagulative necrosis [CORRECT]
C. Caseous necrosis
D. Apoptosis
Correct Answer: B
, Rationale: Correct because dry gangrene is a type of coagulative necrosis resulting from
chronic ischemia, where the tissue becomes dry and shriveled.
Q10: A patient exhibits signs of cellular aging. The shortening of which structure is primarily
responsible for the cessation of cellular replication?
A. Mitochondria
B. Telomeres [CORRECT]
C. Ribosomes
D. Lysosomes
Correct Answer: B
Rationale: Correct because telomeres shorten with each cell division, eventually triggering
cellular senescence and halting replication.
Inflammation & Immunity (Cumulative)
Q11: A patient presents with acute inflammation at a wound site. The initial vascular
response is:
A. Vasoconstriction
B. Vasodilation and increased capillary permeability [CORRECT]
C. Decreased hydrostatic pressure
D. Lymphatic obstruction
Correct Answer: B
Rationale: Correct because acute inflammation begins with vasodilation and increased
vascular permeability, allowing plasma proteins and leukocytes to enter the tissue.
Q12: A patient with a bacterial infection produces thick, yellow-green sputum. This exudate is
classified as:
A. Serous
B. Purulent [CORRECT]
C. Fibrinous
D. Hemorrhagic
Correct Answer: B
Pathophysiology – Comprehensive Final –
Official Blueprint Replica
Cellular & Tissue Injury (Cumulative Review)
Q1: A patient with chronic hypertension develops left ventricular hypertrophy. The primary
cellular adaptation responsible for this change is:
A. Hyperplasia
B. Hypertrophy [CORRECT]
C. Metaplasia
D. Dysplasia
Correct Answer: B
Rationale: Correct because hypertrophy is an increase in cell size in response to increased
workload, such as the chronic pressure overload from hypertension.
Q2: A patient experiences prolonged tissue hypoxia. The earliest cellular change observed is:
A. Nuclear fragmentation
B. Cellular swelling due to sodium and water influx [CORRECT]
C. Lysosomal enzyme release
D. Apoptotic body formation
Correct Answer: B
Rationale: Correct because hypoxia impairs ATP production, causing failure of the sodium-
potassium pump and resulting in cellular swelling.
Q3: A patient with Barrett's esophagus has columnar epithelium replacing normal squamous
epithelium. This process is known as:
A. Dysplasia
B. Metaplasia [CORRECT]
C. Anaplasia
,D. Hyperplasia
Correct Answer: B
Rationale: Correct because metaplasia is the reversible replacement of one mature cell type
by another in response to chronic irritation.
Q4: A patient suffers a myocardial infarction. The type of necrosis most commonly associated
with ischemic injury to the heart is:
A. Liquefactive necrosis
B. Coagulative necrosis [CORRECT]
C. Caseous necrosis
D. Fat necrosis
Correct Answer: B
Rationale: Correct because coagulative necrosis is the hallmark of ischemic injury in solid
organs like the heart, preserving tissue architecture temporarily.
Q5: A patient undergoes chemotherapy, which triggers programmed cell death in malignant
cells. This process is termed:
A. Necrosis
B. Apoptosis [CORRECT]
C. Autophagy
D. Metaplasia
Correct Answer: B
Rationale: Correct because apoptosis is a controlled, programmed cell death pathway that
eliminates damaged or unwanted cells without causing inflammation.
Q6: A patient with acetaminophen toxicity develops liver damage. The primary mechanism of
cellular injury in this scenario is:
A. ATP depletion
B. Free radical injury and lipid peroxidation [CORRECT]
C. Calcium influx
D. Osmotic swelling
,Correct Answer: B
Rationale: Correct because acetaminophen metabolism produces a toxic metabolite (NAPQI)
that depletes glutathione and causes free radical-mediated lipid peroxidation.
Q7: A patient with chronic alcohol use develops a fatty liver. The intracellular accumulation of
triglycerides is primarily due to:
A. Increased fatty acid oxidation
B. Impaired lipoprotein export from the liver [CORRECT]
C. Enhanced protein synthesis
D. Increased cellular ATP production
Correct Answer: B
Rationale: Correct because alcohol metabolism impairs the liver's ability to synthesize and
export lipoproteins, leading to intracellular triglyceride accumulation.
Q8: A patient has a Pap smear showing cervical dysplasia. This finding indicates:
A. Reversible replacement of cell types
B. Disordered cellular growth with loss of uniformity [CORRECT]
C. Benign increase in cell number
D. Programmed cell death
Correct Answer: B
Rationale: Correct because dysplasia is characterized by disordered cellular growth, variation
in cell size and shape, and loss of tissue architecture.
Q9: A patient with severe peripheral artery disease develops dry gangrene of the toes. This is
a form of:
A. Liquefactive necrosis
B. Coagulative necrosis [CORRECT]
C. Caseous necrosis
D. Apoptosis
Correct Answer: B
, Rationale: Correct because dry gangrene is a type of coagulative necrosis resulting from
chronic ischemia, where the tissue becomes dry and shriveled.
Q10: A patient exhibits signs of cellular aging. The shortening of which structure is primarily
responsible for the cessation of cellular replication?
A. Mitochondria
B. Telomeres [CORRECT]
C. Ribosomes
D. Lysosomes
Correct Answer: B
Rationale: Correct because telomeres shorten with each cell division, eventually triggering
cellular senescence and halting replication.
Inflammation & Immunity (Cumulative)
Q11: A patient presents with acute inflammation at a wound site. The initial vascular
response is:
A. Vasoconstriction
B. Vasodilation and increased capillary permeability [CORRECT]
C. Decreased hydrostatic pressure
D. Lymphatic obstruction
Correct Answer: B
Rationale: Correct because acute inflammation begins with vasodilation and increased
vascular permeability, allowing plasma proteins and leukocytes to enter the tissue.
Q12: A patient with a bacterial infection produces thick, yellow-green sputum. This exudate is
classified as:
A. Serous
B. Purulent [CORRECT]
C. Fibrinous
D. Hemorrhagic
Correct Answer: B
