NUR 555 Advanced Clinical
Pathophysiology Quiz 4 | Questions and
Correct Answers with Rationales | 2026
Update | 100% Correct - SNHU.
SECTION 1: CELLULAR INJURY, ADAPTATION & DEATH
Question 1:
A patient has a myocardial infarction. The ischemic myocardial cells show swollen, pale
cytoplasm due to influx of sodium and water. What is this specific cellular injury called?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Hydropic swelling
D) Fatty change
Answer: C
Rationale: Hydropic swelling (cloudy swelling) is the first manifestation of almost all
forms of cellular injury. It occurs because ATP depletion causes failure of the sodium-
potassium pump, allowing sodium and water to rush into the cell. This is a reversible
change if oxygen is restored .
,Question 2:
In alcoholic liver disease, hepatocytes accumulate excess lipids. This type of cellular
adaptation is called:
A) Hyperplasia
B) Metaplasia
C) Dysplasia
D) Fatty change (steatosis)
Answer: D
Rationale: Fatty change is the abnormal accumulation of triglycerides within
parenchymal cells. Alcohol metabolism generates excess NADH, which promotes fatty
acid synthesis and impairs lipoprotein export, leading to lipid vacuole formation in
hepatocytes .
Question 3:
Which cellular organelle is most susceptible to injury from ischemia due to its high
calcium concentration and lipid content?
A) Nucleus
B) Mitochondria
C) Lysosome
D) Ribosome
Answer: B
Rationale: Mitochondria are highly susceptible to ischemic injury. Ischemia causes
calcium to accumulate in the mitochondria, opening the mitochondrial permeability
transition pore, which stops ATP production and ultimately leads to cell death .
Question 4:
When blood flow is restored to ischemic tissue, additional cellular damage can occur.
What is this phenomenon called?
, A) Coagulative necrosis
B) Reperfusion injury
C) Granulomatous inflammation
D) Free radical scavenging
Answer: B
Rationale: Reperfusion injury occurs when blood supply returns to ischemic tissue. The
sudden reintroduction of oxygen leads to a burst of reactive oxygen species (free
radicals) from mitochondria and inflammatory cells, causing additional cell damage
beyond the initial ischemic injury .
Question 5:
What is the hallmark of cellular aging at the chromosomal level?
A) Shortening of telomeres
B) Lengthening of telomeres
C) Increased DNA repair
D) Duplication of chromosomes
Answer: A
Rationale: Telomeres are protective caps on the ends of chromosomes. With each cell
division, telomeres shorten. When they become critically short, the cell can no longer
divide and enters senescence or undergoes apoptosis .
Question 6:
Unlike necrosis, apoptosis does not cause inflammation. Why?
A) Apoptotic cells are phagocytized by macrophages before they rupture and leak cellular
contents
B) Apoptosis only occurs in sterile body cavities
C) Apoptotic cells release anti-inflammatory cytokines
D) Apoptosis does not involve cell death, only shrinkage
Answer: A
Pathophysiology Quiz 4 | Questions and
Correct Answers with Rationales | 2026
Update | 100% Correct - SNHU.
SECTION 1: CELLULAR INJURY, ADAPTATION & DEATH
Question 1:
A patient has a myocardial infarction. The ischemic myocardial cells show swollen, pale
cytoplasm due to influx of sodium and water. What is this specific cellular injury called?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Hydropic swelling
D) Fatty change
Answer: C
Rationale: Hydropic swelling (cloudy swelling) is the first manifestation of almost all
forms of cellular injury. It occurs because ATP depletion causes failure of the sodium-
potassium pump, allowing sodium and water to rush into the cell. This is a reversible
change if oxygen is restored .
,Question 2:
In alcoholic liver disease, hepatocytes accumulate excess lipids. This type of cellular
adaptation is called:
A) Hyperplasia
B) Metaplasia
C) Dysplasia
D) Fatty change (steatosis)
Answer: D
Rationale: Fatty change is the abnormal accumulation of triglycerides within
parenchymal cells. Alcohol metabolism generates excess NADH, which promotes fatty
acid synthesis and impairs lipoprotein export, leading to lipid vacuole formation in
hepatocytes .
Question 3:
Which cellular organelle is most susceptible to injury from ischemia due to its high
calcium concentration and lipid content?
A) Nucleus
B) Mitochondria
C) Lysosome
D) Ribosome
Answer: B
Rationale: Mitochondria are highly susceptible to ischemic injury. Ischemia causes
calcium to accumulate in the mitochondria, opening the mitochondrial permeability
transition pore, which stops ATP production and ultimately leads to cell death .
Question 4:
When blood flow is restored to ischemic tissue, additional cellular damage can occur.
What is this phenomenon called?
, A) Coagulative necrosis
B) Reperfusion injury
C) Granulomatous inflammation
D) Free radical scavenging
Answer: B
Rationale: Reperfusion injury occurs when blood supply returns to ischemic tissue. The
sudden reintroduction of oxygen leads to a burst of reactive oxygen species (free
radicals) from mitochondria and inflammatory cells, causing additional cell damage
beyond the initial ischemic injury .
Question 5:
What is the hallmark of cellular aging at the chromosomal level?
A) Shortening of telomeres
B) Lengthening of telomeres
C) Increased DNA repair
D) Duplication of chromosomes
Answer: A
Rationale: Telomeres are protective caps on the ends of chromosomes. With each cell
division, telomeres shorten. When they become critically short, the cell can no longer
divide and enters senescence or undergoes apoptosis .
Question 6:
Unlike necrosis, apoptosis does not cause inflammation. Why?
A) Apoptotic cells are phagocytized by macrophages before they rupture and leak cellular
contents
B) Apoptosis only occurs in sterile body cavities
C) Apoptotic cells release anti-inflammatory cytokines
D) Apoptosis does not involve cell death, only shrinkage
Answer: A
