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NURS 6501N / NURS6501 Advanced Pathophysiology
Midterm Examination | Comprehensive 150-Question Test Bank with
Verified Answers & Detailed Rationales for MSN/NP Programs
SECTION 1: CELLULAR ADAPTATION, INJURY, AND DEATH (Questions 1–20)
1. A runner has depleted all the oxygen available for muscle energy. Which
process will facilitate continued muscle performance?
A. Aerobic glycolysis
B. Oxidative phosphorylation
C. Anaerobic glycolysis
D. Gluconeogenesis
Valid answer: C
Rationale: Without oxygen, cells rely on anaerobic glycolysis to produce ATP. This
process generates lactic acid and is much less efficient than aerobic metabolism,
but it allows short bursts of continued muscle activity.
2. What is the single most common cause of cellular injury?
A. Physical trauma
B. Chemical injury
C. Hypoxic injury
D. Infectious agents
Valid answer: C
Rationale: Hypoxic injury (oxygen deprivation) is the single most common cause
of cellular injury. It can result from ischemia, anemia, or respiratory failure and
leads to impaired oxidative phosphorylation and ATP depletion.
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3. A patient has a genetic defect that causes the sodium-potassium pump to
function at only 20% efficiency. What expected finding does the healthcare
professional relate to this defect?
A. Cellular dehydration
B. Cellular swelling
C. Hyperpolarization of the cell membrane
D. Increased protein synthesis
Valid answer: B
Rationale: The Na⁺/K⁺ ATPase pump maintains osmotic balance. If it fails, sodium
accumulates inside the cell, drawing water in via osmosis, leading to cellular
swelling (hydropic degeneration).
4. What causes the rapid change in the resting membrane potential that initiates
an action potential?
A. Potassium gates open and potassium rushes out of the cell
B. Sodium gates open and sodium rushes into the cell
C. Calcium gates open and calcium rushes into the cell
D. Chloride gates open and chloride rushes into the cell
Valid answer: B
Rationale: Depolarization occurs when voltage-gated sodium channels open,
allowing sodium to flow down its electrochemical gradient into the cell, shifting
the membrane potential from negative to positive.
5. A patient is diagnosed with irreversible cell injury and cell death. Which
cellular change is most characteristic of this process?
A. Cellular swelling
B. Fatty change
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C. Nuclear dissolution (karyolysis)
D. Increased protein synthesis
Valid answer: C
Rationale: Irreversible cell injury is characterized by nuclear changes including
karyolysis (nuclear dissolution), pyknosis (nuclear shrinkage), and karyorrhexis
(nuclear fragmentation). These changes indicate that the cell has passed the point
of no return.
6. A healthcare professional is teaching about cellular adaptation. Which type of
adaptation involves a decrease in cell size and function?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Valid answer: C
Rationale: Atrophy is a decrease in cell size and function, often due to disuse,
denervation, ischemia, or malnutrition. Hypertrophy is an increase in cell size,
hyperplasia is an increase in cell number, and metaplasia is a replacement of one
cell type with another.
7. The early dilation (swelling) of the cell's endoplasmic reticulum results in
which consequence?
A. Increased protein synthesis
B. Reduced protein synthesis
C. Enhanced cellular metabolism
D. Increased cell division
Valid answer: B
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Rationale: Early dilation (swelling) of the endoplasmic reticulum results in
reduced protein synthesis. This is an early manifestation of cell injury that can
progress to more severe cellular damage.
8. A patient has a myocardial infarction. Which type of necrosis is most likely to
occur in the heart muscle?
A. Liquefactive necrosis
B. Coagulative necrosis
C. Caseous necrosis
D. Fat necrosis
Valid answer: B
Rationale: Coagulative necrosis is the most common type of necrosis and occurs
in solid organs such as the heart, kidney, and liver following ischemia. The tissue
retains its structural outline for several days due to protein denaturation.
9. A patient with tuberculosis has lung lesions. Which type of necrosis is
characteristic of this condition?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Gangrenous necrosis
Valid answer: C
Rationale: Caseous necrosis is characteristic of tuberculosis. It has a cheesy, white
appearance and is a combination of coagulative and liquefactive necrosis. The
tissue is completely destroyed and forms a granuloma.
NURS 6501N / NURS6501 Advanced Pathophysiology
Midterm Examination | Comprehensive 150-Question Test Bank with
Verified Answers & Detailed Rationales for MSN/NP Programs
SECTION 1: CELLULAR ADAPTATION, INJURY, AND DEATH (Questions 1–20)
1. A runner has depleted all the oxygen available for muscle energy. Which
process will facilitate continued muscle performance?
A. Aerobic glycolysis
B. Oxidative phosphorylation
C. Anaerobic glycolysis
D. Gluconeogenesis
Valid answer: C
Rationale: Without oxygen, cells rely on anaerobic glycolysis to produce ATP. This
process generates lactic acid and is much less efficient than aerobic metabolism,
but it allows short bursts of continued muscle activity.
2. What is the single most common cause of cellular injury?
A. Physical trauma
B. Chemical injury
C. Hypoxic injury
D. Infectious agents
Valid answer: C
Rationale: Hypoxic injury (oxygen deprivation) is the single most common cause
of cellular injury. It can result from ischemia, anemia, or respiratory failure and
leads to impaired oxidative phosphorylation and ATP depletion.
, 2
3. A patient has a genetic defect that causes the sodium-potassium pump to
function at only 20% efficiency. What expected finding does the healthcare
professional relate to this defect?
A. Cellular dehydration
B. Cellular swelling
C. Hyperpolarization of the cell membrane
D. Increased protein synthesis
Valid answer: B
Rationale: The Na⁺/K⁺ ATPase pump maintains osmotic balance. If it fails, sodium
accumulates inside the cell, drawing water in via osmosis, leading to cellular
swelling (hydropic degeneration).
4. What causes the rapid change in the resting membrane potential that initiates
an action potential?
A. Potassium gates open and potassium rushes out of the cell
B. Sodium gates open and sodium rushes into the cell
C. Calcium gates open and calcium rushes into the cell
D. Chloride gates open and chloride rushes into the cell
Valid answer: B
Rationale: Depolarization occurs when voltage-gated sodium channels open,
allowing sodium to flow down its electrochemical gradient into the cell, shifting
the membrane potential from negative to positive.
5. A patient is diagnosed with irreversible cell injury and cell death. Which
cellular change is most characteristic of this process?
A. Cellular swelling
B. Fatty change
, 3
C. Nuclear dissolution (karyolysis)
D. Increased protein synthesis
Valid answer: C
Rationale: Irreversible cell injury is characterized by nuclear changes including
karyolysis (nuclear dissolution), pyknosis (nuclear shrinkage), and karyorrhexis
(nuclear fragmentation). These changes indicate that the cell has passed the point
of no return.
6. A healthcare professional is teaching about cellular adaptation. Which type of
adaptation involves a decrease in cell size and function?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Valid answer: C
Rationale: Atrophy is a decrease in cell size and function, often due to disuse,
denervation, ischemia, or malnutrition. Hypertrophy is an increase in cell size,
hyperplasia is an increase in cell number, and metaplasia is a replacement of one
cell type with another.
7. The early dilation (swelling) of the cell's endoplasmic reticulum results in
which consequence?
A. Increased protein synthesis
B. Reduced protein synthesis
C. Enhanced cellular metabolism
D. Increased cell division
Valid answer: B
, 4
Rationale: Early dilation (swelling) of the endoplasmic reticulum results in
reduced protein synthesis. This is an early manifestation of cell injury that can
progress to more severe cellular damage.
8. A patient has a myocardial infarction. Which type of necrosis is most likely to
occur in the heart muscle?
A. Liquefactive necrosis
B. Coagulative necrosis
C. Caseous necrosis
D. Fat necrosis
Valid answer: B
Rationale: Coagulative necrosis is the most common type of necrosis and occurs
in solid organs such as the heart, kidney, and liver following ischemia. The tissue
retains its structural outline for several days due to protein denaturation.
9. A patient with tuberculosis has lung lesions. Which type of necrosis is
characteristic of this condition?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Gangrenous necrosis
Valid answer: C
Rationale: Caseous necrosis is characteristic of tuberculosis. It has a cheesy, white
appearance and is a combination of coagulative and liquefactive necrosis. The
tissue is completely destroyed and forms a granuloma.
