Galen NSG 3280 Exam 2 Pathophysiology – (2026/2027)
Actual Questions, Verified Answers with Rationales |
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CELLULAR ADAPTATION, INJURY & NECROSIS
Q1. A patient with COPD has had prolonged injury to bronchial tissues. What
type of cellular adaptation should the nurse expect to find?
• A. Dysplasia
• B. Hyperplasia
• C. Atrophy
• D. Metaplasia
• Rationale: Metaplasia is the reversible replacement of one differentiated
cell type with another. In COPD, the normal ciliated columnar epithelium of
the airways is replaced by stratified squamous epithelium as an adaptive
response to chronic irritation .
Q2. A patient's pathology report describes "coagulative necrosis with
preservation of tissue architecture." This finding is most consistent with:
• A. Tuberculosis
• B. Myocardial infarction
• C. Pancreatic trauma
• D. Brain abscess
• Rationale: Coagulative necrosis is the hallmark of ischemic injury in solid
organs like the heart (myocardial infarction). The structural framework of
the tissue is preserved for a period of time despite cell death.
Q3. A patient with peritonitis develops adhesions between bowel loops. This is
a consequence of:
• A. Resolution of inflammation
, • B. Regeneration of tissue
• C. Organization of fibrin
• D. Suppuration
• Rationale: Fibrin strands formed during inflammation in the peritoneal
cavity can organize into fibrous adhesions, which are bands of scar tissue
that can cause bowel obstructions .
Q4. In tissue repair, which process involves replacement of damaged tissue with
functional parenchymal cells?
• A. Repair by scar
• B. Regeneration
• C. Granulation
• D. Organization
• Rationale: Regeneration involves replacement of lost tissue with cells of
the same type, restoring normal function. This is different from repair by
scar, which involves the formation of non-functional fibrous tissue.
Q5. What is liquefactive necrosis most commonly associated with?
• A. Myocardial infarction
• B. Tuberculosis
• C. Brain abscess or stroke
• D. Ischemic limb
• Rationale: Liquefactive necrosis occurs when dead cells are completely
digested by hydrolytic enzymes, turning the tissue into a liquid viscous
mass. It is characteristic of bacterial infections (abscesses) and hypoxic
death in the central nervous system (brain).
Q6. Caseous necrosis is a hallmark of which condition?
• A. Myocardial infarction
• B. Tuberculosis
, • C. Acute pancreatitis
• D. Venous infarction
• Rationale: Caseous necrosis (from "caseous" meaning cheese-like) is a
distinct form of necrosis seen almost exclusively in tuberculosis. It
combines features of both coagulative and liquefactive necrosis, resulting
in a soft, friable, "cheesy" debris.
Q7. The process of programmed cell death is known as:
• A. Necrosis
• B. Apoptosis
• C. Atrophy
• D. Metaplasia
• Rationale: Apoptosis is a highly regulated, energy-dependent process of
programmed cell death that eliminates unwanted or damaged cells without
causing an inflammatory response, unlike necrosis.
INFLAMMATION & WOUND HEALING
Q8. The first step in the inflammatory response is:
• A. Leukocyte migration
• B. Vasodilation
• C. Phagocytosis
• D. Fever
• Rationale: Vasodilation of arterioles and capillaries is the initial vascular
response in acute inflammation, increasing blood flow to the injured area
and causing redness (rubor) and heat (calor) .
Q9. The process by which leukocytes emigrate from blood vessels into tissue is
called:
• A. Margination
, • B. Diapedesis
• C. Chemotaxis
• D. Phagocytosis
• Rationale: Diapedesis (also called transmigration) is the process of
leukocyte movement through the vessel wall into interstitial tissue.
Margination is the process of leukocytes adhering to the endothelium .
Q10. Which of the following mediators is released from mast cells and causes
vasodilation?
• A. TNF-α
• B. Interleukin-1
• C. Histamine
• D. Interferon-γ
• Rationale: Histamine is a primary mediator released from mast cell
degranulation. It causes vasodilation and increased vascular permeability .
Q11. A patient with acute pancreatitis develops systemic inflammatory
response syndrome (SIRS). This is mediated by:
• A. Localized inflammation
• B. Cytokine release into circulation
• C. Apoptosis
• D. Ischemic injury
• Rationale: Systemic manifestations of SIRS result from the release of
inflammatory cytokines (like TNF, IL-1, IL-6) into the systemic circulation,
leading to fever, tachycardia, and other systemic effects.
Q12. Which type of inflammation is characterized by the presence of
multinucleated giant cells?
• A. Serous inflammation
• B. Fibrinous inflammation
Actual Questions, Verified Answers with Rationales |
Guarantee Pass
CELLULAR ADAPTATION, INJURY & NECROSIS
Q1. A patient with COPD has had prolonged injury to bronchial tissues. What
type of cellular adaptation should the nurse expect to find?
• A. Dysplasia
• B. Hyperplasia
• C. Atrophy
• D. Metaplasia
• Rationale: Metaplasia is the reversible replacement of one differentiated
cell type with another. In COPD, the normal ciliated columnar epithelium of
the airways is replaced by stratified squamous epithelium as an adaptive
response to chronic irritation .
Q2. A patient's pathology report describes "coagulative necrosis with
preservation of tissue architecture." This finding is most consistent with:
• A. Tuberculosis
• B. Myocardial infarction
• C. Pancreatic trauma
• D. Brain abscess
• Rationale: Coagulative necrosis is the hallmark of ischemic injury in solid
organs like the heart (myocardial infarction). The structural framework of
the tissue is preserved for a period of time despite cell death.
Q3. A patient with peritonitis develops adhesions between bowel loops. This is
a consequence of:
• A. Resolution of inflammation
, • B. Regeneration of tissue
• C. Organization of fibrin
• D. Suppuration
• Rationale: Fibrin strands formed during inflammation in the peritoneal
cavity can organize into fibrous adhesions, which are bands of scar tissue
that can cause bowel obstructions .
Q4. In tissue repair, which process involves replacement of damaged tissue with
functional parenchymal cells?
• A. Repair by scar
• B. Regeneration
• C. Granulation
• D. Organization
• Rationale: Regeneration involves replacement of lost tissue with cells of
the same type, restoring normal function. This is different from repair by
scar, which involves the formation of non-functional fibrous tissue.
Q5. What is liquefactive necrosis most commonly associated with?
• A. Myocardial infarction
• B. Tuberculosis
• C. Brain abscess or stroke
• D. Ischemic limb
• Rationale: Liquefactive necrosis occurs when dead cells are completely
digested by hydrolytic enzymes, turning the tissue into a liquid viscous
mass. It is characteristic of bacterial infections (abscesses) and hypoxic
death in the central nervous system (brain).
Q6. Caseous necrosis is a hallmark of which condition?
• A. Myocardial infarction
• B. Tuberculosis
, • C. Acute pancreatitis
• D. Venous infarction
• Rationale: Caseous necrosis (from "caseous" meaning cheese-like) is a
distinct form of necrosis seen almost exclusively in tuberculosis. It
combines features of both coagulative and liquefactive necrosis, resulting
in a soft, friable, "cheesy" debris.
Q7. The process of programmed cell death is known as:
• A. Necrosis
• B. Apoptosis
• C. Atrophy
• D. Metaplasia
• Rationale: Apoptosis is a highly regulated, energy-dependent process of
programmed cell death that eliminates unwanted or damaged cells without
causing an inflammatory response, unlike necrosis.
INFLAMMATION & WOUND HEALING
Q8. The first step in the inflammatory response is:
• A. Leukocyte migration
• B. Vasodilation
• C. Phagocytosis
• D. Fever
• Rationale: Vasodilation of arterioles and capillaries is the initial vascular
response in acute inflammation, increasing blood flow to the injured area
and causing redness (rubor) and heat (calor) .
Q9. The process by which leukocytes emigrate from blood vessels into tissue is
called:
• A. Margination
, • B. Diapedesis
• C. Chemotaxis
• D. Phagocytosis
• Rationale: Diapedesis (also called transmigration) is the process of
leukocyte movement through the vessel wall into interstitial tissue.
Margination is the process of leukocytes adhering to the endothelium .
Q10. Which of the following mediators is released from mast cells and causes
vasodilation?
• A. TNF-α
• B. Interleukin-1
• C. Histamine
• D. Interferon-γ
• Rationale: Histamine is a primary mediator released from mast cell
degranulation. It causes vasodilation and increased vascular permeability .
Q11. A patient with acute pancreatitis develops systemic inflammatory
response syndrome (SIRS). This is mediated by:
• A. Localized inflammation
• B. Cytokine release into circulation
• C. Apoptosis
• D. Ischemic injury
• Rationale: Systemic manifestations of SIRS result from the release of
inflammatory cytokines (like TNF, IL-1, IL-6) into the systemic circulation,
leading to fever, tachycardia, and other systemic effects.
Q12. Which type of inflammation is characterized by the presence of
multinucleated giant cells?
• A. Serous inflammation
• B. Fibrinous inflammation
