WGU D236 Pathophysiology OA V2 – Complete
Practice Questions with Rationales
SECTION 1: CELLULAR ADAPTATION, INJURY &
INFLAMMATION (Questions 1–20)
Question 1: Which cellular adaptation is characterized by an increase in the
number of cells in an organ or tissue?
A) Atrophy
B) Hypertrophy
C) Metaplasia
D) Hyperplasia
Correct Answer: D) Hyperplasia
Rationale: Hyperplasia is an increase in the number of cells resulting from an
increased rate of cellular division. This can be physiologic (e.g., breast
development during puberty) or pathologic (e.g., endometrial hyperplasia).
Atrophy is a decrease in cell size, hypertrophy is an increase in cell size, and
metaplasia is the replacement of one mature cell type by another.
Question 2: A patient with chronic high blood pressure has an enlarged left
ventricle. This is an example of:
A) Atrophy
B) Dysplasia
,C) Metaplasia
D) Hypertrophy
Correct Answer: D) Hypertrophy
Rationale: Hypertrophy is an increase in the size of cells, which consequently
increases the size of the organ. The left ventricle hypertrophies in response to
chronic pressure overload from hypertension. This is a compensatory
mechanism to meet increased workload demands.
Question 3: The replacement of normal ciliated columnar epithelium with
stratified squamous epithelium in a smoker's airway is:
A) Hyperplasia
B) Dysplasia
C) Atrophy
D) Metaplasia
Correct Answer: D) Metaplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type by
another, often less differentiated, cell type. This occurs in the airways of
smokers as an adaptive response to chronic irritation from cigarette smoke.
The stratified squamous epithelium is more resistant to the irritants but loses
the protective ciliary function.
Question 4: Which term describes abnormal changes in the size, shape,
and organization of mature cells, often considered pre-cancerous?
A) Dysplasia
B) Metaplasia
,C) Anaplasia
D) Hyperplasia
Correct Answer: A) Dysplasia
Rationale: Dysplasia refers to abnormal changes in cell size, shape, and
organization. It is not a true adaptive process but is related to hyperplasia. It
is considered a pre-cancerous condition because if the underlying cause is not
removed, it can progress to carcinoma in situ and invasive cancer.
Question 5: A client with cellular injury is found to have increased
intracellular calcium. This finding is most consistent with:
A) Cellular necrosis
B) Apoptosis
C) Cellular adaptation
D) Cellular regeneration
Correct Answer: A) Cellular necrosis
Rationale: Increased intracellular calcium is a hallmark of cellular necrosis.
Calcium overload activates proteases and phospholipases, leading to cell
membrane destruction and further injury. Apoptosis is programmed cell
death that does not involve significant calcium influx or inflammation.
Question 6: Which process is characterized by programmed cell death
without triggering an inflammatory response?
A) Necrosis
B) Apoptosis
C) Coagulative necrosis
D) Caseous necrosis
, Correct Answer: B) Apoptosis
Rationale: Apoptosis is a controlled, energy-dependent process of
programmed cell death that does not trigger inflammation. Necrosis is
unregulated cell death that releases cellular contents and triggers an
inflammatory response. Coagulative and caseous necrosis are specific types
of necrosis.
Question 7: The nurse notes that a client's wound has granulation tissue
forming. This indicates:
A) The wound is in the inflammatory phase
B) The wound is in the proliferative phase
C) The wound is in the maturation phase
D) The wound is infected
Correct Answer: B) The wound is in the proliferative phase
Rationale: Granulation tissue is a hallmark of the proliferative phase of
wound healing. It consists of new blood vessels, fibroblasts, and collagen. This
phase follows the inflammatory phase and precedes the maturation phase.
Granulation tissue appears as pink, moist, and granular tissue in the wound
bed.
Question 8: A process that 'tags' a microbe for destruction by phagocytes
is:
A) Apoptosis
B) Degranulation
C) Neutralization
D) Opsonization
Practice Questions with Rationales
SECTION 1: CELLULAR ADAPTATION, INJURY &
INFLAMMATION (Questions 1–20)
Question 1: Which cellular adaptation is characterized by an increase in the
number of cells in an organ or tissue?
A) Atrophy
B) Hypertrophy
C) Metaplasia
D) Hyperplasia
Correct Answer: D) Hyperplasia
Rationale: Hyperplasia is an increase in the number of cells resulting from an
increased rate of cellular division. This can be physiologic (e.g., breast
development during puberty) or pathologic (e.g., endometrial hyperplasia).
Atrophy is a decrease in cell size, hypertrophy is an increase in cell size, and
metaplasia is the replacement of one mature cell type by another.
Question 2: A patient with chronic high blood pressure has an enlarged left
ventricle. This is an example of:
A) Atrophy
B) Dysplasia
,C) Metaplasia
D) Hypertrophy
Correct Answer: D) Hypertrophy
Rationale: Hypertrophy is an increase in the size of cells, which consequently
increases the size of the organ. The left ventricle hypertrophies in response to
chronic pressure overload from hypertension. This is a compensatory
mechanism to meet increased workload demands.
Question 3: The replacement of normal ciliated columnar epithelium with
stratified squamous epithelium in a smoker's airway is:
A) Hyperplasia
B) Dysplasia
C) Atrophy
D) Metaplasia
Correct Answer: D) Metaplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type by
another, often less differentiated, cell type. This occurs in the airways of
smokers as an adaptive response to chronic irritation from cigarette smoke.
The stratified squamous epithelium is more resistant to the irritants but loses
the protective ciliary function.
Question 4: Which term describes abnormal changes in the size, shape,
and organization of mature cells, often considered pre-cancerous?
A) Dysplasia
B) Metaplasia
,C) Anaplasia
D) Hyperplasia
Correct Answer: A) Dysplasia
Rationale: Dysplasia refers to abnormal changes in cell size, shape, and
organization. It is not a true adaptive process but is related to hyperplasia. It
is considered a pre-cancerous condition because if the underlying cause is not
removed, it can progress to carcinoma in situ and invasive cancer.
Question 5: A client with cellular injury is found to have increased
intracellular calcium. This finding is most consistent with:
A) Cellular necrosis
B) Apoptosis
C) Cellular adaptation
D) Cellular regeneration
Correct Answer: A) Cellular necrosis
Rationale: Increased intracellular calcium is a hallmark of cellular necrosis.
Calcium overload activates proteases and phospholipases, leading to cell
membrane destruction and further injury. Apoptosis is programmed cell
death that does not involve significant calcium influx or inflammation.
Question 6: Which process is characterized by programmed cell death
without triggering an inflammatory response?
A) Necrosis
B) Apoptosis
C) Coagulative necrosis
D) Caseous necrosis
, Correct Answer: B) Apoptosis
Rationale: Apoptosis is a controlled, energy-dependent process of
programmed cell death that does not trigger inflammation. Necrosis is
unregulated cell death that releases cellular contents and triggers an
inflammatory response. Coagulative and caseous necrosis are specific types
of necrosis.
Question 7: The nurse notes that a client's wound has granulation tissue
forming. This indicates:
A) The wound is in the inflammatory phase
B) The wound is in the proliferative phase
C) The wound is in the maturation phase
D) The wound is infected
Correct Answer: B) The wound is in the proliferative phase
Rationale: Granulation tissue is a hallmark of the proliferative phase of
wound healing. It consists of new blood vessels, fibroblasts, and collagen. This
phase follows the inflammatory phase and precedes the maturation phase.
Granulation tissue appears as pink, moist, and granular tissue in the wound
bed.
Question 8: A process that 'tags' a microbe for destruction by phagocytes
is:
A) Apoptosis
B) Degranulation
C) Neutralization
D) Opsonization
