NUR 555 ADVANCED CLINICAL
PATHOPHYSIOLOGY
COMPREHENSIVE EXAMINATION
QUESTIONS AND ANSWERS
1. A patient with chronic gastroesophageal reflux disease (GERD) undergoes an endoscopy,
which reveals the replacement of normal squamous epithelium with columnar epithelium.
This process is best described as:
A. Dysplasia
B. Anaplasia
C. Hyperplasia
D. Metaplasia
Answer: D
Conceptual Explanation: Metaplasia is a reversible replacement of one mature cell type
by another, often as an adaptation to chronic irritation or inflammation.
2. During cellular injury, the failure of the sodium-potassium (Na+/K+) pump leads to which
immediate intracellular change?
A. Oncotic cell swelling
,B. Increased intracellular potassium
C. Intracellular acidosis
D. Mitochondrial calcification
Answer: A
Conceptual Explanation: Failure of the Na+/K+ pump allows sodium to accumulate inside
the cell, which draws water in by osmosis, resulting in cellular swelling.
3. Which mechanism of cell death is characterized by organized DNA fragmentation, lack of
inflammation, and dependence on caspases?
A. Coagulative necrosis
B. Apoptosis
C. Autophagy
D. Liquefactive necrosis
Answer: B
Conceptual Explanation: Apoptosis is a programmed, active process of cellular self-
destruction that does not typically elicit an inflammatory response.
4. In the context of fluid and electrolyte balance, how does the body compensate for
metabolic acidosis?
A. Decreasing respiratory rate to retain CO2
B. Decreasing the secretion of hydrogen ions in the distal tubule
, C. Increasing renal excretion of bicarbonate
D. Hyperventilation to decrease pCO2
Answer: D
Conceptual Explanation: To compensate for metabolic acidosis, the respiratory system
increases the rate and depth of breathing (Kussmaul respirations) to blow off CO2 and
raise pH.
5. Which type of hypersensitivity reaction is mediated by IgE and involves the degranulation
of mast cells and basophils?
A. Type III (Immune Complex)
B. Type II (Cytotoxic)
C. Type I (Immediate)
D. Type IV (Delayed)
Answer: C
Conceptual Explanation: Type I hypersensitivity is IgE-mediated, triggering mast cell
release of histamine and other mediators in response to an allergen.
6. What is the primary pathophysiological defect in Myasthenia Gravis?
A. Degeneration of lower motor neurons
B. Antibody-mediated destruction of acetylcholine receptors
C. Demyelination of the central nervous system
PATHOPHYSIOLOGY
COMPREHENSIVE EXAMINATION
QUESTIONS AND ANSWERS
1. A patient with chronic gastroesophageal reflux disease (GERD) undergoes an endoscopy,
which reveals the replacement of normal squamous epithelium with columnar epithelium.
This process is best described as:
A. Dysplasia
B. Anaplasia
C. Hyperplasia
D. Metaplasia
Answer: D
Conceptual Explanation: Metaplasia is a reversible replacement of one mature cell type
by another, often as an adaptation to chronic irritation or inflammation.
2. During cellular injury, the failure of the sodium-potassium (Na+/K+) pump leads to which
immediate intracellular change?
A. Oncotic cell swelling
,B. Increased intracellular potassium
C. Intracellular acidosis
D. Mitochondrial calcification
Answer: A
Conceptual Explanation: Failure of the Na+/K+ pump allows sodium to accumulate inside
the cell, which draws water in by osmosis, resulting in cellular swelling.
3. Which mechanism of cell death is characterized by organized DNA fragmentation, lack of
inflammation, and dependence on caspases?
A. Coagulative necrosis
B. Apoptosis
C. Autophagy
D. Liquefactive necrosis
Answer: B
Conceptual Explanation: Apoptosis is a programmed, active process of cellular self-
destruction that does not typically elicit an inflammatory response.
4. In the context of fluid and electrolyte balance, how does the body compensate for
metabolic acidosis?
A. Decreasing respiratory rate to retain CO2
B. Decreasing the secretion of hydrogen ions in the distal tubule
, C. Increasing renal excretion of bicarbonate
D. Hyperventilation to decrease pCO2
Answer: D
Conceptual Explanation: To compensate for metabolic acidosis, the respiratory system
increases the rate and depth of breathing (Kussmaul respirations) to blow off CO2 and
raise pH.
5. Which type of hypersensitivity reaction is mediated by IgE and involves the degranulation
of mast cells and basophils?
A. Type III (Immune Complex)
B. Type II (Cytotoxic)
C. Type I (Immediate)
D. Type IV (Delayed)
Answer: C
Conceptual Explanation: Type I hypersensitivity is IgE-mediated, triggering mast cell
release of histamine and other mediators in response to an allergen.
6. What is the primary pathophysiological defect in Myasthenia Gravis?
A. Degeneration of lower motor neurons
B. Antibody-mediated destruction of acetylcholine receptors
C. Demyelination of the central nervous system
