NR 507 Final Exam – Advanced Pathophysiology 2026/2027 exam
verified with correct answers plus rationales
1. A patient experiences cellular injury caused by prolonged tissue hypoxia. The
earliest major consequence of reduced oxygen availability is:
A. Increased oxidative phosphorylation
B. Increased ATP production
C. Decreased ATP production
D. Increased protein synthesis
Rationale: Oxygen is required for oxidative phosphorylation. Reduced oxygen decreases ATP
production, impairing energy-dependent cellular processes such as the sodium-potassium pump.
2. Failure of the sodium-potassium ATPase during cellular injury causes:
A. Potassium to move into the cell and sodium to leave
B. Sodium and water to accumulate intracellularly
C. Increased ATP production
D. Immediate DNA replication
Rationale: ATP depletion impairs the Na⁺/K⁺ pump, allowing sodium to accumulate
intracellularly. Water follows sodium, producing cellular swelling.
3. Which finding is most characteristic of reversible cellular injury?
A. Nuclear fragmentation
B. Cell membrane rupture
C. Cellular swelling
D. Complete loss of mitochondrial membranes
Rationale: Cellular swelling is a common early and potentially reversible response to injury.
Severe injury can progress to irreversible damage and cell death.
4. Apoptosis differs from necrosis because apoptosis:
A. Always causes extensive inflammation
B. Results from uncontrolled cell swelling
,C. Is a regulated form of programmed cell death
D. Always results from infection
Rationale: Apoptosis is a controlled process used to eliminate damaged or unnecessary cells,
usually without the extensive inflammation associated with necrosis.
5. Necrosis is most commonly associated with:
A. Normal tissue remodeling
B. Physiologic cell turnover
C. Cell injury with membrane disruption and inflammation
D. Controlled removal of individual cells
Rationale: Necrosis results from severe cell injury and commonly causes membrane disruption,
release of cellular contents, and an inflammatory response.
6. Free radicals cause cellular injury primarily by:
A. Increasing ATP synthesis
B. Damaging lipids, proteins, and nucleic acids
C. Preventing all inflammation
D. Increasing DNA repair
Rationale: Reactive oxygen species can oxidize cellular components, causing membrane,
protein, mitochondrial, and DNA damage.
7. Ischemia differs from hypoxemia because ischemia involves:
A. Increased blood flow
B. Reduced blood supply to a tissue
C. Increased oxygen delivery
D. Increased venous return
Rationale: Ischemia is inadequate tissue perfusion, resulting in reduced oxygen and nutrient
delivery and impaired waste removal.
8. Reperfusion injury occurs when:
, A. Blood flow permanently stops
B. Restoration of blood flow causes additional cellular damage
C. Oxygen is completely absent
D. ATP production increases without consequence
Rationale: Restoration of oxygenated blood can generate reactive oxygen species and
inflammatory responses that further injure previously ischemic tissue.
9. Acute inflammation is characterized by:
A. Primarily antibody production
B. Rapid recruitment of leukocytes, particularly neutrophils
C. Absence of vascular changes
D. Exclusive activation of B cells
Rationale: Acute inflammation occurs rapidly and commonly involves vasodilation, increased
vascular permeability, and neutrophil recruitment.
10. Histamine contributes to inflammation primarily by causing:
A. Vasoconstriction and decreased permeability
B. Vasodilation and increased vascular permeability
C. Reduced blood flow
D. Inhibition of leukocyte migration
Rationale: Histamine released from mast cells promotes vasodilation and increases vascular
permeability, contributing to redness, warmth, and edema.
11. Which leukocyte is typically prominent early in acute inflammation?
A. Lymphocyte
B. Plasma cell
C. Neutrophil
D. Eosinophil
Rationale: Neutrophils are generally the predominant early inflammatory leukocytes in acute
inflammation.
verified with correct answers plus rationales
1. A patient experiences cellular injury caused by prolonged tissue hypoxia. The
earliest major consequence of reduced oxygen availability is:
A. Increased oxidative phosphorylation
B. Increased ATP production
C. Decreased ATP production
D. Increased protein synthesis
Rationale: Oxygen is required for oxidative phosphorylation. Reduced oxygen decreases ATP
production, impairing energy-dependent cellular processes such as the sodium-potassium pump.
2. Failure of the sodium-potassium ATPase during cellular injury causes:
A. Potassium to move into the cell and sodium to leave
B. Sodium and water to accumulate intracellularly
C. Increased ATP production
D. Immediate DNA replication
Rationale: ATP depletion impairs the Na⁺/K⁺ pump, allowing sodium to accumulate
intracellularly. Water follows sodium, producing cellular swelling.
3. Which finding is most characteristic of reversible cellular injury?
A. Nuclear fragmentation
B. Cell membrane rupture
C. Cellular swelling
D. Complete loss of mitochondrial membranes
Rationale: Cellular swelling is a common early and potentially reversible response to injury.
Severe injury can progress to irreversible damage and cell death.
4. Apoptosis differs from necrosis because apoptosis:
A. Always causes extensive inflammation
B. Results from uncontrolled cell swelling
,C. Is a regulated form of programmed cell death
D. Always results from infection
Rationale: Apoptosis is a controlled process used to eliminate damaged or unnecessary cells,
usually without the extensive inflammation associated with necrosis.
5. Necrosis is most commonly associated with:
A. Normal tissue remodeling
B. Physiologic cell turnover
C. Cell injury with membrane disruption and inflammation
D. Controlled removal of individual cells
Rationale: Necrosis results from severe cell injury and commonly causes membrane disruption,
release of cellular contents, and an inflammatory response.
6. Free radicals cause cellular injury primarily by:
A. Increasing ATP synthesis
B. Damaging lipids, proteins, and nucleic acids
C. Preventing all inflammation
D. Increasing DNA repair
Rationale: Reactive oxygen species can oxidize cellular components, causing membrane,
protein, mitochondrial, and DNA damage.
7. Ischemia differs from hypoxemia because ischemia involves:
A. Increased blood flow
B. Reduced blood supply to a tissue
C. Increased oxygen delivery
D. Increased venous return
Rationale: Ischemia is inadequate tissue perfusion, resulting in reduced oxygen and nutrient
delivery and impaired waste removal.
8. Reperfusion injury occurs when:
, A. Blood flow permanently stops
B. Restoration of blood flow causes additional cellular damage
C. Oxygen is completely absent
D. ATP production increases without consequence
Rationale: Restoration of oxygenated blood can generate reactive oxygen species and
inflammatory responses that further injure previously ischemic tissue.
9. Acute inflammation is characterized by:
A. Primarily antibody production
B. Rapid recruitment of leukocytes, particularly neutrophils
C. Absence of vascular changes
D. Exclusive activation of B cells
Rationale: Acute inflammation occurs rapidly and commonly involves vasodilation, increased
vascular permeability, and neutrophil recruitment.
10. Histamine contributes to inflammation primarily by causing:
A. Vasoconstriction and decreased permeability
B. Vasodilation and increased vascular permeability
C. Reduced blood flow
D. Inhibition of leukocyte migration
Rationale: Histamine released from mast cells promotes vasodilation and increases vascular
permeability, contributing to redness, warmth, and edema.
11. Which leukocyte is typically prominent early in acute inflammation?
A. Lymphocyte
B. Plasma cell
C. Neutrophil
D. Eosinophil
Rationale: Neutrophils are generally the predominant early inflammatory leukocytes in acute
inflammation.
