,WGU D115 Advanced Pathophysiology Objective Assessment
Final Exam Test Bank | 2026/2027 Edition (PDF)
1. A patient with chronic hypertension develops thickening of the left ventricular wall. Which cellular
adaptation best explains this change?
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Dysplasia
Correct Answer: Hypertrophy
Rationale: Hypertrophy is an increase in cell size in response to increased workload, such as the
hemodynamic overload seen in hypertension. Cardiac muscle cells have limited mitotic capacity and
thus respond primarily through hypertrophy rather than hyperplasia. Metaplasia is a replacement of
one cell type by another, and dysplasia involves abnormal cellular growth; neither describes the
adaptive enlargement of existing myocardial cells.
2. Prolonged myocardial ischemia leading to cell membrane rupture and leakage of intracellular
contents is characteristic of which type of cell death?
A) Apoptosis
B) Necrosis
C) Atrophy
D) Autophagy
Correct Answer: Necrosis
Rationale: Necrosis is the result of irreversible cellular injury and is characterized by cell swelling,
membrane rupture, and an inflammatory response. Apoptosis is programmed cell death that occurs
without inflammation and does not involve membrane rupture. Atrophy is a decrease in cell size, and
autophagy is a cellular recycling process, neither of which describes the acute, unregulated death seen
in ischemia.
,3. Which cellular adaptation is characterized by a reversible change in which one differentiated cell
type is replaced by another?
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Anaplasia
Correct Answer: Metaplasia
Rationale: Metaplasia is a reversible adaptation where one mature cell type is replaced by another
cell type better suited to withstand a chronic irritant. Hyperplasia is an increase in cell number,
hypertrophy is an increase in cell size, and anaplasia is a loss of cellular differentiation associated with
malignancy.
4. A patient with chronic gastroesophageal reflux disease develops replacement of the normal
stratified squamous epithelium of the lower esophagus with columnar epithelium. This change is best
described as:
A) Dysplasia
B) Hyperplasia
C) Metaplasia
D) Neoplasia
Correct Answer: Metaplasia
Rationale: The replacement of squamous epithelium with columnar epithelium (Barrett esophagus) in
response to chronic acid exposure is a classic example of metaplasia. Dysplasia involves disordered
cellular growth, hyperplasia is an increase in cell number, and neoplasia is uncontrolled proliferation.
5. Free radicals cause cellular injury primarily through which mechanism?
A) Increased ATP production
B) Oxidative damage to lipids, proteins, and DNA
C) Stabilization of cell membranes
, D) Enhanced DNA repair
Correct Answer: Oxidative damage to lipids, proteins, and DNA
Rationale: Free radicals are highly reactive molecules that cause cellular injury by lipid peroxidation of
membranes, oxidation of proteins, and DNA strand breaks. They do not increase ATP production,
stabilize membranes, or enhance repair mechanisms.
6. A patient presents with a painless breast mass. Biopsy reveals poorly differentiated cells with
hyperchromatic nuclei and numerous mitotic figures. This histologic appearance is best termed:
A) Metaplasia
B) Hypertrophy
C) Anaplasia
D) Dysplasia
Correct Answer: Anaplasia
Rationale: Anaplasia is the hallmark of malignancy, characterized by loss of cellular differentiation,
pleomorphism, hyperchromatic nuclei, and increased mitotic activity. Metaplasia is a reversible
cellular change, hypertrophy is an increase in cell size, and dysplasia involves abnormal but non-
malignant cellular growth.
7. In a patient with chronic obstructive pulmonary disease, the bronchial epithelium undergoes
transformation from pseudostratified columnar to stratified squamous epithelium. This process is
known as:
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Neoplasia
Correct Answer: Metaplasia
Final Exam Test Bank | 2026/2027 Edition (PDF)
1. A patient with chronic hypertension develops thickening of the left ventricular wall. Which cellular
adaptation best explains this change?
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Dysplasia
Correct Answer: Hypertrophy
Rationale: Hypertrophy is an increase in cell size in response to increased workload, such as the
hemodynamic overload seen in hypertension. Cardiac muscle cells have limited mitotic capacity and
thus respond primarily through hypertrophy rather than hyperplasia. Metaplasia is a replacement of
one cell type by another, and dysplasia involves abnormal cellular growth; neither describes the
adaptive enlargement of existing myocardial cells.
2. Prolonged myocardial ischemia leading to cell membrane rupture and leakage of intracellular
contents is characteristic of which type of cell death?
A) Apoptosis
B) Necrosis
C) Atrophy
D) Autophagy
Correct Answer: Necrosis
Rationale: Necrosis is the result of irreversible cellular injury and is characterized by cell swelling,
membrane rupture, and an inflammatory response. Apoptosis is programmed cell death that occurs
without inflammation and does not involve membrane rupture. Atrophy is a decrease in cell size, and
autophagy is a cellular recycling process, neither of which describes the acute, unregulated death seen
in ischemia.
,3. Which cellular adaptation is characterized by a reversible change in which one differentiated cell
type is replaced by another?
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Anaplasia
Correct Answer: Metaplasia
Rationale: Metaplasia is a reversible adaptation where one mature cell type is replaced by another
cell type better suited to withstand a chronic irritant. Hyperplasia is an increase in cell number,
hypertrophy is an increase in cell size, and anaplasia is a loss of cellular differentiation associated with
malignancy.
4. A patient with chronic gastroesophageal reflux disease develops replacement of the normal
stratified squamous epithelium of the lower esophagus with columnar epithelium. This change is best
described as:
A) Dysplasia
B) Hyperplasia
C) Metaplasia
D) Neoplasia
Correct Answer: Metaplasia
Rationale: The replacement of squamous epithelium with columnar epithelium (Barrett esophagus) in
response to chronic acid exposure is a classic example of metaplasia. Dysplasia involves disordered
cellular growth, hyperplasia is an increase in cell number, and neoplasia is uncontrolled proliferation.
5. Free radicals cause cellular injury primarily through which mechanism?
A) Increased ATP production
B) Oxidative damage to lipids, proteins, and DNA
C) Stabilization of cell membranes
, D) Enhanced DNA repair
Correct Answer: Oxidative damage to lipids, proteins, and DNA
Rationale: Free radicals are highly reactive molecules that cause cellular injury by lipid peroxidation of
membranes, oxidation of proteins, and DNA strand breaks. They do not increase ATP production,
stabilize membranes, or enhance repair mechanisms.
6. A patient presents with a painless breast mass. Biopsy reveals poorly differentiated cells with
hyperchromatic nuclei and numerous mitotic figures. This histologic appearance is best termed:
A) Metaplasia
B) Hypertrophy
C) Anaplasia
D) Dysplasia
Correct Answer: Anaplasia
Rationale: Anaplasia is the hallmark of malignancy, characterized by loss of cellular differentiation,
pleomorphism, hyperchromatic nuclei, and increased mitotic activity. Metaplasia is a reversible
cellular change, hypertrophy is an increase in cell size, and dysplasia involves abnormal but non-
malignant cellular growth.
7. In a patient with chronic obstructive pulmonary disease, the bronchial epithelium undergoes
transformation from pseudostratified columnar to stratified squamous epithelium. This process is
known as:
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Neoplasia
Correct Answer: Metaplasia
