NURS 5432: Advanced Pathophysiology
& Advanced Health Assessment
Test 1 Practice Examination - Complete Study Guide &
Questions
1. A 45-year-old patient with chronic hypertension exhibits left ventricular hypertrophy.
Which cellular adaptation process best describes this cardiac changes?
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
Rationale: Hypertrophy is an increase in the size of individual cells, resulting in an
increased organ size, typically in response to mechanical load or stress such as systemic
hypertension. Hyperplasia involves an increase in cell number, which does not occur in
cardiac myocytes.
2. A smoker's bronchial biopsy reveals normal columnar ciliated epithelial cells replaced
by stratified squamous epithelial cells. This is an example of:
A) Anaplasia
B) Hyperplasia
C) Metaplasia
D) Dysplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type by another
mature cell type that is better able to withstand chronic stress/irritation, such as cigarette
smoke in the airway.
3. During myocardial ischemia, ATP depletion causes failure of the Na+/K+ ATPase
pump. What is the immediate cellular consequence?
A) Efflux of sodium into extracellular space
B) Cellular swelling due to influx of sodium and water
C) Intracellular alkalosis
D) Efflux of calcium into the mitochondrial matrix
Rationale: Failure of the Na+/K+ ATPase pump prevents sodium export, leading to
, intracellular accumulation of sodium. Water passively follows sodium into the cell, resulting
in acute cellular swelling (hydropic change).
4. Which type of necrosis is most characteristic of hypoxia-induced ischemic injury in
the brain?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
Rationale: Liquefactive necrosis is characteristic of ischemic breakdown in the central
nervous system because hydrolytic enzymes and autolytic processes rapidly digest dead
neural tissue into a liquid mass.
5. A patient with tuberculosis has a lung lesion showing soft, friable, cheese-like necrotic
tissue. This pattern is identified as:
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fibrinoid necrosis
Rationale: Caseous necrosis is typical of tuberculous pulmonary infections, presenting as a
combination of coagulative and liquefactive necrosis resembling clumped cheese.
6. Apoptosis differs from necrosis because apoptosis:
A) Causes significant surrounding tissue inflammation
B) Is an energy-dependent programmed process involving individual cells
C) Is always a pathologic response to severe acute physical injury
D) Results in early loss of cell membrane integrity and lyse
Rationale: Apoptosis is an ATP-dependent, tightly regulated cell suicide pathway that
degrades cell contents without breaking the cell membrane or initiating a prominent
inflammatory reaction.
7. Which enzyme system plays a central role in executing the caspase cascade during
programmed cell death?
A) Caspases
B) Cyclooxygenases
C) Matrix metalloproteinases
D) Phospholipase A2
& Advanced Health Assessment
Test 1 Practice Examination - Complete Study Guide &
Questions
1. A 45-year-old patient with chronic hypertension exhibits left ventricular hypertrophy.
Which cellular adaptation process best describes this cardiac changes?
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
Rationale: Hypertrophy is an increase in the size of individual cells, resulting in an
increased organ size, typically in response to mechanical load or stress such as systemic
hypertension. Hyperplasia involves an increase in cell number, which does not occur in
cardiac myocytes.
2. A smoker's bronchial biopsy reveals normal columnar ciliated epithelial cells replaced
by stratified squamous epithelial cells. This is an example of:
A) Anaplasia
B) Hyperplasia
C) Metaplasia
D) Dysplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type by another
mature cell type that is better able to withstand chronic stress/irritation, such as cigarette
smoke in the airway.
3. During myocardial ischemia, ATP depletion causes failure of the Na+/K+ ATPase
pump. What is the immediate cellular consequence?
A) Efflux of sodium into extracellular space
B) Cellular swelling due to influx of sodium and water
C) Intracellular alkalosis
D) Efflux of calcium into the mitochondrial matrix
Rationale: Failure of the Na+/K+ ATPase pump prevents sodium export, leading to
, intracellular accumulation of sodium. Water passively follows sodium into the cell, resulting
in acute cellular swelling (hydropic change).
4. Which type of necrosis is most characteristic of hypoxia-induced ischemic injury in
the brain?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
Rationale: Liquefactive necrosis is characteristic of ischemic breakdown in the central
nervous system because hydrolytic enzymes and autolytic processes rapidly digest dead
neural tissue into a liquid mass.
5. A patient with tuberculosis has a lung lesion showing soft, friable, cheese-like necrotic
tissue. This pattern is identified as:
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fibrinoid necrosis
Rationale: Caseous necrosis is typical of tuberculous pulmonary infections, presenting as a
combination of coagulative and liquefactive necrosis resembling clumped cheese.
6. Apoptosis differs from necrosis because apoptosis:
A) Causes significant surrounding tissue inflammation
B) Is an energy-dependent programmed process involving individual cells
C) Is always a pathologic response to severe acute physical injury
D) Results in early loss of cell membrane integrity and lyse
Rationale: Apoptosis is an ATP-dependent, tightly regulated cell suicide pathway that
degrades cell contents without breaking the cell membrane or initiating a prominent
inflammatory reaction.
7. Which enzyme system plays a central role in executing the caspase cascade during
programmed cell death?
A) Caspases
B) Cyclooxygenases
C) Matrix metalloproteinases
D) Phospholipase A2
