NURS 5433 FAMILY NURSE PRACTITIONER II –
COMPREHENSIVE EXAM BANK UNIVERSITY OF
TEXAS AT ARLINGTON (UTA) 300
MULTIPLECHOICE QUESTIONS WITH CORRECT
ANSWERS & RATIONALES
SECTION 1: CELLULAR ADAPTATION, PATHOPHYSIOLOGY, AND
IMMUNOLOGY (Questions 1–30)
1. A patient with chronic alcohol abuse presents with an enlarged liver. Biopsy
reveals increased smooth endoplasmic reticulum and fatty changes. Which
cellular adaptation has occurred?
A) Atrophy
B) Hypertrophy
C) Hyperplasia
D) Dysplasia
Correct Answer: B) Hypertrophy
Rationale: Hypertrophy refers to an increase in individual cell size, not cell
number. In chronic alcohol abuse, hepatocytes increase in size due to
increased metabolic demands and accumulation of lipids and proteins.
Atrophy is a decrease in cell size, hyperplasia is an increase in cell number,
and dysplasia involves abnormal cell growth and organization. The presence
of increased smooth endoplasmic reticulum is a classic adaptive response in
liver cells exposed to alcohol.
,2. A 55yearold patient with a 30packyear smoking history presents with a
persistent cough and hemoptysis. Lung biopsy shows cells with increased
nucleartocytoplasmic ratio, hyperchromatic nuclei, and loss of normal cellular
polarity. Which term best describes this finding?
A) Metaplasia
B) Dysplasia
C) Hypertrophy
D) Hyperplasia
Correct Answer: B) Dysplasia
Rationale: Dysplasia is characterized by abnormal cellular morphology,
including increased nucleartocytoplasmic ratio, hyperchromatic nuclei, and
loss of normal tissue organization. Dysplasia is considered a preneoplastic
change and carries the highest concern for potential malignant
transformation. Metaplasia is the replacement of one differentiated cell type
with another; hypertrophy is increased cell size; hyperplasia is increased cell
number.
3. A patient with chronic gastroesophageal reflux disease develops
replacement of the normal stratified squamous epithelium of the esophagus
with columnar epithelium. This change is best described as:
A) Dysplasia
B) Metaplasia
C) Neoplasia
D) Atrophy
,Correct Answer: B) Metaplasia
Rationale: Metaplasia is the reversible replacement of one differentiated cell
type with another in response to chronic irritation or inflammation. In
Barrett's esophagus, the normal squamous epithelium is replaced by
columnar epithelium similar to that found in the stomach or intestine. This
adaptive change is protective against further injury but increases the risk of
dysplasia and adenocarcinoma.
4. Which immunoglobulin is primarily found in secretions such as breast milk,
saliva, and tears?
A) IgG
B) IgM
C) IgA
D) IgE
Correct Answer: C) IgA
Rationale: Immunoglobulin A (IgA) is the predominant antibody in mucosal
secretions including breast milk, saliva, tears, and respiratory and
gastrointestinal secretions. It provides localized immune protection at
mucosal surfaces. IgG is the most abundant immunoglobulin in serum and
crosses the placenta; IgM is the first antibody produced in primary immune
responses; IgE is involved in allergic reactions and parasitic infections.
5. A newborn receives passive immunity from maternal antibodies that cross
the placenta. Which immunoglobulin is primarily responsible for this
transplacental transfer?
A) IgA
, B) IgD
C) IgG
D) IgE
Correct Answer: C) IgG
Rationale: Immunoglobulin G (IgG) is the only immunoglobulin class that
crosses the human placenta, providing passive immunity to the fetus. This
transfer begins around 20 weeks of gestation and increases throughout
pregnancy. IgG provides protection against bacterial and viral infections
during the first months of life until the infant's own immune system matures.
6. A patient with systemic lupus erythematosus has antibodies directed
against her own DNA and cellular components. This type of immune response
is best classified as:
A) Type I hypersensitivity
B) Type II hypersensitivity
C) Type III hypersensitivity
D) Type IV hypersensitivity
Correct Answer: C) Type III hypersensitivity
Rationale: Systemic lupus erythematosus is characterized by Type III
hypersensitivity reactions involving the formation of immune complexes
(antigenantibody complexes) that deposit in tissues such as kidneys, skin, and
joints, leading to complement activation and inflammation. Type I is
IgEmediated (allergies, anaphylaxis); Type II involves antibodymediated cell
destruction (autoimmune hemolytic anemia); Type IV is Tcell mediated
(contact dermatitis, tuberculosis).
COMPREHENSIVE EXAM BANK UNIVERSITY OF
TEXAS AT ARLINGTON (UTA) 300
MULTIPLECHOICE QUESTIONS WITH CORRECT
ANSWERS & RATIONALES
SECTION 1: CELLULAR ADAPTATION, PATHOPHYSIOLOGY, AND
IMMUNOLOGY (Questions 1–30)
1. A patient with chronic alcohol abuse presents with an enlarged liver. Biopsy
reveals increased smooth endoplasmic reticulum and fatty changes. Which
cellular adaptation has occurred?
A) Atrophy
B) Hypertrophy
C) Hyperplasia
D) Dysplasia
Correct Answer: B) Hypertrophy
Rationale: Hypertrophy refers to an increase in individual cell size, not cell
number. In chronic alcohol abuse, hepatocytes increase in size due to
increased metabolic demands and accumulation of lipids and proteins.
Atrophy is a decrease in cell size, hyperplasia is an increase in cell number,
and dysplasia involves abnormal cell growth and organization. The presence
of increased smooth endoplasmic reticulum is a classic adaptive response in
liver cells exposed to alcohol.
,2. A 55yearold patient with a 30packyear smoking history presents with a
persistent cough and hemoptysis. Lung biopsy shows cells with increased
nucleartocytoplasmic ratio, hyperchromatic nuclei, and loss of normal cellular
polarity. Which term best describes this finding?
A) Metaplasia
B) Dysplasia
C) Hypertrophy
D) Hyperplasia
Correct Answer: B) Dysplasia
Rationale: Dysplasia is characterized by abnormal cellular morphology,
including increased nucleartocytoplasmic ratio, hyperchromatic nuclei, and
loss of normal tissue organization. Dysplasia is considered a preneoplastic
change and carries the highest concern for potential malignant
transformation. Metaplasia is the replacement of one differentiated cell type
with another; hypertrophy is increased cell size; hyperplasia is increased cell
number.
3. A patient with chronic gastroesophageal reflux disease develops
replacement of the normal stratified squamous epithelium of the esophagus
with columnar epithelium. This change is best described as:
A) Dysplasia
B) Metaplasia
C) Neoplasia
D) Atrophy
,Correct Answer: B) Metaplasia
Rationale: Metaplasia is the reversible replacement of one differentiated cell
type with another in response to chronic irritation or inflammation. In
Barrett's esophagus, the normal squamous epithelium is replaced by
columnar epithelium similar to that found in the stomach or intestine. This
adaptive change is protective against further injury but increases the risk of
dysplasia and adenocarcinoma.
4. Which immunoglobulin is primarily found in secretions such as breast milk,
saliva, and tears?
A) IgG
B) IgM
C) IgA
D) IgE
Correct Answer: C) IgA
Rationale: Immunoglobulin A (IgA) is the predominant antibody in mucosal
secretions including breast milk, saliva, tears, and respiratory and
gastrointestinal secretions. It provides localized immune protection at
mucosal surfaces. IgG is the most abundant immunoglobulin in serum and
crosses the placenta; IgM is the first antibody produced in primary immune
responses; IgE is involved in allergic reactions and parasitic infections.
5. A newborn receives passive immunity from maternal antibodies that cross
the placenta. Which immunoglobulin is primarily responsible for this
transplacental transfer?
A) IgA
, B) IgD
C) IgG
D) IgE
Correct Answer: C) IgG
Rationale: Immunoglobulin G (IgG) is the only immunoglobulin class that
crosses the human placenta, providing passive immunity to the fetus. This
transfer begins around 20 weeks of gestation and increases throughout
pregnancy. IgG provides protection against bacterial and viral infections
during the first months of life until the infant's own immune system matures.
6. A patient with systemic lupus erythematosus has antibodies directed
against her own DNA and cellular components. This type of immune response
is best classified as:
A) Type I hypersensitivity
B) Type II hypersensitivity
C) Type III hypersensitivity
D) Type IV hypersensitivity
Correct Answer: C) Type III hypersensitivity
Rationale: Systemic lupus erythematosus is characterized by Type III
hypersensitivity reactions involving the formation of immune complexes
(antigenantibody complexes) that deposit in tissues such as kidneys, skin, and
joints, leading to complement activation and inflammation. Type I is
IgEmediated (allergies, anaphylaxis); Type II involves antibodymediated cell
destruction (autoimmune hemolytic anemia); Type IV is Tcell mediated
(contact dermatitis, tuberculosis).
