UNDERGRADUATE NURSING PATHOPHYSIOLOGY
N212 PATHOPHYSIOLOGY
EXAM 1 (EASTWICK COLLEGE) A+
2026/2027 Official Exam
Nursing Review of Pathophysiology — Foundational Concepts
A+ QUESTIONS 5 SECTIONS 100% RATIONALES
VERIFIED COMPLETE INCLUDED
CATEGORIES
Section 1: Cellular Adaptation, Injury & Death
Section 2: Inflammation & Tissue Repair
Section 3: Fluid, Electrolyte & Acid-Base Balance
Section 4: Immunity & Hypersensitivity
Section 5: Stress Response, Neoplasia & Inflammatory Exemplars
STUVIAACTUALEXAM
Original practice content aligned to public course domains • For educational use
, Section 1: Cellular Adaptation, Injury & Death
Q1. A 68-year-old man with long-standing hypertension is found to have left ventricular wall thickening on
echocardiogram. The nurse explains that this change represents which cellular adaptation?
A. Metaplasia of myocardial tissue secondary to chronic ischemia
B. Atrophy of the ventricular wall due to progressive heart failure
C. Hyperplasia of cardiac myocytes in response to increased afterload
D. Hypertrophy of cardiac myocytes caused by sustained pressure overload
Correct Answer: D
Rationale:
Sustained hypertension increases afterload, triggering hypertrophic growth of individual cardiac myocytes. Hyperplasia does not
occur in adult cardiac muscle because myocytes are permanent cells with limited proliferative capacity.
Q2. A patient who has been bedridden for three weeks develops marked wasting of the leg muscles. Which
cellular process best accounts for this change?
A. Hypertrophy of remaining muscle fibers attempting to compensate
B. Pathologic hyperplasia driven by inflammatory cytokines
C. Metaplastic replacement of skeletal muscle by fibrous tissue
D. Disuse atrophy resulting from reduced workload and decreased protein synthesis
Correct Answer: D
Rationale:
Prolonged immobilization reduces mechanical stress on skeletal muscle, leading to decreased protein synthesis and
accelerated protein degradation, which produces disuse atrophy. The process is reversible once normal activity resumes.
Q3. During a cervical biopsy, the pathologist notes replacement of normal columnar epithelium by stratified
squamous epithelium in a patient with chronic cervicitis. This finding is an example of which adaptive
change?
A. Dysplasia indicating irreversible premalignant transformation
B. Hyperplasia of reserve cells that always progresses to carcinoma
C. Hypertrophy of the epithelial layer secondary to hormonal stimulation
D. Metaplasia that is potentially reversible if the chronic irritant is removed
Correct Answer: D
Rationale:
Metaplasia is the reversible replacement of one differentiated cell type by another better suited to withstand chronic stress. In
the cervix, persistent irritation can induce squamous metaplasia; removal of the stimulus may allow return to normal epithelium.
, N212 PATHOPHYSIOLOGY EXAM 1 — 2026/2027 Page 3
Q4. A tissue sample from a patient with Barrett esophagus shows intestinal-type epithelium in the distal
esophagus. The nurse recognizes that this adaptive change increases the long-term risk for which condition?
A. Spontaneous regression to normal squamous epithelium in all cases
B. Adenocarcinoma arising from the metaplastic epithelium
C. Benign esophageal stricture without malignant potential
D. Squamous cell carcinoma of the esophagus
Correct Answer: B
Rationale:
Barrett esophagus is intestinal metaplasia of the distal esophagus caused by chronic gastroesophageal reflux. The metaplastic
columnar epithelium carries a well-documented increased risk of progression to esophageal adenocarcinoma.
Q5. A laboratory report describes cells with nuclear shrinkage, chromatin condensation, and cytoplasmic
eosinophilia in a region of ischemic myocardium. These features are most consistent with which process?
A. Liquefactive necrosis typically seen in the central nervous system
B. Apoptosis of individual myocytes without inflammation
C. Reversible cellular swelling that will recover with reperfusion
D. Coagulative necrosis characteristic of ischemic injury in solid organs
Correct Answer: D
Rationale:
Coagulative necrosis is the hallmark of ischemic injury in most solid organs, including the heart. The described nuclear and
cytoplasmic changes reflect protein denaturation while tissue architecture is initially preserved.
Q6. A patient sustains a severe burn injury. Histologic examination of the deepest zone of injury reveals complete
loss of cellular detail and a pale, firm appearance. This zone corresponds to which type of tissue damage?
A. Zone of inflammation driven by neutrophil infiltration alone
B. Zone of coagulation characterized by irreversible necrosis
C. Zone of stasis that remains viable if perfusion is restored promptly
D. Zone of hyperemia that will recover without scarring
Correct Answer: B
Rationale:
In burn pathology the zone of coagulation is the central area of irreversible cell death caused by direct thermal injury.
Surrounding zones of stasis and hyperemia may still be salvageable with optimal care.
N212 PATHOPHYSIOLOGY
EXAM 1 (EASTWICK COLLEGE) A+
2026/2027 Official Exam
Nursing Review of Pathophysiology — Foundational Concepts
A+ QUESTIONS 5 SECTIONS 100% RATIONALES
VERIFIED COMPLETE INCLUDED
CATEGORIES
Section 1: Cellular Adaptation, Injury & Death
Section 2: Inflammation & Tissue Repair
Section 3: Fluid, Electrolyte & Acid-Base Balance
Section 4: Immunity & Hypersensitivity
Section 5: Stress Response, Neoplasia & Inflammatory Exemplars
STUVIAACTUALEXAM
Original practice content aligned to public course domains • For educational use
, Section 1: Cellular Adaptation, Injury & Death
Q1. A 68-year-old man with long-standing hypertension is found to have left ventricular wall thickening on
echocardiogram. The nurse explains that this change represents which cellular adaptation?
A. Metaplasia of myocardial tissue secondary to chronic ischemia
B. Atrophy of the ventricular wall due to progressive heart failure
C. Hyperplasia of cardiac myocytes in response to increased afterload
D. Hypertrophy of cardiac myocytes caused by sustained pressure overload
Correct Answer: D
Rationale:
Sustained hypertension increases afterload, triggering hypertrophic growth of individual cardiac myocytes. Hyperplasia does not
occur in adult cardiac muscle because myocytes are permanent cells with limited proliferative capacity.
Q2. A patient who has been bedridden for three weeks develops marked wasting of the leg muscles. Which
cellular process best accounts for this change?
A. Hypertrophy of remaining muscle fibers attempting to compensate
B. Pathologic hyperplasia driven by inflammatory cytokines
C. Metaplastic replacement of skeletal muscle by fibrous tissue
D. Disuse atrophy resulting from reduced workload and decreased protein synthesis
Correct Answer: D
Rationale:
Prolonged immobilization reduces mechanical stress on skeletal muscle, leading to decreased protein synthesis and
accelerated protein degradation, which produces disuse atrophy. The process is reversible once normal activity resumes.
Q3. During a cervical biopsy, the pathologist notes replacement of normal columnar epithelium by stratified
squamous epithelium in a patient with chronic cervicitis. This finding is an example of which adaptive
change?
A. Dysplasia indicating irreversible premalignant transformation
B. Hyperplasia of reserve cells that always progresses to carcinoma
C. Hypertrophy of the epithelial layer secondary to hormonal stimulation
D. Metaplasia that is potentially reversible if the chronic irritant is removed
Correct Answer: D
Rationale:
Metaplasia is the reversible replacement of one differentiated cell type by another better suited to withstand chronic stress. In
the cervix, persistent irritation can induce squamous metaplasia; removal of the stimulus may allow return to normal epithelium.
, N212 PATHOPHYSIOLOGY EXAM 1 — 2026/2027 Page 3
Q4. A tissue sample from a patient with Barrett esophagus shows intestinal-type epithelium in the distal
esophagus. The nurse recognizes that this adaptive change increases the long-term risk for which condition?
A. Spontaneous regression to normal squamous epithelium in all cases
B. Adenocarcinoma arising from the metaplastic epithelium
C. Benign esophageal stricture without malignant potential
D. Squamous cell carcinoma of the esophagus
Correct Answer: B
Rationale:
Barrett esophagus is intestinal metaplasia of the distal esophagus caused by chronic gastroesophageal reflux. The metaplastic
columnar epithelium carries a well-documented increased risk of progression to esophageal adenocarcinoma.
Q5. A laboratory report describes cells with nuclear shrinkage, chromatin condensation, and cytoplasmic
eosinophilia in a region of ischemic myocardium. These features are most consistent with which process?
A. Liquefactive necrosis typically seen in the central nervous system
B. Apoptosis of individual myocytes without inflammation
C. Reversible cellular swelling that will recover with reperfusion
D. Coagulative necrosis characteristic of ischemic injury in solid organs
Correct Answer: D
Rationale:
Coagulative necrosis is the hallmark of ischemic injury in most solid organs, including the heart. The described nuclear and
cytoplasmic changes reflect protein denaturation while tissue architecture is initially preserved.
Q6. A patient sustains a severe burn injury. Histologic examination of the deepest zone of injury reveals complete
loss of cellular detail and a pale, firm appearance. This zone corresponds to which type of tissue damage?
A. Zone of inflammation driven by neutrophil infiltration alone
B. Zone of coagulation characterized by irreversible necrosis
C. Zone of stasis that remains viable if perfusion is restored promptly
D. Zone of hyperemia that will recover without scarring
Correct Answer: B
Rationale:
In burn pathology the zone of coagulation is the central area of irreversible cell death caused by direct thermal injury.
Surrounding zones of stasis and hyperemia may still be salvageable with optimal care.
