NIGHTINGALE PATHOPHYSIOLOGY MIDTERM EXAM VERIFIED
WITH CORRECT ANSWERS PLUS RATIONALES 2026/2027
INSTANT PDF
1. Which statement best describes pathophysiology?
A. The study of normal anatomy
B. The study of drug administration
C. The study of altered physiological processes associated with disease
D. The study of surgical procedures
Answer: C. The study of altered physiological processes associated with
disease
RATIONALE: Pathophysiology examines how disease or injury disrupts
normal physiological function at the cellular, tissue, organ, and systemic levels.
2. What does etiology refer to?
A. The cause or origin of a disease
B. The clinical treatment of disease
C. The expected outcome of treatment
D. The physical examination of a patient
Answer: A. The cause or origin of a disease
RATIONALE: Etiology identifies the cause or contributing factors responsible
for the development of a disease.
3. A patient develops cellular injury after prolonged oxygen deprivation.
Which condition most directly explains this injury?
A. Hyperplasia
B. Hypoxia
C. Hypertrophy
D. Metaplasia
Answer: B. Hypoxia
, RATIONALE: Hypoxia is inadequate oxygen availability. Because oxygen is
required for efficient ATP production, prolonged hypoxia can impair cellular
metabolism and cause injury.
4. Which cellular adaptation involves an increase in cell size?
A. Atrophy
B. Metaplasia
C. Hyperplasia
D. Hypertrophy
Answer: D. Hypertrophy
RATIONALE: Hypertrophy is an increase in individual cell size. It commonly
occurs when cells experience increased workload.
5. Which cellular adaptation involves an increase in the number of cells?
A. Hyperplasia
B. Atrophy
C. Hypertrophy
D. Dysplasia
Answer: A. Hyperplasia
RATIONALE: Hyperplasia occurs when cellular proliferation increases the
number of cells within a tissue.
6. A patient has skeletal muscle wasting after prolonged immobilization.
Which adaptation is occurring?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Answer: C. Atrophy
, RATIONALE: Atrophy is a reduction in cell size and often results from
decreased workload, inadequate nutrition, loss of innervation, or reduced blood
supply.
7. A smoker develops replacement of normal respiratory epithelium with a
different type of epithelial cell. Which process is this?
A. Hypertrophy
B. Metaplasia
C. Atrophy
D. Hyperplasia
Answer: B. Metaplasia
RATIONALE: Metaplasia is a reversible change in which one differentiated
cell type is replaced by another better able to tolerate chronic stress.
8. Which factor is most directly responsible for ATP depletion during severe
hypoxia?
A. Increased DNA replication
B. Increased protein synthesis
C. Reduced oxidative phosphorylation
D. Increased lysosomal activity
Answer: C. Reduced oxidative phosphorylation
RATIONALE: Oxygen is required for oxidative phosphorylation in
mitochondria. When oxygen is inadequate, ATP production falls.
9. What is one of the earliest consequences of ATP depletion in an injured
cell?
A. Increased sodium-potassium pump activity
B. Failure of the sodium-potassium pump
C. Increased DNA synthesis
D. Immediate cellular calcification
, Answer: B. Failure of the sodium-potassium pump
RATIONALE: ATP depletion impairs energy-dependent membrane pumps,
particularly the Na⁺/K⁺ pump, causing intracellular sodium and water
accumulation and cellular swelling.
10. Cellular swelling caused by accumulation of water is also called:
A. Hydropic change
B. Caseation
C. Coagulation
D. Fibrosis
Answer: A. Hydropic change
RATIONALE: Hydropic change is a reversible cellular injury characterized by
intracellular water accumulation and swelling.
11. Which finding is most consistent with reversible cellular injury?
A. Severe membrane rupture
B. Nuclear fragmentation with complete cell destruction
C. Cellular swelling
D. Extensive lysosomal leakage
Answer: C. Cellular swelling
RATIONALE: Cellular swelling is a common early and potentially reversible
response to injury.
12. Which finding most strongly suggests irreversible cellular injury?
A. Mild cellular swelling
B. Fatty change
C. Membrane rupture
D. Temporary reduction in ATP
Answer: C. Membrane rupture
WITH CORRECT ANSWERS PLUS RATIONALES 2026/2027
INSTANT PDF
1. Which statement best describes pathophysiology?
A. The study of normal anatomy
B. The study of drug administration
C. The study of altered physiological processes associated with disease
D. The study of surgical procedures
Answer: C. The study of altered physiological processes associated with
disease
RATIONALE: Pathophysiology examines how disease or injury disrupts
normal physiological function at the cellular, tissue, organ, and systemic levels.
2. What does etiology refer to?
A. The cause or origin of a disease
B. The clinical treatment of disease
C. The expected outcome of treatment
D. The physical examination of a patient
Answer: A. The cause or origin of a disease
RATIONALE: Etiology identifies the cause or contributing factors responsible
for the development of a disease.
3. A patient develops cellular injury after prolonged oxygen deprivation.
Which condition most directly explains this injury?
A. Hyperplasia
B. Hypoxia
C. Hypertrophy
D. Metaplasia
Answer: B. Hypoxia
, RATIONALE: Hypoxia is inadequate oxygen availability. Because oxygen is
required for efficient ATP production, prolonged hypoxia can impair cellular
metabolism and cause injury.
4. Which cellular adaptation involves an increase in cell size?
A. Atrophy
B. Metaplasia
C. Hyperplasia
D. Hypertrophy
Answer: D. Hypertrophy
RATIONALE: Hypertrophy is an increase in individual cell size. It commonly
occurs when cells experience increased workload.
5. Which cellular adaptation involves an increase in the number of cells?
A. Hyperplasia
B. Atrophy
C. Hypertrophy
D. Dysplasia
Answer: A. Hyperplasia
RATIONALE: Hyperplasia occurs when cellular proliferation increases the
number of cells within a tissue.
6. A patient has skeletal muscle wasting after prolonged immobilization.
Which adaptation is occurring?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Answer: C. Atrophy
, RATIONALE: Atrophy is a reduction in cell size and often results from
decreased workload, inadequate nutrition, loss of innervation, or reduced blood
supply.
7. A smoker develops replacement of normal respiratory epithelium with a
different type of epithelial cell. Which process is this?
A. Hypertrophy
B. Metaplasia
C. Atrophy
D. Hyperplasia
Answer: B. Metaplasia
RATIONALE: Metaplasia is a reversible change in which one differentiated
cell type is replaced by another better able to tolerate chronic stress.
8. Which factor is most directly responsible for ATP depletion during severe
hypoxia?
A. Increased DNA replication
B. Increased protein synthesis
C. Reduced oxidative phosphorylation
D. Increased lysosomal activity
Answer: C. Reduced oxidative phosphorylation
RATIONALE: Oxygen is required for oxidative phosphorylation in
mitochondria. When oxygen is inadequate, ATP production falls.
9. What is one of the earliest consequences of ATP depletion in an injured
cell?
A. Increased sodium-potassium pump activity
B. Failure of the sodium-potassium pump
C. Increased DNA synthesis
D. Immediate cellular calcification
, Answer: B. Failure of the sodium-potassium pump
RATIONALE: ATP depletion impairs energy-dependent membrane pumps,
particularly the Na⁺/K⁺ pump, causing intracellular sodium and water
accumulation and cellular swelling.
10. Cellular swelling caused by accumulation of water is also called:
A. Hydropic change
B. Caseation
C. Coagulation
D. Fibrosis
Answer: A. Hydropic change
RATIONALE: Hydropic change is a reversible cellular injury characterized by
intracellular water accumulation and swelling.
11. Which finding is most consistent with reversible cellular injury?
A. Severe membrane rupture
B. Nuclear fragmentation with complete cell destruction
C. Cellular swelling
D. Extensive lysosomal leakage
Answer: C. Cellular swelling
RATIONALE: Cellular swelling is a common early and potentially reversible
response to injury.
12. Which finding most strongly suggests irreversible cellular injury?
A. Mild cellular swelling
B. Fatty change
C. Membrane rupture
D. Temporary reduction in ATP
Answer: C. Membrane rupture
