NSG 530 – ADVANCED PATHOPHYSIOLOGY
EXAM 1 EXAM
(100 Questions and answers with
rationales Wilkes University | 2026 update
INSTRUCTIONS: Select the best answer for each question.
===================================================================
=============
1. During which phase of the cell cycle does DNA replication occur?
A) G1 phase
B) S phase
C) G2 phase
D) M phase
CORRECT ANSWER: B) S phase
RATIONALE: DNA replication occurs during the S (synthesis) phase of interphase.
The G1 phase involves cell growth and preparation for DNA synthesis. G2 phase
involves further growth and preparation for mitosis. The M phase is mitosis
itself.
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,2. A patient has a mutation in the p53 tumor suppressor gene. Which cellular
process is most directly impaired?
A) DNA repair and cell cycle arrest
B) Telomerase activation
C) Oncogene expression
D) Apoptosis inhibition
CORRECT ANSWER: A) DNA repair and cell cycle arrest
RATIONALE: The p53 gene, known as the "guardian of the genome," regulates
the
cell cycle by causing G1 arrest to allow DNA repair or initiating apoptosis if
damage is irreparable. Mutations in p53 are associated with many cancers due
to
loss of this checkpoint control.
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3. Which type of cellular adaptation involves an increase in cell size?
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
CORRECT ANSWER: B) Hypertrophy
RATIONALE: Hypertrophy is an increase in cell size, often seen in cardiac muscle
, in response to increased workload. Hyperplasia is an increase in cell number.
Metaplasia is the replacement of one differentiated cell type with another.
Dysplasia refers to abnormal cellular development and is considered pre-
neoplastic.
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4. A 65-year-old male with chronic emphysema develops metaplasia in his
bronchial
epithelium. What cell type replaces the normal pseudostratified ciliated
columnar epithelium?
A) Simple squamous epithelium
B) Stratified squamous epithelium
C) Simple cuboidal epithelium
D) Transitional epithelium
CORRECT ANSWER: B) Stratified squamous epithelium
RATIONALE: In chronic irritation (such as from smoking in emphysema), the
respiratory epithelium undergoes squamous metaplasia, replacing ciliated
columnar
cells with stratified squamous epithelium. While this is a protective adaptation,
it impairs mucociliary clearance.
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, 5. Which mechanism is primarily responsible for cellular injury in hypoxia?
A) Lysosomal enzyme release
B) Decreased ATP production
C) Protein synthesis inhibition
D) DNA fragmentation
CORRECT ANSWER: B) Decreased ATP production
RATIONALE: Hypoxia leads to decreased oxidative phosphorylation and ATP
depletion.
This causes failure of the Na+/K+-ATPase pump, leading to cellular swelling,
calcium influx, and eventually cell death. ATP depletion is the central event in
hypoxic cell injury.
--------------------------------------------------------------------------------
6. Reperfusion injury following myocardial infarction is primarily caused by:
A) Accumulation of lactic acid
B) Generation of reactive oxygen species (ROS)
C) Decreased intracellular calcium
D) Inhibition of protein synthesis
CORRECT ANSWER: B) Generation of reactive oxygen species (ROS)
RATIONALE: When oxygen is reintroduced to ischemic tissue, there is a burst of
ROS production (superoxide, hydroxyl radicals, hydrogen peroxide) that
damages
EXAM 1 EXAM
(100 Questions and answers with
rationales Wilkes University | 2026 update
INSTRUCTIONS: Select the best answer for each question.
===================================================================
=============
1. During which phase of the cell cycle does DNA replication occur?
A) G1 phase
B) S phase
C) G2 phase
D) M phase
CORRECT ANSWER: B) S phase
RATIONALE: DNA replication occurs during the S (synthesis) phase of interphase.
The G1 phase involves cell growth and preparation for DNA synthesis. G2 phase
involves further growth and preparation for mitosis. The M phase is mitosis
itself.
--------------------------------------------------------------------------------
,2. A patient has a mutation in the p53 tumor suppressor gene. Which cellular
process is most directly impaired?
A) DNA repair and cell cycle arrest
B) Telomerase activation
C) Oncogene expression
D) Apoptosis inhibition
CORRECT ANSWER: A) DNA repair and cell cycle arrest
RATIONALE: The p53 gene, known as the "guardian of the genome," regulates
the
cell cycle by causing G1 arrest to allow DNA repair or initiating apoptosis if
damage is irreparable. Mutations in p53 are associated with many cancers due
to
loss of this checkpoint control.
--------------------------------------------------------------------------------
3. Which type of cellular adaptation involves an increase in cell size?
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
CORRECT ANSWER: B) Hypertrophy
RATIONALE: Hypertrophy is an increase in cell size, often seen in cardiac muscle
, in response to increased workload. Hyperplasia is an increase in cell number.
Metaplasia is the replacement of one differentiated cell type with another.
Dysplasia refers to abnormal cellular development and is considered pre-
neoplastic.
--------------------------------------------------------------------------------
4. A 65-year-old male with chronic emphysema develops metaplasia in his
bronchial
epithelium. What cell type replaces the normal pseudostratified ciliated
columnar epithelium?
A) Simple squamous epithelium
B) Stratified squamous epithelium
C) Simple cuboidal epithelium
D) Transitional epithelium
CORRECT ANSWER: B) Stratified squamous epithelium
RATIONALE: In chronic irritation (such as from smoking in emphysema), the
respiratory epithelium undergoes squamous metaplasia, replacing ciliated
columnar
cells with stratified squamous epithelium. While this is a protective adaptation,
it impairs mucociliary clearance.
--------------------------------------------------------------------------------
, 5. Which mechanism is primarily responsible for cellular injury in hypoxia?
A) Lysosomal enzyme release
B) Decreased ATP production
C) Protein synthesis inhibition
D) DNA fragmentation
CORRECT ANSWER: B) Decreased ATP production
RATIONALE: Hypoxia leads to decreased oxidative phosphorylation and ATP
depletion.
This causes failure of the Na+/K+-ATPase pump, leading to cellular swelling,
calcium influx, and eventually cell death. ATP depletion is the central event in
hypoxic cell injury.
--------------------------------------------------------------------------------
6. Reperfusion injury following myocardial infarction is primarily caused by:
A) Accumulation of lactic acid
B) Generation of reactive oxygen species (ROS)
C) Decreased intracellular calcium
D) Inhibition of protein synthesis
CORRECT ANSWER: B) Generation of reactive oxygen species (ROS)
RATIONALE: When oxygen is reintroduced to ischemic tissue, there is a burst of
ROS production (superoxide, hydroxyl radicals, hydrogen peroxide) that
damages
