NUR 631 Midterm Exam 2026/2027 – Advanced
Physiology & Pathophysiology Study Guide
Questions and Answers with Rationales
SECTION I — CELLULAR PHYSIOLOGY, ADAPTATION & INJURY
1. Which cellular process is primarily responsible for maintaining the
resting membrane potential of a neuron?
A. Calcium influx
B. Sodium-potassium ATPase activity
C. Chloride secretion
D. Protein synthesis
Answer: B. Sodium-potassium ATPase activity
Rationale: The sodium-potassium pump uses ATP to move sodium out
of cells and potassium into cells, helping maintain the electrochemical
gradient required for the resting membrane potential.
2. A patient develops cellular swelling following severe hypoxia.
Which mechanism best explains this finding?
A. Increased protein synthesis
B. Failure of ATP-dependent ion pumps
C. Increased DNA replication
D. Excessive lysosomal activity
Answer: B. Failure of ATP-dependent ion pumps
Rationale: ATP depletion impairs the sodium-potassium pump, causing
intracellular sodium and water accumulation and resulting in cellular
swelling.
,3. Which finding is most characteristic of reversible cellular injury?
A. Nuclear fragmentation
B. Cellular swelling
C. Membrane rupture
D. Extensive mitochondrial destruction
Answer: B. Cellular swelling
Rationale: Cellular swelling is an early, potentially reversible response
to impaired energy production and ion homeostasis.
4. Which form of cell death is generally characterized by cell
shrinkage, chromatin condensation, and formation of apoptotic
bodies?
A. Necrosis
B. Apoptosis
C. Gangrene
D. Autolysis
Answer: B. Apoptosis
Rationale: Apoptosis is regulated programmed cell death characterized
by cellular shrinkage, nuclear fragmentation, and apoptotic-body
formation without significant inflammation.
5. A major difference between necrosis and apoptosis is that necrosis
generally:
A. Requires caspase activation
B. Produces no inflammation
C. Causes membrane disruption and inflammation
D. Is always physiologic
,Answer: C. Causes membrane disruption and inflammation
Rationale: Necrotic cell death commonly causes membrane rupture
and release of intracellular contents, triggering inflammation.
6. Which organelle is primarily responsible for ATP production?
A. Lysosome
B. Golgi apparatus
C. Mitochondrion
D. Ribosome
Answer: C. Mitochondrion
Rationale: Mitochondria generate most cellular ATP through oxidative
phosphorylation.
7. Which reactive oxygen species can cause lipid peroxidation and
cellular membrane damage?
A. Free radicals
B. Albumin
C. Insulin
D. Glycogen
Answer: A. Free radicals
Rationale: Reactive oxygen species can oxidize membrane lipids,
proteins, and nucleic acids, producing cellular injury.
8. Hypertrophy refers to:
A. An increase in cell number
B. A decrease in cell size
C. An increase in individual cell size
D. Replacement of one mature cell type by another
, Answer: C. An increase in individual cell size
Rationale: Hypertrophy occurs when individual cells enlarge, often
because of increased workload.
9. Hyperplasia is best defined as:
A. Increased cell size
B. Increased cell number
C. Decreased cell number
D. Cellular death
Answer: B. Increased cell number
Rationale: Hyperplasia results from increased cellular proliferation.
10. Metaplasia involves:
A. Irreversible malignant transformation
B. Replacement of one differentiated cell type with another
C. Complete cellular destruction
D. Increased ATP production
Answer: B. Replacement of one differentiated cell type with another
Rationale: Metaplasia is an adaptive response in which one mature cell
type is replaced by another better able to tolerate chronic stress.
11. Which cellular adaptation is commonly associated with prolonged
hormonal stimulation?
A. Hyperplasia
B. Necrosis
C. Atrophy
D. Apoptosis
Answer: A. Hyperplasia
Rationale: Certain hormones and growth factors can stimulate cellular
proliferation, producing hyperplasia.
Physiology & Pathophysiology Study Guide
Questions and Answers with Rationales
SECTION I — CELLULAR PHYSIOLOGY, ADAPTATION & INJURY
1. Which cellular process is primarily responsible for maintaining the
resting membrane potential of a neuron?
A. Calcium influx
B. Sodium-potassium ATPase activity
C. Chloride secretion
D. Protein synthesis
Answer: B. Sodium-potassium ATPase activity
Rationale: The sodium-potassium pump uses ATP to move sodium out
of cells and potassium into cells, helping maintain the electrochemical
gradient required for the resting membrane potential.
2. A patient develops cellular swelling following severe hypoxia.
Which mechanism best explains this finding?
A. Increased protein synthesis
B. Failure of ATP-dependent ion pumps
C. Increased DNA replication
D. Excessive lysosomal activity
Answer: B. Failure of ATP-dependent ion pumps
Rationale: ATP depletion impairs the sodium-potassium pump, causing
intracellular sodium and water accumulation and resulting in cellular
swelling.
,3. Which finding is most characteristic of reversible cellular injury?
A. Nuclear fragmentation
B. Cellular swelling
C. Membrane rupture
D. Extensive mitochondrial destruction
Answer: B. Cellular swelling
Rationale: Cellular swelling is an early, potentially reversible response
to impaired energy production and ion homeostasis.
4. Which form of cell death is generally characterized by cell
shrinkage, chromatin condensation, and formation of apoptotic
bodies?
A. Necrosis
B. Apoptosis
C. Gangrene
D. Autolysis
Answer: B. Apoptosis
Rationale: Apoptosis is regulated programmed cell death characterized
by cellular shrinkage, nuclear fragmentation, and apoptotic-body
formation without significant inflammation.
5. A major difference between necrosis and apoptosis is that necrosis
generally:
A. Requires caspase activation
B. Produces no inflammation
C. Causes membrane disruption and inflammation
D. Is always physiologic
,Answer: C. Causes membrane disruption and inflammation
Rationale: Necrotic cell death commonly causes membrane rupture
and release of intracellular contents, triggering inflammation.
6. Which organelle is primarily responsible for ATP production?
A. Lysosome
B. Golgi apparatus
C. Mitochondrion
D. Ribosome
Answer: C. Mitochondrion
Rationale: Mitochondria generate most cellular ATP through oxidative
phosphorylation.
7. Which reactive oxygen species can cause lipid peroxidation and
cellular membrane damage?
A. Free radicals
B. Albumin
C. Insulin
D. Glycogen
Answer: A. Free radicals
Rationale: Reactive oxygen species can oxidize membrane lipids,
proteins, and nucleic acids, producing cellular injury.
8. Hypertrophy refers to:
A. An increase in cell number
B. A decrease in cell size
C. An increase in individual cell size
D. Replacement of one mature cell type by another
, Answer: C. An increase in individual cell size
Rationale: Hypertrophy occurs when individual cells enlarge, often
because of increased workload.
9. Hyperplasia is best defined as:
A. Increased cell size
B. Increased cell number
C. Decreased cell number
D. Cellular death
Answer: B. Increased cell number
Rationale: Hyperplasia results from increased cellular proliferation.
10. Metaplasia involves:
A. Irreversible malignant transformation
B. Replacement of one differentiated cell type with another
C. Complete cellular destruction
D. Increased ATP production
Answer: B. Replacement of one differentiated cell type with another
Rationale: Metaplasia is an adaptive response in which one mature cell
type is replaced by another better able to tolerate chronic stress.
11. Which cellular adaptation is commonly associated with prolonged
hormonal stimulation?
A. Hyperplasia
B. Necrosis
C. Atrophy
D. Apoptosis
Answer: A. Hyperplasia
Rationale: Certain hormones and growth factors can stimulate cellular
proliferation, producing hyperplasia.
