Walden NURS 3020 Pathophysiology
Final Exam Practice Examination 2026–
2027 Comprehensive Question Practice
Test with Answers & Rationales Free Pdf
Access
Cellular Adaptation, Injury &
Inflammation
1. Which cellular adaptation involves an increase in individual cell size?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Answer: B. Hypertrophy
Rationale: Hypertrophy is an increase in cell size. It commonly occurs when cells experience increased workload,
such as cardiac muscle in chronic hypertension.
2. Which process involves an increase in the number of cells?
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Apoptosis
Answer: C. Hyperplasia
Rationale: Hyperplasia results from increased cell proliferation and produces an increase in tissue or organ size.
3. A patient has prolonged immobilization of a limb. Which cellular adaptation is expected?
A. Atrophy
B. Hyperplasia
C. Hypertrophy
D. Dysplasia
,Answer: A. Atrophy
Rationale: Reduced workload can cause cells to decrease in size and activity, resulting in tissue atrophy.
4. Which process is considered programmed cell death?
A. Necrosis
B. Apoptosis
C. Ischemia
D. Hypertrophy
Answer: B. Apoptosis
Rationale: Apoptosis is regulated cellular death that helps remove damaged or unnecessary cells without the
extensive inflammation associated with necrosis.
5. Which finding is most characteristic of necrotic cell death?
A. Cell shrinkage without inflammation
B. Membrane disruption and cellular swelling
C. Formation of apoptotic bodies only
D. Complete preservation of cellular contents
Answer: B. Membrane disruption and cellular swelling
Rationale: Necrosis involves cellular swelling, membrane damage, leakage of intracellular contents, and
inflammation.
6. Ischemia causes cellular injury primarily because of reduced:
A. Oxygen and nutrient delivery
B. Carbon dioxide production
C. Cellular waste production
D. Blood viscosity
Answer: A. Oxygen and nutrient delivery
Rationale: Ischemia decreases blood flow and therefore limits oxygen and nutrient delivery while impairing waste
removal.
7. Which organelle is primarily responsible for aerobic ATP production?
A. Ribosome
B. Lysosome
C. Mitochondrion
D. Golgi apparatus
Answer: C. Mitochondrion
Rationale: Mitochondria generate most cellular ATP through oxidative phosphorylation.
,8. Severe ATP depletion directly impairs which cellular process?
A. Passive diffusion
B. Sodium-potassium pump function
C. Oxygen diffusion
D. DNA transcription only
Answer: B. Sodium-potassium pump function
Rationale: The sodium-potassium pump requires ATP. ATP depletion causes intracellular sodium and water
accumulation, contributing to cellular swelling.
9. Which substance is a major reactive oxygen species involved in oxidative cellular injury?
A. Free radical
B. Albumin
C. Insulin
D. Hemoglobin
Answer: A. Free radical
Rationale: Reactive oxygen species can damage lipids, proteins, and DNA, contributing to cellular injury.
10. Reperfusion injury can occur when:
A. Blood flow is restored after ischemia
B. Blood flow stops permanently
C. Oxygen is completely absent
D. Cellular metabolism decreases normally
Answer: A. Blood flow is restored after ischemia
Rationale: Restoration of oxygenated blood can generate reactive oxygen species and inflammatory responses
that further damage previously ischemic tissue.
Inflammation & Immunity
11. Which finding is a classic local manifestation of acute inflammation?
A. Pallor
B. Redness
C. Hypothermia
D. Bradycardia
Answer: B. Redness
Rationale: Vasodilation increases local blood flow, producing redness and warmth.
12. Which inflammatory mediator is associated with vasodilation and increased vascular permeability?
A. Histamine
B. Insulin
, C. Erythropoietin
D. Thyroxine
Answer: A. Histamine
Rationale: Histamine released from mast cells contributes to vasodilation and increased vascular permeability
during acute inflammation.
13. Which leukocyte is usually among the first cells recruited during acute inflammation?
A. Neutrophil
B. Erythrocyte
C. Platelet
D. Plasma cell
Answer: A. Neutrophil
Rationale: Neutrophils rapidly migrate to sites of acute inflammation and participate in pathogen destruction and
phagocytosis.
14. Which process describes a neutrophil engulfing a microorganism?
A. Chemotaxis
B. Phagocytosis
C. Apoptosis
D. Metaplasia
Answer: B. Phagocytosis
Rationale: Phagocytosis involves engulfment and intracellular destruction of pathogens or cellular debris.
15. Which inflammatory response involves movement of leukocytes toward chemical signals?
A. Chemotaxis
B. Osmosis
C. Filtration
D. Diffusion
Answer: A. Chemotaxis
Rationale: Chemotaxis directs immune cells toward areas of infection or tissue injury in response to chemical
gradients.
16. Fever during infection is primarily mediated by:
A. Pyrogens affecting hypothalamic temperature regulation
B. Decreased metabolic activity
C. Reduced cytokine production
D. Increased insulin secretion
Answer: A. Pyrogens affecting hypothalamic temperature regulation
Final Exam Practice Examination 2026–
2027 Comprehensive Question Practice
Test with Answers & Rationales Free Pdf
Access
Cellular Adaptation, Injury &
Inflammation
1. Which cellular adaptation involves an increase in individual cell size?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Answer: B. Hypertrophy
Rationale: Hypertrophy is an increase in cell size. It commonly occurs when cells experience increased workload,
such as cardiac muscle in chronic hypertension.
2. Which process involves an increase in the number of cells?
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Apoptosis
Answer: C. Hyperplasia
Rationale: Hyperplasia results from increased cell proliferation and produces an increase in tissue or organ size.
3. A patient has prolonged immobilization of a limb. Which cellular adaptation is expected?
A. Atrophy
B. Hyperplasia
C. Hypertrophy
D. Dysplasia
,Answer: A. Atrophy
Rationale: Reduced workload can cause cells to decrease in size and activity, resulting in tissue atrophy.
4. Which process is considered programmed cell death?
A. Necrosis
B. Apoptosis
C. Ischemia
D. Hypertrophy
Answer: B. Apoptosis
Rationale: Apoptosis is regulated cellular death that helps remove damaged or unnecessary cells without the
extensive inflammation associated with necrosis.
5. Which finding is most characteristic of necrotic cell death?
A. Cell shrinkage without inflammation
B. Membrane disruption and cellular swelling
C. Formation of apoptotic bodies only
D. Complete preservation of cellular contents
Answer: B. Membrane disruption and cellular swelling
Rationale: Necrosis involves cellular swelling, membrane damage, leakage of intracellular contents, and
inflammation.
6. Ischemia causes cellular injury primarily because of reduced:
A. Oxygen and nutrient delivery
B. Carbon dioxide production
C. Cellular waste production
D. Blood viscosity
Answer: A. Oxygen and nutrient delivery
Rationale: Ischemia decreases blood flow and therefore limits oxygen and nutrient delivery while impairing waste
removal.
7. Which organelle is primarily responsible for aerobic ATP production?
A. Ribosome
B. Lysosome
C. Mitochondrion
D. Golgi apparatus
Answer: C. Mitochondrion
Rationale: Mitochondria generate most cellular ATP through oxidative phosphorylation.
,8. Severe ATP depletion directly impairs which cellular process?
A. Passive diffusion
B. Sodium-potassium pump function
C. Oxygen diffusion
D. DNA transcription only
Answer: B. Sodium-potassium pump function
Rationale: The sodium-potassium pump requires ATP. ATP depletion causes intracellular sodium and water
accumulation, contributing to cellular swelling.
9. Which substance is a major reactive oxygen species involved in oxidative cellular injury?
A. Free radical
B. Albumin
C. Insulin
D. Hemoglobin
Answer: A. Free radical
Rationale: Reactive oxygen species can damage lipids, proteins, and DNA, contributing to cellular injury.
10. Reperfusion injury can occur when:
A. Blood flow is restored after ischemia
B. Blood flow stops permanently
C. Oxygen is completely absent
D. Cellular metabolism decreases normally
Answer: A. Blood flow is restored after ischemia
Rationale: Restoration of oxygenated blood can generate reactive oxygen species and inflammatory responses
that further damage previously ischemic tissue.
Inflammation & Immunity
11. Which finding is a classic local manifestation of acute inflammation?
A. Pallor
B. Redness
C. Hypothermia
D. Bradycardia
Answer: B. Redness
Rationale: Vasodilation increases local blood flow, producing redness and warmth.
12. Which inflammatory mediator is associated with vasodilation and increased vascular permeability?
A. Histamine
B. Insulin
, C. Erythropoietin
D. Thyroxine
Answer: A. Histamine
Rationale: Histamine released from mast cells contributes to vasodilation and increased vascular permeability
during acute inflammation.
13. Which leukocyte is usually among the first cells recruited during acute inflammation?
A. Neutrophil
B. Erythrocyte
C. Platelet
D. Plasma cell
Answer: A. Neutrophil
Rationale: Neutrophils rapidly migrate to sites of acute inflammation and participate in pathogen destruction and
phagocytosis.
14. Which process describes a neutrophil engulfing a microorganism?
A. Chemotaxis
B. Phagocytosis
C. Apoptosis
D. Metaplasia
Answer: B. Phagocytosis
Rationale: Phagocytosis involves engulfment and intracellular destruction of pathogens or cellular debris.
15. Which inflammatory response involves movement of leukocytes toward chemical signals?
A. Chemotaxis
B. Osmosis
C. Filtration
D. Diffusion
Answer: A. Chemotaxis
Rationale: Chemotaxis directs immune cells toward areas of infection or tissue injury in response to chemical
gradients.
16. Fever during infection is primarily mediated by:
A. Pyrogens affecting hypothalamic temperature regulation
B. Decreased metabolic activity
C. Reduced cytokine production
D. Increased insulin secretion
Answer: A. Pyrogens affecting hypothalamic temperature regulation
