WGU D115 Advanced Pathophysiology – Pre-Assessment Exam
& Study Guide (2025/2026)
250 Practice Questions with Verified Rationalized Answers
Unit 2: Cellular Adaptation, Injury & Neoplasia
(Questions 1–35)
1. A 68-year-old male with a 40-pack-year smoking history
presents with a chronic cough. Bronchial biopsy reveals
stratified squamous epithelium replacing the normal
pseudostratified ciliated columnar epithelium. Which cellular
adaptation has occurred?
A) Hyperplasia
,B) Hypertrophy
C) Metaplasia
D) Dysplasia
Answer C: — Metaplasia
Rationale: Metaplasia is the reversible replacement of one
differentiated cell type by another mature cell type better able
to tolerate a particular stressor. Chronic tobacco exposure
causes normal respiratory epithelium to be replaced by
stratified squamous epithelium. ---
2. A 45-year-old woman with chronic hypertension has left
ventricular wall thickness of 14 mm (normal <11 mm). The
cardiomyocytes demonstrate increased organelle content
and protein synthesis. This represents which cellular
adaptation?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
,D) Metaplasia
Answer B: — Hypertrophy
Rationale: Cardiac hypertrophy in response to chronic
pressure overload occurs via increased synthesis of contractile
proteins, mitochondria, and sarcoplasmic reticulum within
existing cardiomyocytes. Cardiac muscle cells are terminally
differentiated and cannot undergo hyperplasia. ---
3. A 55-year-old man presents with acute myocardial
infarction. Histology of the infarcted tissue shows cell
swelling, loss of plasma membrane integrity, karyolysis, and
intense inflammatory infiltration. Which type of cell death is
occurring?
A) Apoptosis
B) Necrosis
C) Autophagy
D) Pyroptosis
Answer B: — Necrosis
, Rationale: Myocardial infarction causes ischemic necrosis
(coagulative necrosis) characterized by ATP depletion, failure
of ion pumps, cell swelling, membrane rupture, and enzymatic
digestion with inflammation. ---
4. Which process is primarily responsible for maintaining
genetic stability during cell division?
A) Transcription
B) Translation
C) DNA replication proofreading
D) Protein folding
Answer C: — DNA replication proofreading
Rationale: DNA polymerase possesses proofreading
capabilities that identify and correct mismatched nucleotides
during replication, reducing mutation rates and preserving
genetic integrity. ---
& Study Guide (2025/2026)
250 Practice Questions with Verified Rationalized Answers
Unit 2: Cellular Adaptation, Injury & Neoplasia
(Questions 1–35)
1. A 68-year-old male with a 40-pack-year smoking history
presents with a chronic cough. Bronchial biopsy reveals
stratified squamous epithelium replacing the normal
pseudostratified ciliated columnar epithelium. Which cellular
adaptation has occurred?
A) Hyperplasia
,B) Hypertrophy
C) Metaplasia
D) Dysplasia
Answer C: — Metaplasia
Rationale: Metaplasia is the reversible replacement of one
differentiated cell type by another mature cell type better able
to tolerate a particular stressor. Chronic tobacco exposure
causes normal respiratory epithelium to be replaced by
stratified squamous epithelium. ---
2. A 45-year-old woman with chronic hypertension has left
ventricular wall thickness of 14 mm (normal <11 mm). The
cardiomyocytes demonstrate increased organelle content
and protein synthesis. This represents which cellular
adaptation?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
,D) Metaplasia
Answer B: — Hypertrophy
Rationale: Cardiac hypertrophy in response to chronic
pressure overload occurs via increased synthesis of contractile
proteins, mitochondria, and sarcoplasmic reticulum within
existing cardiomyocytes. Cardiac muscle cells are terminally
differentiated and cannot undergo hyperplasia. ---
3. A 55-year-old man presents with acute myocardial
infarction. Histology of the infarcted tissue shows cell
swelling, loss of plasma membrane integrity, karyolysis, and
intense inflammatory infiltration. Which type of cell death is
occurring?
A) Apoptosis
B) Necrosis
C) Autophagy
D) Pyroptosis
Answer B: — Necrosis
, Rationale: Myocardial infarction causes ischemic necrosis
(coagulative necrosis) characterized by ATP depletion, failure
of ion pumps, cell swelling, membrane rupture, and enzymatic
digestion with inflammation. ---
4. Which process is primarily responsible for maintaining
genetic stability during cell division?
A) Transcription
B) Translation
C) DNA replication proofreading
D) Protein folding
Answer C: — DNA replication proofreading
Rationale: DNA polymerase possesses proofreading
capabilities that identify and correct mismatched nucleotides
during replication, reducing mutation rates and preserving
genetic integrity. ---
