WGU D236 Objective Assessment 2026 –
Pathopharmacological Foundations Actual
Exam Prep
1. Which cellular adaptation involves an increase in cell size rather than cell
number?
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Atrophy
Answer: B. Hypertrophy
Rationale: Hypertrophy is an enlargement of individual cells, often caused by
increased workload. Cardiac muscle commonly undergoes hypertrophy in
response to chronic hypertension.
2. A patient with chronic bronchial irritation develops replacement of ciliated
columnar epithelium with stratified squamous epithelium. Which process is
occurring?
A. Atrophy
B. Hypertrophy
C. Metaplasia
D. Hyperplasia
Answer: C. Metaplasia
Rationale: Metaplasia is a reversible change in which one mature cell type is
replaced by another better able to tolerate chronic stress.
3. Which finding is most characteristic of apoptosis?
A. Cellular swelling and rupture
B. Severe surrounding inflammation
,C. Programmed cellular death
D. Immediate tissue liquefaction
Answer: C. Programmed cellular death
Rationale: Apoptosis is regulated, programmed cell death that generally removes
damaged or unnecessary cells without producing the extensive inflammation
associated with necrosis.
4. Which cellular structure is primarily responsible for producing ATP
through aerobic metabolism?
A. Ribosome
B. Lysosome
C. Mitochondrion
D. Golgi apparatus
Answer: C. Mitochondrion
Rationale: Mitochondria generate most cellular ATP through oxidative
phosphorylation.
5. Hypoxia causes cellular injury primarily because it decreases:
A. DNA replication
B. ATP production
C. Protein absorption
D. Extracellular sodium
Answer: B. ATP production
Rationale: Oxygen is required for efficient aerobic ATP production. Hypoxia
decreases ATP, impairing membrane pumps and other energy-dependent cellular
processes.
6. Which electrolyte shift commonly occurs when ATP-dependent sodium-
potassium pumps fail?
A. Sodium moves out of cells
B. Potassium moves into cells
C. Sodium accumulates inside cells
D. Calcium leaves the cell rapidly
Answer: C. Sodium accumulates inside cells
,Rationale: Failure of the sodium-potassium pump allows intracellular sodium to
rise, causing water to enter the cell and contributing to cellular swelling.
7. Which process describes irreversible cell injury characterized by cellular
membrane disruption?
A. Adaptation
B. Necrosis
C. Hypertrophy
D. Atrophy
Answer: B. Necrosis
Rationale: Necrosis involves irreversible cell injury with membrane breakdown
and leakage of intracellular contents, often triggering inflammation.
8. Which free radical is capable of causing oxidative cellular damage?
A. Oxygen radical
B. Chloride ion
C. Sodium ion
D. Bicarbonate ion
Answer: A. Oxygen radical
Rationale: Reactive oxygen species can damage cellular lipids, proteins, and DNA.
9. Which cellular adaptation occurs when an organ decreases in size because
of reduced workload?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Answer: C. Atrophy
Rationale: Atrophy is a reduction in cell size and sometimes cell number,
commonly associated with decreased workload, poor nutrition, or loss of nerve
stimulation.
10. Which statement best describes dysplasia?
A. Normal increase in cell size
B. Disorganized abnormal cellular growth
, C. Programmed cellular death
D. Temporary fluid accumulation
Answer: B. Disorganized abnormal cellular growth
Rationale: Dysplasia involves abnormal cellular size, shape, and organization and
may occur in tissues exposed to chronic irritation.
11. Which organelle contains enzymes that digest cellular waste?
A. Lysosome
B. Ribosome
C. Centriole
D. Nucleolus
Answer: A. Lysosome
Rationale: Lysosomes contain hydrolytic enzymes that break down cellular debris
and damaged components.
12. Which structure contains the genetic material that directs cellular protein
synthesis?
A. Nucleus
B. Lysosome
C. Golgi apparatus
D. Centriole
Answer: A. Nucleus
Rationale: The nucleus contains DNA, which stores genetic information used to
regulate cellular function and protein production.
13. A mutation that activates a gene promoting uncontrolled cell division is
most closely associated with a:
A. Tumor suppressor gene
B. Proto-oncogene
C. Structural protein gene
D. Mitochondrial enzyme
Answer: B. Proto-oncogene
Pathopharmacological Foundations Actual
Exam Prep
1. Which cellular adaptation involves an increase in cell size rather than cell
number?
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Atrophy
Answer: B. Hypertrophy
Rationale: Hypertrophy is an enlargement of individual cells, often caused by
increased workload. Cardiac muscle commonly undergoes hypertrophy in
response to chronic hypertension.
2. A patient with chronic bronchial irritation develops replacement of ciliated
columnar epithelium with stratified squamous epithelium. Which process is
occurring?
A. Atrophy
B. Hypertrophy
C. Metaplasia
D. Hyperplasia
Answer: C. Metaplasia
Rationale: Metaplasia is a reversible change in which one mature cell type is
replaced by another better able to tolerate chronic stress.
3. Which finding is most characteristic of apoptosis?
A. Cellular swelling and rupture
B. Severe surrounding inflammation
,C. Programmed cellular death
D. Immediate tissue liquefaction
Answer: C. Programmed cellular death
Rationale: Apoptosis is regulated, programmed cell death that generally removes
damaged or unnecessary cells without producing the extensive inflammation
associated with necrosis.
4. Which cellular structure is primarily responsible for producing ATP
through aerobic metabolism?
A. Ribosome
B. Lysosome
C. Mitochondrion
D. Golgi apparatus
Answer: C. Mitochondrion
Rationale: Mitochondria generate most cellular ATP through oxidative
phosphorylation.
5. Hypoxia causes cellular injury primarily because it decreases:
A. DNA replication
B. ATP production
C. Protein absorption
D. Extracellular sodium
Answer: B. ATP production
Rationale: Oxygen is required for efficient aerobic ATP production. Hypoxia
decreases ATP, impairing membrane pumps and other energy-dependent cellular
processes.
6. Which electrolyte shift commonly occurs when ATP-dependent sodium-
potassium pumps fail?
A. Sodium moves out of cells
B. Potassium moves into cells
C. Sodium accumulates inside cells
D. Calcium leaves the cell rapidly
Answer: C. Sodium accumulates inside cells
,Rationale: Failure of the sodium-potassium pump allows intracellular sodium to
rise, causing water to enter the cell and contributing to cellular swelling.
7. Which process describes irreversible cell injury characterized by cellular
membrane disruption?
A. Adaptation
B. Necrosis
C. Hypertrophy
D. Atrophy
Answer: B. Necrosis
Rationale: Necrosis involves irreversible cell injury with membrane breakdown
and leakage of intracellular contents, often triggering inflammation.
8. Which free radical is capable of causing oxidative cellular damage?
A. Oxygen radical
B. Chloride ion
C. Sodium ion
D. Bicarbonate ion
Answer: A. Oxygen radical
Rationale: Reactive oxygen species can damage cellular lipids, proteins, and DNA.
9. Which cellular adaptation occurs when an organ decreases in size because
of reduced workload?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Answer: C. Atrophy
Rationale: Atrophy is a reduction in cell size and sometimes cell number,
commonly associated with decreased workload, poor nutrition, or loss of nerve
stimulation.
10. Which statement best describes dysplasia?
A. Normal increase in cell size
B. Disorganized abnormal cellular growth
, C. Programmed cellular death
D. Temporary fluid accumulation
Answer: B. Disorganized abnormal cellular growth
Rationale: Dysplasia involves abnormal cellular size, shape, and organization and
may occur in tissues exposed to chronic irritation.
11. Which organelle contains enzymes that digest cellular waste?
A. Lysosome
B. Ribosome
C. Centriole
D. Nucleolus
Answer: A. Lysosome
Rationale: Lysosomes contain hydrolytic enzymes that break down cellular debris
and damaged components.
12. Which structure contains the genetic material that directs cellular protein
synthesis?
A. Nucleus
B. Lysosome
C. Golgi apparatus
D. Centriole
Answer: A. Nucleus
Rationale: The nucleus contains DNA, which stores genetic information used to
regulate cellular function and protein production.
13. A mutation that activates a gene promoting uncontrolled cell division is
most closely associated with a:
A. Tumor suppressor gene
B. Proto-oncogene
C. Structural protein gene
D. Mitochondrial enzyme
Answer: B. Proto-oncogene
