NUR 529 PATHO EXAM 1,2,3 | PRACTICE QUESTIONS AND
ANSWERS 2026/2027 | VERIFIED ANSWERS PLUS
RATIONALES | GRADED Q&A STUDY GUIDE | LATEST 2027
UNIVERSITY OF ALABAMA
Study Tips for NUR 529
1. Master Cellular Adaptation: Know the differences between atrophy, hypertrophy,
hyperplasia, metaplasia, and dysplasia. Understand the mechanisms and clinical
examples of each.
2. Understand Cell Injury and Death: Know the differences between reversible and
irreversible injury, necrosis vs. apoptosis, and the various types of necrosis.
3. Study Inflammation and Immunity: Know the types of hypersensitivity reactions,
complement components, immunoglobulins, and the roles of different immune cells.
4. Know Genetic Inheritance Patterns: Understand autosomal dominant, autosomal
recessive, and X-linked recessive inheritance. Know the characteristics of common
genetic disorders.
5. Review Fluid and Electrolyte Balance: Understand the mechanisms of edema, the
effects of aldosterone and ADH, and the signs of hyperkalemia and hypocalcemia.
6. Master Acid-Base Disturbances: Know how to interpret arterial blood gases and the
conditions that cause metabolic and respiratory acidosis and alkalosis.
7. Study Cardiovascular Disorders: Understand heart failure, atherosclerosis,
hypertension, and hematologic disorders.
8. Know Respiratory and Renal Pathophysiology: Understand COPD, asthma,
pneumonia, ARDS, acute kidney injury, and chronic kidney disease.
9. Review Endocrine Disorders: Know the pathophysiology of diabetes, thyroid disorders,
adrenal disorders, and SIADH/diabetes insipidus.
10. Understand Neurologic Disorders: Know increased ICP, stroke, seizures, meningitis,
and Parkinson's disease.
,SECTION 1: CELLULAR ADAPTATION, INJURY & DEATH
(Questions 1-30)
Question 1
A tissue biopsy from a patient with long-standing, untreated hypertension reveals
significant thickening of the left ventricular wall. Which cellular adaptation has occurred?
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Dysplasia
Correct Answer: C
Rationale: Hypertrophy is an increase in the size of individual cells, often caused by an
increased mechanical workload or stress, such as the heart pumping against high
systemic vascular resistance. Hyperplasia involves an increase in cell number; metaplasia
is the replacement of one mature cell type with another; dysplasia involves disordered
growth.
Question 2
A biopsy of a chronic smoker's bronchi reveals that normal ciliated columnar epithelial
cells have been replaced by stratified squamous epithelial cells. This is an example of
which process?
A) Anaplasia
B) Hyperplasia
C) Metaplasia
D) Atrophy
Correct Answer: C
,Rationale: Metaplasia is the reversible replacement of one mature cell type by another
mature cell type, usually as an adaptive response to chronic irritation or injury. Chronic
smoking causes bronchial metaplasia as a protective adaptation.
Question 3
During an ischemic event, a lack of oxygen leads to a decrease in cellular ATP
production. Which immediate consequence occurs within the cell?
A) Shrinkage of the nucleus
B) Failure of the sodium-potassium pump, leading to cellular swelling
C) Decreased intracellular calcium levels
D) Increased intracellular pH
Correct Answer: B
Rationale: Decreased ATP causes the Na⁺/K⁺ ATPase pump to fail. Sodium accumulates
inside the cell, pulling water in by osmosis, which results in acute cellular swelling. This is
a hallmark of reversible cell injury.
Question 4
A patient has been diagnosed with a condition that triggers premature, programmed
cellular suicide in specific healthy tissues. What is the medical term for this programmed
cell death?
A) Liquefactive necrosis
B) Coagulative necrosis
C) Apoptosis
D) Infarction
Correct Answer: C
Rationale: Apoptosis is a highly regulated, distinct process of programmed cell death
designed to eliminate unwanted or damaged cells without triggering inflammation. It is
distinct from necrosis, which involves cell swelling and inflammation.
, Question 5
A patient presents with acute ischemia to leg muscle. Biopsy shows pale, swollen
myocytes with intact cell membranes. Which cellular function failure most directly
explains the observed cellular swelling?
A) Failure of Na⁺/K⁺ ATPase leading to intracellular sodium accumulation
B) Loss of plasma membrane tight junctions between myocytes
C) Inhibition of ribosomal protein synthesis
D) Increased activity of mitochondrial cytochrome oxidase
Correct Answer: A
Rationale: Na⁺/K⁺ ATPase requires ATP to export Na⁺. ATP depletion causes pump
failure, resulting in intracellular Na⁺ and water accumulation, and cell swelling. Intact cell
membranes indicate the injury is still reversible at this stage.
Question 6
An ICU patient with severe sepsis has rising lactate, hypotension, and decreasing urine
output. Kidney biopsy shows cell swelling and loss of brush border with intact cell
membranes. Which injury type best describes these renal tubular changes?
A) Irreversible necrosis due to membrane rupture and inflammation
B) Reversible ischemic injury (cellular swelling) due to ATP depletion and Na⁺ influx
C) Apoptosis via caspase activation with apoptotic body formation
D) Autophagic preservation of organelles preventing cell death
Correct Answer: B
Rationale: Early ischemic injury causes ATP depletion → failure of Na⁺/K⁺ pumps →
intracellular Na⁺ accumulation → osmotic water influx → cell swelling. Intact cell
membranes indicate the injury is still reversible at this stage.
ANSWERS 2026/2027 | VERIFIED ANSWERS PLUS
RATIONALES | GRADED Q&A STUDY GUIDE | LATEST 2027
UNIVERSITY OF ALABAMA
Study Tips for NUR 529
1. Master Cellular Adaptation: Know the differences between atrophy, hypertrophy,
hyperplasia, metaplasia, and dysplasia. Understand the mechanisms and clinical
examples of each.
2. Understand Cell Injury and Death: Know the differences between reversible and
irreversible injury, necrosis vs. apoptosis, and the various types of necrosis.
3. Study Inflammation and Immunity: Know the types of hypersensitivity reactions,
complement components, immunoglobulins, and the roles of different immune cells.
4. Know Genetic Inheritance Patterns: Understand autosomal dominant, autosomal
recessive, and X-linked recessive inheritance. Know the characteristics of common
genetic disorders.
5. Review Fluid and Electrolyte Balance: Understand the mechanisms of edema, the
effects of aldosterone and ADH, and the signs of hyperkalemia and hypocalcemia.
6. Master Acid-Base Disturbances: Know how to interpret arterial blood gases and the
conditions that cause metabolic and respiratory acidosis and alkalosis.
7. Study Cardiovascular Disorders: Understand heart failure, atherosclerosis,
hypertension, and hematologic disorders.
8. Know Respiratory and Renal Pathophysiology: Understand COPD, asthma,
pneumonia, ARDS, acute kidney injury, and chronic kidney disease.
9. Review Endocrine Disorders: Know the pathophysiology of diabetes, thyroid disorders,
adrenal disorders, and SIADH/diabetes insipidus.
10. Understand Neurologic Disorders: Know increased ICP, stroke, seizures, meningitis,
and Parkinson's disease.
,SECTION 1: CELLULAR ADAPTATION, INJURY & DEATH
(Questions 1-30)
Question 1
A tissue biopsy from a patient with long-standing, untreated hypertension reveals
significant thickening of the left ventricular wall. Which cellular adaptation has occurred?
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Dysplasia
Correct Answer: C
Rationale: Hypertrophy is an increase in the size of individual cells, often caused by an
increased mechanical workload or stress, such as the heart pumping against high
systemic vascular resistance. Hyperplasia involves an increase in cell number; metaplasia
is the replacement of one mature cell type with another; dysplasia involves disordered
growth.
Question 2
A biopsy of a chronic smoker's bronchi reveals that normal ciliated columnar epithelial
cells have been replaced by stratified squamous epithelial cells. This is an example of
which process?
A) Anaplasia
B) Hyperplasia
C) Metaplasia
D) Atrophy
Correct Answer: C
,Rationale: Metaplasia is the reversible replacement of one mature cell type by another
mature cell type, usually as an adaptive response to chronic irritation or injury. Chronic
smoking causes bronchial metaplasia as a protective adaptation.
Question 3
During an ischemic event, a lack of oxygen leads to a decrease in cellular ATP
production. Which immediate consequence occurs within the cell?
A) Shrinkage of the nucleus
B) Failure of the sodium-potassium pump, leading to cellular swelling
C) Decreased intracellular calcium levels
D) Increased intracellular pH
Correct Answer: B
Rationale: Decreased ATP causes the Na⁺/K⁺ ATPase pump to fail. Sodium accumulates
inside the cell, pulling water in by osmosis, which results in acute cellular swelling. This is
a hallmark of reversible cell injury.
Question 4
A patient has been diagnosed with a condition that triggers premature, programmed
cellular suicide in specific healthy tissues. What is the medical term for this programmed
cell death?
A) Liquefactive necrosis
B) Coagulative necrosis
C) Apoptosis
D) Infarction
Correct Answer: C
Rationale: Apoptosis is a highly regulated, distinct process of programmed cell death
designed to eliminate unwanted or damaged cells without triggering inflammation. It is
distinct from necrosis, which involves cell swelling and inflammation.
, Question 5
A patient presents with acute ischemia to leg muscle. Biopsy shows pale, swollen
myocytes with intact cell membranes. Which cellular function failure most directly
explains the observed cellular swelling?
A) Failure of Na⁺/K⁺ ATPase leading to intracellular sodium accumulation
B) Loss of plasma membrane tight junctions between myocytes
C) Inhibition of ribosomal protein synthesis
D) Increased activity of mitochondrial cytochrome oxidase
Correct Answer: A
Rationale: Na⁺/K⁺ ATPase requires ATP to export Na⁺. ATP depletion causes pump
failure, resulting in intracellular Na⁺ and water accumulation, and cell swelling. Intact cell
membranes indicate the injury is still reversible at this stage.
Question 6
An ICU patient with severe sepsis has rising lactate, hypotension, and decreasing urine
output. Kidney biopsy shows cell swelling and loss of brush border with intact cell
membranes. Which injury type best describes these renal tubular changes?
A) Irreversible necrosis due to membrane rupture and inflammation
B) Reversible ischemic injury (cellular swelling) due to ATP depletion and Na⁺ influx
C) Apoptosis via caspase activation with apoptotic body formation
D) Autophagic preservation of organelles preventing cell death
Correct Answer: B
Rationale: Early ischemic injury causes ATP depletion → failure of Na⁺/K⁺ pumps →
intracellular Na⁺ accumulation → osmotic water influx → cell swelling. Intact cell
membranes indicate the injury is still reversible at this stage.
