NURS 6501 Advanced Pathophysiology –
Academic Year 2026/2027 – Midterm
Comprehensive Examination | Verified
Questions
ACTUAL QUESTIONS
Domain 1: Cellular Processes and Genetic Factors
Question 1. Which of the following best describes atrophy?
A. An increase in cell size
B. A decrease in cell size or number, often due to reduced workload or nutrient
supply
C. An increase in the number of cells
D. Transformation of one cell type into another
Correct Answer: B
Rationale: Atrophy is a reversible reduction in cell size or number resulting from
decreased demand, denervation, ischemia, inadequate nutrition, or aging. Organ
size may decrease accordingly.
Question 2. Hypertrophy is characterized by:
A. An increase in the number of cells
B. An increase in the size of existing cells, commonly in response to increased
workload
C. Replacement of one differentiated cell type by another
D. Programmed cell death
Correct Answer: B
Rationale: Hypertrophy involves enlargement of individual cells, typically in
response to mechanical stress or hormonal stimulation, as seen in cardiac muscle
under sustained pressure overload.
Question 3. Metaplasia refers to:
A. An increase in cell number
B. The reversible replacement of one differentiated cell type by another
differentiated cell type
C. Irreversible genetic mutation
D. Necrotic cell death only
,Correct Answer: B
Rationale: Metaplasia is an adaptive substitution of one mature cell type for
another that is better able to withstand a stressful environment, such as squamous
metaplasia in the respiratory tract of smokers.
Question 4. Which of the following is a hallmark of irreversible cell injury?
A. Cellular swelling that resolves with restoration of ATP
B. Severe membrane damage, mitochondrial dysfunction with inability to restore
ATP, and nuclear changes such as pyknosis or karyolysis
C. Transient loss of ATP only
D. Mild fatty change that reverses with treatment
Correct Answer: B
Rationale: Irreversible injury is marked by profound membrane damage,
mitochondrial permeability transition, calcium overload, and nuclear dissolution.
These changes lead to necrosis or apoptosis.
Question 5. Apoptosis differs from necrosis in that apoptosis:
A. Always provokes a strong inflammatory response
B. Is a form of programmed cell death that does not incite inflammation
C. Results in cell swelling and lysis
D. Is always pathological
Correct Answer: B
Rationale: Apoptosis is an active, energy-dependent process of programmed cell
death that avoids inflammation by packaging cellular contents into apoptotic
bodies for phagocytosis. Necrosis is passive and inflammatory.
Question 6. Which of the following is an example of physiological
hyperplasia?
A. Endometrial proliferation during the menstrual cycle
B. Cardiac muscle enlargement in hypertension
C. Squamous metaplasia in the lungs of a smoker
D. Atrophy of disused skeletal muscle
Correct Answer: A
Rationale: Physiologic hyperplasia occurs in response to hormonal stimulation
(e.g., breast and endometrial proliferation during pregnancy and the menstrual
cycle) or compensatory mechanisms (e.g., liver regeneration).
Question 7. Dysplasia is best described as:
A. A reversible change in cell size
,B. Disordered cellular growth characterized by variation in cell size, shape, and
organization
C. A normal physiologic adaptation
D. Programmed cell death
Correct Answer: B
Rationale: Dysplasia refers to deranged cellular growth and is often a precursor to
malignancy. It is characterized by pleomorphism, hyperchromasia, and increased
mitotic figures.
Question 8. Which mechanism is primarily responsible for hypoxic cell
injury?
A. Increased ATP production
B. Decreased oxidative phosphorylation and ATP depletion
C. Increased protein synthesis
D. Enhanced DNA repair
Correct Answer: B
Rationale: Hypoxia leads to decreased oxidative phosphorylation, ATP depletion,
failure of the Na+/K+ ATPase pump, cellular swelling, and eventual necrosis. This
is the most common mechanism of cell injury.
Question 9. What is a free radical?
A. A stable molecule with paired electrons
B. An unstable atom or molecule with an unpaired electron that can cause
oxidative damage
C. A type of protein
D. A genetic mutation
Correct Answer: B
Rationale: Free radicals (reactive oxygen species) have unpaired electrons, making
them highly reactive. They can damage lipids, proteins, and DNA, contributing to
cell injury and aging.
Question 10. Which of the following is a cause of cellular aging?
A. Telomere shortening
B. Increased stem cell regeneration
C. Enhanced DNA repair mechanisms
D. Increased mitochondrial function
Correct Answer: A
, Rationale: Telomere shortening is a recognized hallmark of cellular aging. Each
cell division shortens the telomeres, eventually leading to replicative senescence.
Question 11. A point mutation involves:
A. The insertion or deletion of a single nucleotide
B. The substitution of a single nucleotide, which may result in a missense or
nonsense mutation
C. The duplication of an entire chromosome
D. The deletion of an entire chromosome
Correct Answer: B
Rationale: A point mutation is a change in a single nucleotide base pair. It can be
silent, missense (changes an amino acid), or nonsense (creates a stop codon).
Question 12. Which genetic disorder is caused by an autosomal dominant
mutation?
A. Cystic fibrosis
B. Huntington's disease
C. Sickle cell anemia
D. Tay-Sachs disease
Correct Answer: B
Rationale: Huntington's disease is an autosomal dominant disorder. Cystic fibrosis,
sickle cell anemia, and Tay-Sachs disease are autosomal recessive.
Question 13. What is a karyotype?
A. A visual representation of an individual's chromosomes
B. A type of genetic mutation
C. A protein involved in cell division
D. A medication used to treat genetic disorders
Correct Answer: A
Rationale: A karyotype is a standardized arrangement of chromosomes used to
detect chromosomal abnormalities such as aneuploidy (e.g., trisomy 21), deletions,
and translocations.
Question 14. Which of the following best describes an autosomal recessive
disorder?
A. Only one copy of the mutated gene is needed to cause the disease
B. Two copies of the mutated gene (one from each parent) are needed to cause the
disease
C. It only affects males
Academic Year 2026/2027 – Midterm
Comprehensive Examination | Verified
Questions
ACTUAL QUESTIONS
Domain 1: Cellular Processes and Genetic Factors
Question 1. Which of the following best describes atrophy?
A. An increase in cell size
B. A decrease in cell size or number, often due to reduced workload or nutrient
supply
C. An increase in the number of cells
D. Transformation of one cell type into another
Correct Answer: B
Rationale: Atrophy is a reversible reduction in cell size or number resulting from
decreased demand, denervation, ischemia, inadequate nutrition, or aging. Organ
size may decrease accordingly.
Question 2. Hypertrophy is characterized by:
A. An increase in the number of cells
B. An increase in the size of existing cells, commonly in response to increased
workload
C. Replacement of one differentiated cell type by another
D. Programmed cell death
Correct Answer: B
Rationale: Hypertrophy involves enlargement of individual cells, typically in
response to mechanical stress or hormonal stimulation, as seen in cardiac muscle
under sustained pressure overload.
Question 3. Metaplasia refers to:
A. An increase in cell number
B. The reversible replacement of one differentiated cell type by another
differentiated cell type
C. Irreversible genetic mutation
D. Necrotic cell death only
,Correct Answer: B
Rationale: Metaplasia is an adaptive substitution of one mature cell type for
another that is better able to withstand a stressful environment, such as squamous
metaplasia in the respiratory tract of smokers.
Question 4. Which of the following is a hallmark of irreversible cell injury?
A. Cellular swelling that resolves with restoration of ATP
B. Severe membrane damage, mitochondrial dysfunction with inability to restore
ATP, and nuclear changes such as pyknosis or karyolysis
C. Transient loss of ATP only
D. Mild fatty change that reverses with treatment
Correct Answer: B
Rationale: Irreversible injury is marked by profound membrane damage,
mitochondrial permeability transition, calcium overload, and nuclear dissolution.
These changes lead to necrosis or apoptosis.
Question 5. Apoptosis differs from necrosis in that apoptosis:
A. Always provokes a strong inflammatory response
B. Is a form of programmed cell death that does not incite inflammation
C. Results in cell swelling and lysis
D. Is always pathological
Correct Answer: B
Rationale: Apoptosis is an active, energy-dependent process of programmed cell
death that avoids inflammation by packaging cellular contents into apoptotic
bodies for phagocytosis. Necrosis is passive and inflammatory.
Question 6. Which of the following is an example of physiological
hyperplasia?
A. Endometrial proliferation during the menstrual cycle
B. Cardiac muscle enlargement in hypertension
C. Squamous metaplasia in the lungs of a smoker
D. Atrophy of disused skeletal muscle
Correct Answer: A
Rationale: Physiologic hyperplasia occurs in response to hormonal stimulation
(e.g., breast and endometrial proliferation during pregnancy and the menstrual
cycle) or compensatory mechanisms (e.g., liver regeneration).
Question 7. Dysplasia is best described as:
A. A reversible change in cell size
,B. Disordered cellular growth characterized by variation in cell size, shape, and
organization
C. A normal physiologic adaptation
D. Programmed cell death
Correct Answer: B
Rationale: Dysplasia refers to deranged cellular growth and is often a precursor to
malignancy. It is characterized by pleomorphism, hyperchromasia, and increased
mitotic figures.
Question 8. Which mechanism is primarily responsible for hypoxic cell
injury?
A. Increased ATP production
B. Decreased oxidative phosphorylation and ATP depletion
C. Increased protein synthesis
D. Enhanced DNA repair
Correct Answer: B
Rationale: Hypoxia leads to decreased oxidative phosphorylation, ATP depletion,
failure of the Na+/K+ ATPase pump, cellular swelling, and eventual necrosis. This
is the most common mechanism of cell injury.
Question 9. What is a free radical?
A. A stable molecule with paired electrons
B. An unstable atom or molecule with an unpaired electron that can cause
oxidative damage
C. A type of protein
D. A genetic mutation
Correct Answer: B
Rationale: Free radicals (reactive oxygen species) have unpaired electrons, making
them highly reactive. They can damage lipids, proteins, and DNA, contributing to
cell injury and aging.
Question 10. Which of the following is a cause of cellular aging?
A. Telomere shortening
B. Increased stem cell regeneration
C. Enhanced DNA repair mechanisms
D. Increased mitochondrial function
Correct Answer: A
, Rationale: Telomere shortening is a recognized hallmark of cellular aging. Each
cell division shortens the telomeres, eventually leading to replicative senescence.
Question 11. A point mutation involves:
A. The insertion or deletion of a single nucleotide
B. The substitution of a single nucleotide, which may result in a missense or
nonsense mutation
C. The duplication of an entire chromosome
D. The deletion of an entire chromosome
Correct Answer: B
Rationale: A point mutation is a change in a single nucleotide base pair. It can be
silent, missense (changes an amino acid), or nonsense (creates a stop codon).
Question 12. Which genetic disorder is caused by an autosomal dominant
mutation?
A. Cystic fibrosis
B. Huntington's disease
C. Sickle cell anemia
D. Tay-Sachs disease
Correct Answer: B
Rationale: Huntington's disease is an autosomal dominant disorder. Cystic fibrosis,
sickle cell anemia, and Tay-Sachs disease are autosomal recessive.
Question 13. What is a karyotype?
A. A visual representation of an individual's chromosomes
B. A type of genetic mutation
C. A protein involved in cell division
D. A medication used to treat genetic disorders
Correct Answer: A
Rationale: A karyotype is a standardized arrangement of chromosomes used to
detect chromosomal abnormalities such as aneuploidy (e.g., trisomy 21), deletions,
and translocations.
Question 14. Which of the following best describes an autosomal recessive
disorder?
A. Only one copy of the mutated gene is needed to cause the disease
B. Two copies of the mutated gene (one from each parent) are needed to cause the
disease
C. It only affects males
