NURS 5315: ADVANCED PATHOPHYSIOLOGY
EXAM 2 / ACTUAL EXAM | QUESTIONS AND CORRECT
VERIFIED ANSWERS WITH RATIONALES | UTA
100% GUARANTEED PASS!!
<LATEST VERSION>
1. A myocardial cell experiences severe ischemia after abrupt occlusion of a
coronary artery. Which intracellular event occurs earliest as ATP production
declines?
A. Massive lysosomal rupture and cellular digestion
B. Failure of the sodium-potassium ATPase with intracellular sodium
accumulation
C. Activation of endonucleases causing DNA fragmentation
D. Release of cytochrome c initiating apoptosis
Answer: B
Rationale: ATP depletion first impairs energy-dependent membrane pumps,
particularly the Na⁺/K⁺ ATPase. Sodium accumulates inside the cell, water follows
osmotically, and acute cellular swelling develops. Calcium dysregulation,
membrane damage, and irreversible injury occur later as the injury progresses.
,2. A patient develops an acute renal infarction following thrombosis of a renal
artery. Histologic examination would most likely demonstrate which type of
necrosis?
A. Liquefactive necrosis
B. Fat necrosis
C. Coagulative necrosis
D. Caseous necrosis
Answer: C
Rationale: Coagulative necrosis is the characteristic pattern of ischemic injury in
most solid organs, including the heart and kidneys. Protein denaturation preserves
the basic tissue architecture for a period of time despite cell death.
3. A patient with a cerebral infarction develops a softened, fluid-filled area within
the affected brain tissue several days later. Which process best explains this
finding?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
Answer: B
Rationale: Brain tissue commonly undergoes liquefactive necrosis following
ischemic injury because enzymatic digestion rapidly breaks down dead cells,
producing a softened or liquefied lesion.
4. A patient with acute pancreatitis develops areas of chalky-white tissue
surrounding the pancreas. Which pathophysiologic process produced this finding?
A. Protein denaturation caused by ischemia
B. Deposition of circulating immune complexes
C. Lipase-mediated fat breakdown with calcium soap formation
D. T-cell-mediated destruction of adipocytes
,Answer: C
Rationale: Pancreatic lipases hydrolyze triglycerides into free fatty acids. The
fatty acids bind calcium, producing insoluble calcium soaps in a process called
saponification. This is characteristic of fat necrosis.
5. During tissue remodeling, a population of cells is eliminated without
surrounding tissue inflammation. The affected cells shrink, their chromatin
condenses, and membrane-bound apoptotic bodies form. Which mechanism is
most consistent with these findings?
A. Passive cellular rupture caused by ischemia
B. ATP-dependent programmed cell death
C. Neutrophil-mediated tissue digestion
D. Complement-mediated membrane destruction
Answer: B
Rationale: Apoptosis is regulated, ATP-dependent programmed cell death. Cells
shrink, nuclear material condenses, and cellular fragments are packaged into
apoptotic bodies that can be removed without the prominent inflammatory
response associated with necrosis.
6. A patient sustains a superficial thermal injury and immediately develops
localized redness, warmth, swelling, and pain. Which mediator is primarily
responsible for the rapid increase in vascular permeability during the early
response?
A. Histamine
B. Prostaglandin E₂
C. Interleukin-1
D. Leukotriene D₄
Answer: A
Rationale: Histamine is rapidly released from mast cells and promotes
vasodilation and increased vascular permeability during acute inflammation.
, Prostaglandins contribute importantly to pain and fever, while leukotrienes have
prominent effects on bronchoconstriction and permeability.
7. Following endothelial activation at an injured site, leukocytes move from the
circulating blood into damaged tissue. Which sequence correctly describes this
process?
A. Adhesion → margination → chemotaxis → rolling → transmigration
B. Margination → rolling → adhesion → transmigration → chemotaxis
C. Rolling → margination → adhesion → chemotaxis → transmigration
D. Chemotaxis → rolling → adhesion → margination → transmigration
Answer: B
Rationale: Leukocytes first move toward the endothelial surface through
margination, then interact transiently with the endothelium by rolling. Firm
adhesion follows, after which cells pass through the vessel wall by transmigration
and move toward the injury along a chemical gradient by chemotaxis.
8. A patient with bacterial pneumonia has a marked influx of neutrophils into the
alveolar spaces. Which characteristic of acute inflammation best explains why
neutrophils predominate early?
A. They are the principal antibody-producing cells in injured tissue.
B. They are rapidly recruited from the bloodstream by inflammatory chemotactic
signals.
C. They remain permanently in tissues and become activated only after
macrophage recruitment.
D. They are responsible for producing immunoglobulin-containing immune
complexes.
Answer: B
Rationale: Neutrophils are the predominant leukocytes during the early phase of
acute inflammation. Chemotactic mediators direct them toward the site of injury or
infection, where they phagocytose pathogens and release antimicrobial substances.
EXAM 2 / ACTUAL EXAM | QUESTIONS AND CORRECT
VERIFIED ANSWERS WITH RATIONALES | UTA
100% GUARANTEED PASS!!
<LATEST VERSION>
1. A myocardial cell experiences severe ischemia after abrupt occlusion of a
coronary artery. Which intracellular event occurs earliest as ATP production
declines?
A. Massive lysosomal rupture and cellular digestion
B. Failure of the sodium-potassium ATPase with intracellular sodium
accumulation
C. Activation of endonucleases causing DNA fragmentation
D. Release of cytochrome c initiating apoptosis
Answer: B
Rationale: ATP depletion first impairs energy-dependent membrane pumps,
particularly the Na⁺/K⁺ ATPase. Sodium accumulates inside the cell, water follows
osmotically, and acute cellular swelling develops. Calcium dysregulation,
membrane damage, and irreversible injury occur later as the injury progresses.
,2. A patient develops an acute renal infarction following thrombosis of a renal
artery. Histologic examination would most likely demonstrate which type of
necrosis?
A. Liquefactive necrosis
B. Fat necrosis
C. Coagulative necrosis
D. Caseous necrosis
Answer: C
Rationale: Coagulative necrosis is the characteristic pattern of ischemic injury in
most solid organs, including the heart and kidneys. Protein denaturation preserves
the basic tissue architecture for a period of time despite cell death.
3. A patient with a cerebral infarction develops a softened, fluid-filled area within
the affected brain tissue several days later. Which process best explains this
finding?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
Answer: B
Rationale: Brain tissue commonly undergoes liquefactive necrosis following
ischemic injury because enzymatic digestion rapidly breaks down dead cells,
producing a softened or liquefied lesion.
4. A patient with acute pancreatitis develops areas of chalky-white tissue
surrounding the pancreas. Which pathophysiologic process produced this finding?
A. Protein denaturation caused by ischemia
B. Deposition of circulating immune complexes
C. Lipase-mediated fat breakdown with calcium soap formation
D. T-cell-mediated destruction of adipocytes
,Answer: C
Rationale: Pancreatic lipases hydrolyze triglycerides into free fatty acids. The
fatty acids bind calcium, producing insoluble calcium soaps in a process called
saponification. This is characteristic of fat necrosis.
5. During tissue remodeling, a population of cells is eliminated without
surrounding tissue inflammation. The affected cells shrink, their chromatin
condenses, and membrane-bound apoptotic bodies form. Which mechanism is
most consistent with these findings?
A. Passive cellular rupture caused by ischemia
B. ATP-dependent programmed cell death
C. Neutrophil-mediated tissue digestion
D. Complement-mediated membrane destruction
Answer: B
Rationale: Apoptosis is regulated, ATP-dependent programmed cell death. Cells
shrink, nuclear material condenses, and cellular fragments are packaged into
apoptotic bodies that can be removed without the prominent inflammatory
response associated with necrosis.
6. A patient sustains a superficial thermal injury and immediately develops
localized redness, warmth, swelling, and pain. Which mediator is primarily
responsible for the rapid increase in vascular permeability during the early
response?
A. Histamine
B. Prostaglandin E₂
C. Interleukin-1
D. Leukotriene D₄
Answer: A
Rationale: Histamine is rapidly released from mast cells and promotes
vasodilation and increased vascular permeability during acute inflammation.
, Prostaglandins contribute importantly to pain and fever, while leukotrienes have
prominent effects on bronchoconstriction and permeability.
7. Following endothelial activation at an injured site, leukocytes move from the
circulating blood into damaged tissue. Which sequence correctly describes this
process?
A. Adhesion → margination → chemotaxis → rolling → transmigration
B. Margination → rolling → adhesion → transmigration → chemotaxis
C. Rolling → margination → adhesion → chemotaxis → transmigration
D. Chemotaxis → rolling → adhesion → margination → transmigration
Answer: B
Rationale: Leukocytes first move toward the endothelial surface through
margination, then interact transiently with the endothelium by rolling. Firm
adhesion follows, after which cells pass through the vessel wall by transmigration
and move toward the injury along a chemical gradient by chemotaxis.
8. A patient with bacterial pneumonia has a marked influx of neutrophils into the
alveolar spaces. Which characteristic of acute inflammation best explains why
neutrophils predominate early?
A. They are the principal antibody-producing cells in injured tissue.
B. They are rapidly recruited from the bloodstream by inflammatory chemotactic
signals.
C. They remain permanently in tissues and become activated only after
macrophage recruitment.
D. They are responsible for producing immunoglobulin-containing immune
complexes.
Answer: B
Rationale: Neutrophils are the predominant leukocytes during the early phase of
acute inflammation. Chemotactic mediators direct them toward the site of injury or
infection, where they phagocytose pathogens and release antimicrobial substances.
