NR 507 Week 8 Final Exam Questions 1-100 NR-507 Advanced
Pathophysiology NR 507 Week 8 Final Exam Examplify Online
Proctored Questions and Answers Graded A+
SECTION 1: Cellular Adaptation, Injury & Death
1. Which cellular adaptation is characterized by the reversible replacement of one mature cell
type by another, less mature cell type?
A) Atrophy
B) Metaplasia
C) Hyperplasia
D) Dysplasia
Correct Answer: B) Metaplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type by another,
often occurring as a protective response to chronic irritation or stress. For example, the normal
columnar epithelium of the bronchus may be replaced by stratified squamous epithelium in
chronic smokers . Atrophy refers to shrinkage of cells, hyperplasia involves an increase in cell
number, and dysplasia is disordered growth with loss of cellular organization.
2. A 42-year-old male with poorly controlled hypertension undergoes echocardiography that
reveals significant left ventricular wall thickening. Myocardial biopsy shows enlarged cardiac
myocytes with increased cytoplasmic structural proteins. This change represents:
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
Correct Answer: B) Hypertrophy
Rationale: Cardiac myocytes are terminally differentiated cells that cannot divide. In
response to chronic pressure overload (hypertension), they increase in size through the addition
of structural proteins—a classic example of hypertrophy . Hyperplasia involves cell proliferation
and does not occur in cardiac muscle.
,3. Which of the following is the single most common cause of cellular injury?
A) Free radical injury
B) Chemical injury
C) Hypoxia
D) Genetic mutations
Correct Answer: C) Hypoxia
Rationale: Hypoxia—insufficient oxygen delivery to tissues—is the most common and
clinically significant cause of cellular injury. Without adequate oxygen, oxidative
phosphorylation ceases, ATP production falls, and the Na⁺/K⁺ ATPase pump fails, leading to
cellular swelling and eventually necrosis .
4. A 67-year-old male with a 40-pack-year smoking history undergoes bronchoscopy with
biopsy. The pathologist identifies columnar epithelial cells that have been replaced by
stratified squamous epithelial cells. The basement membrane is intact. This finding is best
classified as:
A) Anaplasia
B) Carcinoma in situ
C) Metaplasia
D) Invasive carcinoma
Correct Answer: C) Metaplasia
Rationale: This is a classic description of squamous metaplasia of the bronchial epithelium,
a protective response to chronic smoke exposure. The intact basement membrane distinguishes
it from invasive carcinoma, and the organized nature of the change distinguishes it from
anaplasia or carcinoma in situ .
5. In apoptosis, which characteristic distinguishes it from necrosis?
A) Cell swelling and rupture
B) Inflammatory response
C) Programmed cell death without inflammation
D) Passive process caused by injury
Correct Answer: C) Programmed cell death without inflammation
, Rationale: Apoptosis is an active, programmed form of cell death that does not trigger an
inflammatory response because the cell membrane remains intact and the cell is packaged into
apoptotic bodies for phagocytosis. Necrosis, in contrast, involves cell swelling, membrane
rupture, and inflammation .
6. A nurse is reviewing ischemia-reperfusion injury. Which mechanism primarily causes this
type of cellular damage?
A) Sustained hypoxia during ischemia
B) Oxidative stress from reactive oxygen species
C) Direct mechanical trauma
D) Genetic mutation
Correct Answer: B) Oxidative stress from reactive oxygen species
Rationale: During ischemia, cells are deprived of oxygen. When blood flow is restored
(reperfusion), oxygen reintroduction generates a burst of reactive oxygen species (free radicals)
that overwhelm endogenous antioxidant defenses, causing additional cellular damage—a
phenomenon known as ischemia-reperfusion injury .
7. A mutation in the tumor suppressor gene p53 is most associated with which consequence?
A) Enhanced DNA repair
B) Uncontrolled cell growth and cancer
C) Increased apoptosis
D) Decreased angiogenesis
Correct Answer: B) Uncontrolled cell growth and cancer
Rationale: p53 is known as the "guardian of the genome." It normally arrests the cell cycle
to allow DNA repair or triggers apoptosis if damage is irreparable. Loss of p53 function permits
cells with damaged DNA to proliferate, leading to genomic instability and cancer development .
8. A 65-year-old male presents with a laryngeal lesion. Biopsy reveals disordered cellular
growth, loss of cellular polarity, and nuclear hyperchromasia, but the basement membrane
remains intact. This pathological finding is best described as:
, A) Anaplasia
B) Dysplasia
C) Carcinoma in situ
D) Invasive squamous cell carcinoma
Correct Answer: B) Dysplasia
Rationale: Dysplasia is characterized by disordered cellular growth, loss of cellular polarity,
and nuclear atypia (including hyperchromasia). When these changes are severe but the
basement membrane remains intact, it is classified as dysplasia (or severe dysplasia). Carcinoma
in situ also has an intact basement membrane but involves the full thickness of the epithelium .
9. Which of the following is a characteristic feature of necrosis but NOT apoptosis?
A) Cell shrinkage
B) Intact cell membrane
C) Inflammatory response
D) Formation of apoptotic bodies
Correct Answer: C) Inflammatory response
Rationale: Necrosis involves loss of membrane integrity, enzymatic digestion of cells, and
release of cellular contents that trigger an inflammatory response. Apoptosis is an organized,
energy-dependent process that avoids inflammation by packaging cellular contents into
membrane-bound apoptotic bodies .
10. A 58-year-old male construction worker with a 30-year history of smoking two packs per
day presents with fatigue and shortness of breath. His carboxyhemoglobin level is 12%. The
cellular injury pattern is best classified as:
A) Hypoxic injury due to decreased oxygen-carrying capacity of hemoglobin
B) Ischemic injury due to reduced arterial blood flow
C) Chemical injury due to direct toxin-mediated destruction
D) Apoptotic injury triggered by carbon monoxide
Correct Answer: A) Hypoxic injury due to decreased oxygen-carrying capacity of
hemoglobin
Rationale: Carbon monoxide binds hemoglobin with approximately 200 times the affinity of
oxygen, drastically reducing the oxygen-carrying capacity of the blood. This causes hypoxic
Pathophysiology NR 507 Week 8 Final Exam Examplify Online
Proctored Questions and Answers Graded A+
SECTION 1: Cellular Adaptation, Injury & Death
1. Which cellular adaptation is characterized by the reversible replacement of one mature cell
type by another, less mature cell type?
A) Atrophy
B) Metaplasia
C) Hyperplasia
D) Dysplasia
Correct Answer: B) Metaplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type by another,
often occurring as a protective response to chronic irritation or stress. For example, the normal
columnar epithelium of the bronchus may be replaced by stratified squamous epithelium in
chronic smokers . Atrophy refers to shrinkage of cells, hyperplasia involves an increase in cell
number, and dysplasia is disordered growth with loss of cellular organization.
2. A 42-year-old male with poorly controlled hypertension undergoes echocardiography that
reveals significant left ventricular wall thickening. Myocardial biopsy shows enlarged cardiac
myocytes with increased cytoplasmic structural proteins. This change represents:
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
Correct Answer: B) Hypertrophy
Rationale: Cardiac myocytes are terminally differentiated cells that cannot divide. In
response to chronic pressure overload (hypertension), they increase in size through the addition
of structural proteins—a classic example of hypertrophy . Hyperplasia involves cell proliferation
and does not occur in cardiac muscle.
,3. Which of the following is the single most common cause of cellular injury?
A) Free radical injury
B) Chemical injury
C) Hypoxia
D) Genetic mutations
Correct Answer: C) Hypoxia
Rationale: Hypoxia—insufficient oxygen delivery to tissues—is the most common and
clinically significant cause of cellular injury. Without adequate oxygen, oxidative
phosphorylation ceases, ATP production falls, and the Na⁺/K⁺ ATPase pump fails, leading to
cellular swelling and eventually necrosis .
4. A 67-year-old male with a 40-pack-year smoking history undergoes bronchoscopy with
biopsy. The pathologist identifies columnar epithelial cells that have been replaced by
stratified squamous epithelial cells. The basement membrane is intact. This finding is best
classified as:
A) Anaplasia
B) Carcinoma in situ
C) Metaplasia
D) Invasive carcinoma
Correct Answer: C) Metaplasia
Rationale: This is a classic description of squamous metaplasia of the bronchial epithelium,
a protective response to chronic smoke exposure. The intact basement membrane distinguishes
it from invasive carcinoma, and the organized nature of the change distinguishes it from
anaplasia or carcinoma in situ .
5. In apoptosis, which characteristic distinguishes it from necrosis?
A) Cell swelling and rupture
B) Inflammatory response
C) Programmed cell death without inflammation
D) Passive process caused by injury
Correct Answer: C) Programmed cell death without inflammation
, Rationale: Apoptosis is an active, programmed form of cell death that does not trigger an
inflammatory response because the cell membrane remains intact and the cell is packaged into
apoptotic bodies for phagocytosis. Necrosis, in contrast, involves cell swelling, membrane
rupture, and inflammation .
6. A nurse is reviewing ischemia-reperfusion injury. Which mechanism primarily causes this
type of cellular damage?
A) Sustained hypoxia during ischemia
B) Oxidative stress from reactive oxygen species
C) Direct mechanical trauma
D) Genetic mutation
Correct Answer: B) Oxidative stress from reactive oxygen species
Rationale: During ischemia, cells are deprived of oxygen. When blood flow is restored
(reperfusion), oxygen reintroduction generates a burst of reactive oxygen species (free radicals)
that overwhelm endogenous antioxidant defenses, causing additional cellular damage—a
phenomenon known as ischemia-reperfusion injury .
7. A mutation in the tumor suppressor gene p53 is most associated with which consequence?
A) Enhanced DNA repair
B) Uncontrolled cell growth and cancer
C) Increased apoptosis
D) Decreased angiogenesis
Correct Answer: B) Uncontrolled cell growth and cancer
Rationale: p53 is known as the "guardian of the genome." It normally arrests the cell cycle
to allow DNA repair or triggers apoptosis if damage is irreparable. Loss of p53 function permits
cells with damaged DNA to proliferate, leading to genomic instability and cancer development .
8. A 65-year-old male presents with a laryngeal lesion. Biopsy reveals disordered cellular
growth, loss of cellular polarity, and nuclear hyperchromasia, but the basement membrane
remains intact. This pathological finding is best described as:
, A) Anaplasia
B) Dysplasia
C) Carcinoma in situ
D) Invasive squamous cell carcinoma
Correct Answer: B) Dysplasia
Rationale: Dysplasia is characterized by disordered cellular growth, loss of cellular polarity,
and nuclear atypia (including hyperchromasia). When these changes are severe but the
basement membrane remains intact, it is classified as dysplasia (or severe dysplasia). Carcinoma
in situ also has an intact basement membrane but involves the full thickness of the epithelium .
9. Which of the following is a characteristic feature of necrosis but NOT apoptosis?
A) Cell shrinkage
B) Intact cell membrane
C) Inflammatory response
D) Formation of apoptotic bodies
Correct Answer: C) Inflammatory response
Rationale: Necrosis involves loss of membrane integrity, enzymatic digestion of cells, and
release of cellular contents that trigger an inflammatory response. Apoptosis is an organized,
energy-dependent process that avoids inflammation by packaging cellular contents into
membrane-bound apoptotic bodies .
10. A 58-year-old male construction worker with a 30-year history of smoking two packs per
day presents with fatigue and shortness of breath. His carboxyhemoglobin level is 12%. The
cellular injury pattern is best classified as:
A) Hypoxic injury due to decreased oxygen-carrying capacity of hemoglobin
B) Ischemic injury due to reduced arterial blood flow
C) Chemical injury due to direct toxin-mediated destruction
D) Apoptotic injury triggered by carbon monoxide
Correct Answer: A) Hypoxic injury due to decreased oxygen-carrying capacity of
hemoglobin
Rationale: Carbon monoxide binds hemoglobin with approximately 200 times the affinity of
oxygen, drastically reducing the oxygen-carrying capacity of the blood. This causes hypoxic
