CHAMBERLAIN NR 283
PATHOPHYSIOLOGY EXAM 3
REVIEW: 220 REAL EXAM-STYLE
QUESTIONS WITH VERIFIED
ANSWERS AND DETAILED
RATIONALES (2026/2027 EDITION)
Section 1: Cellular Adaptation, Injury, and Genetics (Questions
1–25)
1. A patient with long-standing, untreated hypertension undergoes an
echocardiogram. The results reveal 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.
2. A tissue 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columnar epithelial cells have been replaced by stratified squamous epithelial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. Metaplasia
C. Hyperplasia
D. Dysplasia
,Correct Answer: B. 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.
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.
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.
5. A child is diagnosed with Cystic Fibrosis. Both parents are asymptomatic
carriers of the disease. What is the pattern of genetic inheritance for this
condition?
A. Autosomal dominant
B. Autosomal recessive
C. X-linked dominant
D. X-linked recessive
Correct Answer: B. Rationale: Cystic Fibrosis is an autosomal recessive disorder,
,meaning an individual must inherit two copies of the mutated gene (one from each
parent) to manifest the disease.
6. A genetic screening reveals that a fetus has a chromosomal makeup of 47,
XY, +21. Which clinical condition will this child have at birth?
A. Turner syndrome
B. Klinefelter syndrome
C. Down syndrome
D. Edward syndrome
Correct Answer: C. Rationale: The karyotype 47, XY, +21 indicates trisomy 21, which is
the chromosomal abnormality responsible for Down syndrome.
7. A nurse is reviewing a biopsy report that describes a progressive decrease in
myocardial cell size in a patient with chronic severe ischemia. The nurse should
recognize this cellular adaptation as which of the following?
A. Hypertrophy
B. Atrophy
C. Dysplasia
D. Metaplasia
Correct Answer: B. Rationale: Atrophy is a cellular adaptation characterized by a
decrease or shrinkage in cellular size. When it occurs in myocardial tissue due to
chronic ischemia, it is often a survival mechanism to lower the oxygen and metabolic
demands of the cells.
8. A patient with long-standing, untreated hypertension shows an increase in
the size of myocardial cells without an increase in cell number. Which term
describes this adaptation?
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
Correct Answer: B. Rationale: Hypertrophy is an increase in individual cell size, typically
caused by increased mechanical demand or workload, as seen in the left ventricle of
hypertensive patients.
, 9. A chronic smoker undergoes a bronchoscopy, and the biopsy shows that
normal ciliated columnar epithelial cells in the trachea have been replaced by
stratified squamous epithelial cells. This represents which cellular adaptation?
A. Dysplasia
B. Anaplasia
C. Metaplasia
D. Hyperplasia
Correct Answer: C. Rationale: Metaplasia is the reversible replacement of one mature
cell type by another mature cell type, usually in response to chronic irritation or
inflammation.
10. A Pap smear report notes the presence of abnormal, disordered cellular
growth with variations in cell size, shape, and organization in the cervix. What
is the correct term for this finding?
A. Metaplasia
B. Dysplasia
C. Hypertrophy
D. Atrophy
Correct Answer: B. Rationale: Dysplasia refers to abnormal, disordered cell growth and
maturation characterized by variations in cell size, shape, and organization. While it is
not true cancer, it is considered a precancerous change.
11. A patient experiences a prolonged period of ischemia to the lower
extremity due to an arterial occlusion. Which cellular change occurs first due to
the lack of oxygen?
A. Increased intracellular pH
B. Failure of the sodium-potassium pump
C. Direct rupture of the cell membrane
D. Accelerated oxidative phosphorylation
Correct Answer: B. Rationale: Ischemia decreases ATP production via oxidative
phosphorylation. Without ATP, the sodium-potassium (Na+/K+) ATPase pump fails,
causing sodium.
PATHOPHYSIOLOGY EXAM 3
REVIEW: 220 REAL EXAM-STYLE
QUESTIONS WITH VERIFIED
ANSWERS AND DETAILED
RATIONALES (2026/2027 EDITION)
Section 1: Cellular Adaptation, Injury, and Genetics (Questions
1–25)
1. A patient with long-standing, untreated hypertension undergoes an
echocardiogram. The results reveal 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.
2. A tissue 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. Metaplasia
C. Hyperplasia
D. Dysplasia
,Correct Answer: B. 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.
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.
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.
5. A child is diagnosed with Cystic Fibrosis. Both parents are asymptomatic
carriers of the disease. What is the pattern of genetic inheritance for this
condition?
A. Autosomal dominant
B. Autosomal recessive
C. X-linked dominant
D. X-linked recessive
Correct Answer: B. Rationale: Cystic Fibrosis is an autosomal recessive disorder,
,meaning an individual must inherit two copies of the mutated gene (one from each
parent) to manifest the disease.
6. A genetic screening reveals that a fetus has a chromosomal makeup of 47,
XY, +21. Which clinical condition will this child have at birth?
A. Turner syndrome
B. Klinefelter syndrome
C. Down syndrome
D. Edward syndrome
Correct Answer: C. Rationale: The karyotype 47, XY, +21 indicates trisomy 21, which is
the chromosomal abnormality responsible for Down syndrome.
7. A nurse is reviewing a biopsy report that describes a progressive decrease in
myocardial cell size in a patient with chronic severe ischemia. The nurse should
recognize this cellular adaptation as which of the following?
A. Hypertrophy
B. Atrophy
C. Dysplasia
D. Metaplasia
Correct Answer: B. Rationale: Atrophy is a cellular adaptation characterized by a
decrease or shrinkage in cellular size. When it occurs in myocardial tissue due to
chronic ischemia, it is often a survival mechanism to lower the oxygen and metabolic
demands of the cells.
8. A patient with long-standing, untreated hypertension shows an increase in
the size of myocardial cells without an increase in cell number. Which term
describes this adaptation?
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
Correct Answer: B. Rationale: Hypertrophy is an increase in individual cell size, typically
caused by increased mechanical demand or workload, as seen in the left ventricle of
hypertensive patients.
, 9. A chronic smoker undergoes a bronchoscopy, and the biopsy shows that
normal ciliated columnar epithelial cells in the trachea have been replaced by
stratified squamous epithelial cells. This represents which cellular adaptation?
A. Dysplasia
B. Anaplasia
C. Metaplasia
D. Hyperplasia
Correct Answer: C. Rationale: Metaplasia is the reversible replacement of one mature
cell type by another mature cell type, usually in response to chronic irritation or
inflammation.
10. A Pap smear report notes the presence of abnormal, disordered cellular
growth with variations in cell size, shape, and organization in the cervix. What
is the correct term for this finding?
A. Metaplasia
B. Dysplasia
C. Hypertrophy
D. Atrophy
Correct Answer: B. Rationale: Dysplasia refers to abnormal, disordered cell growth and
maturation characterized by variations in cell size, shape, and organization. While it is
not true cancer, it is considered a precancerous change.
11. A patient experiences a prolonged period of ischemia to the lower
extremity due to an arterial occlusion. Which cellular change occurs first due to
the lack of oxygen?
A. Increased intracellular pH
B. Failure of the sodium-potassium pump
C. Direct rupture of the cell membrane
D. Accelerated oxidative phosphorylation
Correct Answer: B. Rationale: Ischemia decreases ATP production via oxidative
phosphorylation. Without ATP, the sodium-potassium (Na+/K+) ATPase pump fails,
causing sodium.
