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NSG 3280 PATHOPHYSIOLOGY FOR NURSES I EXAM WITH
VERIFIED ANSWERS DETAILED RATIONALES GRADED A+
NSG 3280 Pathophysiology for Nurses I
SECTION 1: CELLULAR ADAPTATION, INJURY & DEATH (Questions 1–35)
Question 1. A 68-year-old patient with long-standing hypertension develops progressive left
ventricular hypertrophy. The nurse recognizes that the cardiac myocytes have adapted through
which cellular process to reduce wall stress?
A) Hyperplasia of cardiac myocytes
B) Hypertrophy of cardiac myocytes
C) Atrophy of myocardial fibers
D) Metaplasia of endocardial tissue
Answer: B
Rationale: Sustained pressure overload causes individual cardiac myocytes to enlarge, a process
known as hypertrophy, which increases contractile force and normalizes wall tension according
to Laplace's law.
Question 2. During a myocardial infarction, a region of myocardium becomes irreversibly
injured. Which microscopic finding best indicates that the cells have progressed beyond
reversible injury?
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A) Cellular swelling and fatty change
B) Nuclear pyknosis, karyorrhexis, and karyolysis
C) Membrane blebbing with loss of microvilli
D) Dilated endoplasmic reticulum
Answer: B
Rationale: Nuclear changes, including pyknosis, karyorrhexis, and karyolysis, are hallmarks of
irreversible cell death. Cellular swelling and fatty change can occur in reversible injury and may
resolve if perfusion is restored promptly.
Question 3. A patient receives a chemotherapy agent known to generate free radicals. Which
cellular structure is most vulnerable to free-radical-mediated lipid peroxidation?
A) Mitochondrial DNA
B) Nuclear histone proteins
C) Plasma membrane phospholipids
D) Ribosomal RNA
Answer: C
Rationale: Free radicals preferentially attack polyunsaturated fatty acids in membrane
phospholipids, initiating lipid peroxidation that damages membrane integrity. Although DNA
and proteins can also be injured, lipid peroxidation of the plasma membrane is the classic and
earliest membrane lesion.
Question 4. A patient with chronic obstructive pulmonary disease has had prolonged injury to
the bronchial tissues. The nurse expects to find which type of cellular adaptation?
A) Dysplasia
B) Hyperplasia
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C) Atrophy
D) Metaplasia
Answer: D
Rationale: Metaplasia involves the replacement of one cell type with another better suited to
the environment, which commonly occurs in chronic irritation such as COPD. Dysplasia is more
advanced and disorganized and may be precancerous.
Question 5. A patient with a massive myocardial infarction is expected to have which type of
necrosis in the cardiac tissue?
A) Liquefactive necrosis
B) Caseous necrosis
C) Fat necrosis
D) Coagulative necrosis
Answer: D
Rationale: Coagulative necrosis is the most common type and typically results from ischemia in
solid organs like the heart. Liquefactive necrosis usually occurs in the brain, caseous necrosis is
characteristic of tuberculosis, and fat necrosis occurs in adipose tissue.
Question 6. A pathologist examining tissue from a healing surgical wound notes the presence of
granulation tissue. Which combination of cells and matrix is most characteristic of this stage of
healing?
A) Dense collagen bundles and few vessels
B) Mature scar with parallel collagen fibers
C) Predominant neutrophils and fibrin
D) Proliferating fibroblasts, new capillaries, and loose extracellular matrix
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Answer: D
Rationale: Granulation tissue is defined by proliferating fibroblasts, newly formed capillaries
(angiogenesis), and a loose provisional extracellular matrix. Dense collagen characterizes later
remodeling.
Question 7. A patient is found to have liver disease, resulting in the removal of a lobe of his
liver. Adaptation to the reduced size of the liver leads to what process in the remaining liver
cells?
A) Metaplasia
B) Organ atrophy
C) Compensatory hyperplasia
D) Physiologic hyperplasia
Answer: C
Rationale: Compensatory hyperplasia occurs when remaining cells proliferate to restore organ
mass after tissue loss. This is a common adaptive response in organs with regenerative capacity,
such as the liver.
Question 8. A 20-year-old college student has presented to her campus medical clinic for a
scheduled Pap smear. The clinician who will interpret the smear will examine cell samples for
evidence of what?
A) Changes in cell shape, size, and organization
B) Presence of unexpected cell types
C) Ischemic changes in cell sample
D) Abnormally high numbers of cells
Answer: A
Rationale: Pap smears are examined for cellular changes including alterations in cell shape, size,
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NSG 3280 PATHOPHYSIOLOGY FOR NURSES I EXAM WITH
VERIFIED ANSWERS DETAILED RATIONALES GRADED A+
NSG 3280 Pathophysiology for Nurses I
SECTION 1: CELLULAR ADAPTATION, INJURY & DEATH (Questions 1–35)
Question 1. A 68-year-old patient with long-standing hypertension develops progressive left
ventricular hypertrophy. The nurse recognizes that the cardiac myocytes have adapted through
which cellular process to reduce wall stress?
A) Hyperplasia of cardiac myocytes
B) Hypertrophy of cardiac myocytes
C) Atrophy of myocardial fibers
D) Metaplasia of endocardial tissue
Answer: B
Rationale: Sustained pressure overload causes individual cardiac myocytes to enlarge, a process
known as hypertrophy, which increases contractile force and normalizes wall tension according
to Laplace's law.
Question 2. During a myocardial infarction, a region of myocardium becomes irreversibly
injured. Which microscopic finding best indicates that the cells have progressed beyond
reversible injury?
1|Page
,Page 2 of 100
A) Cellular swelling and fatty change
B) Nuclear pyknosis, karyorrhexis, and karyolysis
C) Membrane blebbing with loss of microvilli
D) Dilated endoplasmic reticulum
Answer: B
Rationale: Nuclear changes, including pyknosis, karyorrhexis, and karyolysis, are hallmarks of
irreversible cell death. Cellular swelling and fatty change can occur in reversible injury and may
resolve if perfusion is restored promptly.
Question 3. A patient receives a chemotherapy agent known to generate free radicals. Which
cellular structure is most vulnerable to free-radical-mediated lipid peroxidation?
A) Mitochondrial DNA
B) Nuclear histone proteins
C) Plasma membrane phospholipids
D) Ribosomal RNA
Answer: C
Rationale: Free radicals preferentially attack polyunsaturated fatty acids in membrane
phospholipids, initiating lipid peroxidation that damages membrane integrity. Although DNA
and proteins can also be injured, lipid peroxidation of the plasma membrane is the classic and
earliest membrane lesion.
Question 4. A patient with chronic obstructive pulmonary disease has had prolonged injury to
the bronchial tissues. The nurse expects to find which type of cellular adaptation?
A) Dysplasia
B) Hyperplasia
2|Page
,Page 3 of 100
C) Atrophy
D) Metaplasia
Answer: D
Rationale: Metaplasia involves the replacement of one cell type with another better suited to
the environment, which commonly occurs in chronic irritation such as COPD. Dysplasia is more
advanced and disorganized and may be precancerous.
Question 5. A patient with a massive myocardial infarction is expected to have which type of
necrosis in the cardiac tissue?
A) Liquefactive necrosis
B) Caseous necrosis
C) Fat necrosis
D) Coagulative necrosis
Answer: D
Rationale: Coagulative necrosis is the most common type and typically results from ischemia in
solid organs like the heart. Liquefactive necrosis usually occurs in the brain, caseous necrosis is
characteristic of tuberculosis, and fat necrosis occurs in adipose tissue.
Question 6. A pathologist examining tissue from a healing surgical wound notes the presence of
granulation tissue. Which combination of cells and matrix is most characteristic of this stage of
healing?
A) Dense collagen bundles and few vessels
B) Mature scar with parallel collagen fibers
C) Predominant neutrophils and fibrin
D) Proliferating fibroblasts, new capillaries, and loose extracellular matrix
3|Page
, Page 4 of 100
Answer: D
Rationale: Granulation tissue is defined by proliferating fibroblasts, newly formed capillaries
(angiogenesis), and a loose provisional extracellular matrix. Dense collagen characterizes later
remodeling.
Question 7. A patient is found to have liver disease, resulting in the removal of a lobe of his
liver. Adaptation to the reduced size of the liver leads to what process in the remaining liver
cells?
A) Metaplasia
B) Organ atrophy
C) Compensatory hyperplasia
D) Physiologic hyperplasia
Answer: C
Rationale: Compensatory hyperplasia occurs when remaining cells proliferate to restore organ
mass after tissue loss. This is a common adaptive response in organs with regenerative capacity,
such as the liver.
Question 8. A 20-year-old college student has presented to her campus medical clinic for a
scheduled Pap smear. The clinician who will interpret the smear will examine cell samples for
evidence of what?
A) Changes in cell shape, size, and organization
B) Presence of unexpected cell types
C) Ischemic changes in cell sample
D) Abnormally high numbers of cells
Answer: A
Rationale: Pap smears are examined for cellular changes including alterations in cell shape, size,
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