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NR 283 PATHOPHYSIOLOGY TEST
QUESTIONS WITH SOLUTIONS AND
RATIONALES
Section 1: Cellular Adaptation & Injury (Questions 1-15)
1. A patient presents with structural changes in the lower esophagus due to
chronic acid reflux. The normal squamous epithelium has been replaced by
columnar epithelial cells. What cellular adaptation does this represent?
A. Hyperplasia
B. Dysplasia
C. Metaplasia
D. Atrophy
Correct Answer: C
Rationale: Metaplasia is the reversible replacement of one mature cell type by
another mature cell type, frequently occurring in response to chronic irritation
like gastroesophageal reflux disease (GERD) .
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2. A nurse is caring for a patient with a large, non-healing lower extremity wound.
Granulation tissue is forming, requiring a high rate of mitotic division. Which
cellular process describes this increase in the total number of cells?
A. Hypertrophy
B. Hyperplasia
C. Anaplasia
D. Neoplasia
Correct Answer: B
Rationale: Hyperplasia is an increase in the number of cells within an organ or
tissue, resulting from an increased rate of cellular division, which is essential
during normal wound healing .
3. An autopsy of an elderly patient reveals a decrease in the overall mass and size
of the brain tissue. What is the correct term for this specific cellular adaptation to
aging and decreased metabolic demand?
A. Hyperplasia
B. Metaplasia
C. Atrophy
D. Hypertrophy
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Correct Answer: C
Rationale: Atrophy is a decrease or shrinkage in cellular size. When it occurs in a
large number of cells, the entire organ shrinks, which is commonly seen in brain
tissue during advanced aging .
4. A biopsy of the cervix reveals abnormal variations in cellular size, shape, and
organization, along with an increased rate of mitosis. How should the nurse
classify these specific cellular changes?
A. Hyperplasia
B. Metaplasia
C. Dysplasia
D. Atrophy
Correct Answer: C
Rationale: Dysplasia refers to abnormal changes in the size, shape, and
organization of mature cells. It is not a true adaptation and is frequently
considered a precancerous change .
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5. During an ischemic event, a lack of oxygen leads to a rapid decline in cellular
ATP production. Which immediate consequence occurs due to the failure of the
active sodium-potassium transport pump?
A. Intracellular accumulation of potassium
B. Severe cellular dehydration and shrinkage
C. Influx of sodium and water into the cell
D. Increased extracellular fluid volume
Correct Answer: C
Rationale: When ATP is depleted, the Na+/K+ ATPase pump fails. Sodium
accumulates inside the cell, creating an osmotic gradient that pulls water inward,
causing acute cellular swelling .
6. A patient undergoes a tissue biopsy that reveals cellular death characterized by
nuclear dissolution, severe cell membrane rupture, and the release of intracellular
contents triggering local inflammation. What type of cell death is this?
A. Apoptosis
B. Autophagy
C. Necrosis
D. Anaplasia
NR 283 PATHOPHYSIOLOGY TEST
QUESTIONS WITH SOLUTIONS AND
RATIONALES
Section 1: Cellular Adaptation & Injury (Questions 1-15)
1. A patient presents with structural changes in the lower esophagus due to
chronic acid reflux. The normal squamous epithelium has been replaced by
columnar epithelial cells. What cellular adaptation does this represent?
A. Hyperplasia
B. Dysplasia
C. Metaplasia
D. Atrophy
Correct Answer: C
Rationale: Metaplasia is the reversible replacement of one mature cell type by
another mature cell type, frequently occurring in response to chronic irritation
like gastroesophageal reflux disease (GERD) .
,2|Page
2. A nurse is caring for a patient with a large, non-healing lower extremity wound.
Granulation tissue is forming, requiring a high rate of mitotic division. Which
cellular process describes this increase in the total number of cells?
A. Hypertrophy
B. Hyperplasia
C. Anaplasia
D. Neoplasia
Correct Answer: B
Rationale: Hyperplasia is an increase in the number of cells within an organ or
tissue, resulting from an increased rate of cellular division, which is essential
during normal wound healing .
3. An autopsy of an elderly patient reveals a decrease in the overall mass and size
of the brain tissue. What is the correct term for this specific cellular adaptation to
aging and decreased metabolic demand?
A. Hyperplasia
B. Metaplasia
C. Atrophy
D. Hypertrophy
,3|Page
Correct Answer: C
Rationale: Atrophy is a decrease or shrinkage in cellular size. When it occurs in a
large number of cells, the entire organ shrinks, which is commonly seen in brain
tissue during advanced aging .
4. A biopsy of the cervix reveals abnormal variations in cellular size, shape, and
organization, along with an increased rate of mitosis. How should the nurse
classify these specific cellular changes?
A. Hyperplasia
B. Metaplasia
C. Dysplasia
D. Atrophy
Correct Answer: C
Rationale: Dysplasia refers to abnormal changes in the size, shape, and
organization of mature cells. It is not a true adaptation and is frequently
considered a precancerous change .
, 4|Page
5. During an ischemic event, a lack of oxygen leads to a rapid decline in cellular
ATP production. Which immediate consequence occurs due to the failure of the
active sodium-potassium transport pump?
A. Intracellular accumulation of potassium
B. Severe cellular dehydration and shrinkage
C. Influx of sodium and water into the cell
D. Increased extracellular fluid volume
Correct Answer: C
Rationale: When ATP is depleted, the Na+/K+ ATPase pump fails. Sodium
accumulates inside the cell, creating an osmotic gradient that pulls water inward,
causing acute cellular swelling .
6. A patient undergoes a tissue biopsy that reveals cellular death characterized by
nuclear dissolution, severe cell membrane rupture, and the release of intracellular
contents triggering local inflammation. What type of cell death is this?
A. Apoptosis
B. Autophagy
C. Necrosis
D. Anaplasia
