NURS 231 Pathophysiology Modules 1–10
| Exam Questions & Study Guide
SECTION I: Cellular Adaptation, Injury, and Death (Questions 1–18)
1. A 70-year-old patient with long-standing hypertension develops thickening
of the left ventricular wall. Which cellular adaptation is primarily
responsible?
A. Hyperplasia
B. Metaplasia
C. Hypertrophy
D. Atrophy
Correct Answer: C
Rationale: Hypertrophy is an increase in individual cell size in response to
increased workload. Cardiac muscle cells have limited ability to divide, so the left
ventricle adapts to chronic pressure overload by hypertrophying . Hyperplasia
involves an increase in cell number and occurs in tissues capable of mitotic
division; metaplasia is the replacement of one mature cell type with another;
atrophy is a decrease in cell size.
2. Which finding is most characteristic of reversible cell injury?
A. Mitochondrial DNA fragmentation
B. Cell membrane rupture
C. ATP depletion with cell swelling
D. Nuclear dissolution
Correct Answer: C
Rationale: Reversible injury often involves ATP depletion, failure of the
sodium–potassium pump, sodium and water influx, and cellular swelling.
Membrane rupture and nuclear dissolution are features of irreversible
,injury/necrosis . Mitochondrial DNA fragmentation and nuclear dissolution
indicate irreversible damage and cell death.
3. A lung biopsy from a chronic smoker shows replacement of normal
columnar bronchial epithelium with stratified squamous epithelium. This
adaptation is called:
A. Dysplasia
B. Metaplasia
C. Anaplasia
D. Neoplasia
Correct Answer: B
Rationale: Metaplasia is the reversible replacement of one mature
epithelial cell type by another that is better able to withstand stress. In smokers,
squamous metaplasia can occur in the bronchial lining . Dysplasia involves
disordered growth with cellular atypia; anaplasia denotes lack of differentiation;
neoplasia refers to new abnormal growth (tumor).
4. Which mechanism best explains cellular swelling in acute hypoxia?
A. Increased Na⁺/K⁺-ATPase activity
B. Failure of Na⁺/K⁺-ATPase with sodium and water influx
C. Immediate activation of caspases
D. Increased lysosomal enzyme release
Correct Answer: B
Rationale: Hypoxia reduces ATP production. Without adequate ATP, the
Na⁺/K⁺-ATPase fails, intracellular sodium rises, water follows osmotically, and the
cell swells . Caspase activation occurs in apoptosis; lysosomal enzyme release
is a later consequence of severe injury, not the primary mechanism of acute
swelling.
,5. SATA: Which features are characteristic of necrosis rather than apoptosis?
Select all that apply.
A. Inflammation
B. Energy-dependent programmed cell death
C. Cell swelling
D. Caspase activation
E. Loss of membrane integrity
Correct Answer: A, C, E
Rationale: Necrosis is typically uncontrolled, accompanied by cell
swelling, membrane integrity loss, and inflammation. Apoptosis is programmed,
energy-dependent, caspase-mediated, and generally does not incite inflammation .
Options B and D describe apoptosis, not necrosis.
6. Which organelle is the primary site of ATP production?
A. Ribosome
B. Mitochondrion
C. Golgi apparatus
D. Lysosome
Correct Answer: B
Rationale: Mitochondria generate most cellular ATP through oxidative
phosphorylation. Ribosomes synthesize protein, the Golgi modifies and packages
proteins, and lysosomes contain digestive enzymes . Ribosomes are sites of
protein synthesis, not ATP generation.
7. A bodybuilder's skeletal muscle enlargement from resistance training is best
classified as:
A. Pathologic hypertrophy
B. Physiologic hypertrophy
, C. Hyperplasia
D. Metaplasia
Correct Answer: B
Rationale: Resistance training causes physiologic hypertrophy of skeletal
muscle cells. Pathologic hypertrophy occurs in disease states, such as ventricular
hypertrophy from hypertension . Hyperplasia is an increase in cell number, not
size; metaplasia is a change in cell type.
8. Which is the best example of atrophy?
A. Enlarged prostate in older adulthood
B. Shrunken limb muscle after prolonged immobilization
C. Breast enlargement during pregnancy
D. Thickened callus on the foot
Correct Answer: B
Rationale: Atrophy is a decrease in cell size. Disuse from immobilization
leads to muscle atrophy. Prostate enlargement and pregnancy-related breast
growth involve hyperplasia/hypertrophy, and a callus involves hyperkeratosis .
Option A represents hyperplasia; option C represents hyperplasia/hypertrophy;
option D represents hyperkeratosis (a form of adaptation).
9. SATA: Which factors can cause cellular injury? Select all that apply.
A. Hypoxia
B. Free radicals
C. Ionizing radiation
D. Genetic mutations
E. Balanced nutrition
Correct Answer: A, B, C, D
| Exam Questions & Study Guide
SECTION I: Cellular Adaptation, Injury, and Death (Questions 1–18)
1. A 70-year-old patient with long-standing hypertension develops thickening
of the left ventricular wall. Which cellular adaptation is primarily
responsible?
A. Hyperplasia
B. Metaplasia
C. Hypertrophy
D. Atrophy
Correct Answer: C
Rationale: Hypertrophy is an increase in individual cell size in response to
increased workload. Cardiac muscle cells have limited ability to divide, so the left
ventricle adapts to chronic pressure overload by hypertrophying . Hyperplasia
involves an increase in cell number and occurs in tissues capable of mitotic
division; metaplasia is the replacement of one mature cell type with another;
atrophy is a decrease in cell size.
2. Which finding is most characteristic of reversible cell injury?
A. Mitochondrial DNA fragmentation
B. Cell membrane rupture
C. ATP depletion with cell swelling
D. Nuclear dissolution
Correct Answer: C
Rationale: Reversible injury often involves ATP depletion, failure of the
sodium–potassium pump, sodium and water influx, and cellular swelling.
Membrane rupture and nuclear dissolution are features of irreversible
,injury/necrosis . Mitochondrial DNA fragmentation and nuclear dissolution
indicate irreversible damage and cell death.
3. A lung biopsy from a chronic smoker shows replacement of normal
columnar bronchial epithelium with stratified squamous epithelium. This
adaptation is called:
A. Dysplasia
B. Metaplasia
C. Anaplasia
D. Neoplasia
Correct Answer: B
Rationale: Metaplasia is the reversible replacement of one mature
epithelial cell type by another that is better able to withstand stress. In smokers,
squamous metaplasia can occur in the bronchial lining . Dysplasia involves
disordered growth with cellular atypia; anaplasia denotes lack of differentiation;
neoplasia refers to new abnormal growth (tumor).
4. Which mechanism best explains cellular swelling in acute hypoxia?
A. Increased Na⁺/K⁺-ATPase activity
B. Failure of Na⁺/K⁺-ATPase with sodium and water influx
C. Immediate activation of caspases
D. Increased lysosomal enzyme release
Correct Answer: B
Rationale: Hypoxia reduces ATP production. Without adequate ATP, the
Na⁺/K⁺-ATPase fails, intracellular sodium rises, water follows osmotically, and the
cell swells . Caspase activation occurs in apoptosis; lysosomal enzyme release
is a later consequence of severe injury, not the primary mechanism of acute
swelling.
,5. SATA: Which features are characteristic of necrosis rather than apoptosis?
Select all that apply.
A. Inflammation
B. Energy-dependent programmed cell death
C. Cell swelling
D. Caspase activation
E. Loss of membrane integrity
Correct Answer: A, C, E
Rationale: Necrosis is typically uncontrolled, accompanied by cell
swelling, membrane integrity loss, and inflammation. Apoptosis is programmed,
energy-dependent, caspase-mediated, and generally does not incite inflammation .
Options B and D describe apoptosis, not necrosis.
6. Which organelle is the primary site of ATP production?
A. Ribosome
B. Mitochondrion
C. Golgi apparatus
D. Lysosome
Correct Answer: B
Rationale: Mitochondria generate most cellular ATP through oxidative
phosphorylation. Ribosomes synthesize protein, the Golgi modifies and packages
proteins, and lysosomes contain digestive enzymes . Ribosomes are sites of
protein synthesis, not ATP generation.
7. A bodybuilder's skeletal muscle enlargement from resistance training is best
classified as:
A. Pathologic hypertrophy
B. Physiologic hypertrophy
, C. Hyperplasia
D. Metaplasia
Correct Answer: B
Rationale: Resistance training causes physiologic hypertrophy of skeletal
muscle cells. Pathologic hypertrophy occurs in disease states, such as ventricular
hypertrophy from hypertension . Hyperplasia is an increase in cell number, not
size; metaplasia is a change in cell type.
8. Which is the best example of atrophy?
A. Enlarged prostate in older adulthood
B. Shrunken limb muscle after prolonged immobilization
C. Breast enlargement during pregnancy
D. Thickened callus on the foot
Correct Answer: B
Rationale: Atrophy is a decrease in cell size. Disuse from immobilization
leads to muscle atrophy. Prostate enlargement and pregnancy-related breast
growth involve hyperplasia/hypertrophy, and a callus involves hyperkeratosis .
Option A represents hyperplasia; option C represents hyperplasia/hypertrophy;
option D represents hyperkeratosis (a form of adaptation).
9. SATA: Which factors can cause cellular injury? Select all that apply.
A. Hypoxia
B. Free radicals
C. Ionizing radiation
D. Genetic mutations
E. Balanced nutrition
Correct Answer: A, B, C, D
