Pathophysiology Final Exam 1
Questions and All Correct Answers
2025-2026 Edition.
What causes ischemia and other toxic injuries that causes the accumulation of intracellular
calcium? (chapter 2 4th edition) - Answer Ischemia: Deficit of oxygen in the cells (i.e.,
decreased blood flow due to vasoconstriction or vascular obstruction) (can lead to hypoxia)
What is Normal? Normally, intracellular calcium ion levels are kept extremely low compared
with extracellular levels. This is maintained by energy-dependent calcium/magnesium-ATPase.
Not Normal: Ischemia and certain toxins lead to an increase in cytosolic calcium because of the
increased influx across the cell membrane and the release of calcium from intracellular stores
(mitochondria and SER). The increased calcium may activate a number of enzymes with
potentially damaging effects. Phospholipases can damage the cell membrane.
Proteases can damage the cytoskeleton and membrane proteins. ATPases can break down ATP.
Endonucleases can fragment chromatin.
A client with diabetes has impiared sensation, circulation, and oxygenation of his feet. He steps
on a piece of glass, the wound does not heal, and the tissue area becomes necrotic. The
necrotic cell death is characterized by:
A) Rapid apoptosis
B) Cellular breakage
C) Shrinkage and collapse
D) Chronic inflammation - Answer Ans: B) Cellular breakage
A client has been diagnosed with gram-negative pneuomonia of the lower lobe. Knowing that
gram-negative bateria have a lipopolysaccharide endotoxin on their outer cell membrane, the
health care provider should be assessing the client for which pathophysiological end result?
A) Damage to cellular mitochondria
B) Increased ATP levels
C) Activation of the p53 protein
D) Apoptosis - Answer Ans: D) Apoptosis
,A) Release growth factors that stimulate epithelial cell growth
B) Facilitate the body's ability to grow new vessels in the injured area
C) Remove debris from the wound
D) Synthesize and secrete collagen
E) Proliferate to form the granulation tissue to serve as a foundation for scar tissue to form -
Answer Ans: A, B, C
A) Release growth factors that stimulate epithelial cell growth
B) Facilitate the body's ability to grow new vessels in the injured area
C) Remove debris from the wound
A client underwent an open cholecystectomy 4 days ago, and her incision is now in the
proliferative phase of healing. What is the dominant cellular process that characterizes this
phase of the client's healing?
A) Hemostasis and vasoconstriction
B) Keloid formation
C) Collagen secretion by fibroblasts
D) Phagocytosis by neutrophils - Answer Ans: C) Collagen secretion by fibroblasts
Epithelialization, the first component of the proliferative phase of wound healing, is delayed in
open wounds until what type of tissue has formed?
A) Granulation tissue
B) Fibrinous meshwork
C) Capillary circulation
D) Collagenous layers - Answer Ans: A) Granulation tissue
A client presents to the clinic with a swollen, painful "hang nail" on the index finger. There is a
large pustule over the site that needs to be lanced. The health care worker knows that which
mediator of inflammation causes this increase in capillary permeability and pain?
A) Serotonin
B) Histamine
C) Bradykinin
D) Nitric oxide - Answer Ans: C) Bradykinin
,Following a kitchen accident with a knife, the client's cut has experienced a decrease in the
amount of bleeding and has developed a clot. The nurse knows this is primarily a result of
humoral control of blood flow with the release of:
A) Histamine
B) Bradykinin
C) Serotonin
D) Prostaglandin E2 - Answer Ans: C) Serotonin
Feedback: Serotonin release causes vasoconstriction of blood vessels and plays a major role in
control of bleeding. Histamine, bradykinin, and prostaglandin E2 cause vasodilation of blood
vessels.
A client who lives with angina pectoris has taken a sublingual dose of nitroglycerin to treat the
chest pain he experiences while mowing his lawn. This drug facilitates release of nitric oxide,
which will have what physiologic effect?
A) Smooth muscle relaxation of vessels
B) Decreased heart rate and increased stroke volume
C) Increased preload
D) Reduction of cardiac refractory periods - Answer Ans: A) Smooth muscle relaxation of
vessels
Feedback: Nitroglycerin produces its effects by releasing nitric oxide in vascular smooth muscle
of the target tissues, resulting in relaxation of this muscle and increased blood flow. This drug
does not decrease heart rate. Because it vasodilates, it decreases preload. Nitroglycerine does
not affect cardiac refractory periods.
Which of the following clients would be an example of cellular atrophy?
A) A middle-aged femal experiencing menopause due to loss of estrogen stimulation
B) A postnephrectomy client whose remaining kidney enlarges to compensate for the loss
C) A hypertensive, noncompliant client who has developed a progressive increase in left
ventricular mass
D) A female client with the change in uterine size as a result of pregnancy - Answer Ans: A) A
middle-aged femal experiencing menopause due to loss of estrogen stimulation
A client has experienced significant decreases in mobility and stamina during a 3-week hospital
, C) Disuse atrophy of muscle cells during a prolonged period of immobility
D) Ischemic atrophy resulting from vascular changes while on bedrest - Answer Ans: C) Disuse
atrophy of muscle cells during a prolonged period of immobility
The client is found to have liver disease, resulting in the removal of a lobe of his liver.
Adaptation to be reduced size of the liver leads to which phenomenon in the remaining liver
cells?
A) Metaplasia
B) Organ atrophy
C) Compensatory hyperplasia
D) Physiologic hypertrophy - Answer Ans: C) Compensatory hyperplasia
A client presents for a scheduled Papanicolaou (Pap) smear. The clinician who will interpret the
smear will examine cell samples for evidence of:
A) Changes in cell shape, size, and organization
B) The presence of unexpected cell types
C) Ischemic changes in cell samples
D) Abnormally high numbers of cells in a specified field - Answer Ans: A) Changes in cell shape,
size, and organization
Ischemia and other toxic injuries increase the accumulation of intracellular calcium as a result
of:
A) Release of stored calcium from the mitochondria
B) Improved intracellular volume regulation
C) Decreased influx across the cell membrane
D) Attraction of calcium to fatty infiltrates - Answer ANS: A) Release of stored calcium from the
mitochondria
In the ICU setting, clients who develop shock need thorough head-to-toe assessments. Which of
the following clinical manifestations would alert the health care provider that client may be
developing ischemia associated with gastrointestinal redistribution of blood flow?
A) Gastric bleeding
B) Nausea and vomiting
C) Irritable bowel syndrome
Questions and All Correct Answers
2025-2026 Edition.
What causes ischemia and other toxic injuries that causes the accumulation of intracellular
calcium? (chapter 2 4th edition) - Answer Ischemia: Deficit of oxygen in the cells (i.e.,
decreased blood flow due to vasoconstriction or vascular obstruction) (can lead to hypoxia)
What is Normal? Normally, intracellular calcium ion levels are kept extremely low compared
with extracellular levels. This is maintained by energy-dependent calcium/magnesium-ATPase.
Not Normal: Ischemia and certain toxins lead to an increase in cytosolic calcium because of the
increased influx across the cell membrane and the release of calcium from intracellular stores
(mitochondria and SER). The increased calcium may activate a number of enzymes with
potentially damaging effects. Phospholipases can damage the cell membrane.
Proteases can damage the cytoskeleton and membrane proteins. ATPases can break down ATP.
Endonucleases can fragment chromatin.
A client with diabetes has impiared sensation, circulation, and oxygenation of his feet. He steps
on a piece of glass, the wound does not heal, and the tissue area becomes necrotic. The
necrotic cell death is characterized by:
A) Rapid apoptosis
B) Cellular breakage
C) Shrinkage and collapse
D) Chronic inflammation - Answer Ans: B) Cellular breakage
A client has been diagnosed with gram-negative pneuomonia of the lower lobe. Knowing that
gram-negative bateria have a lipopolysaccharide endotoxin on their outer cell membrane, the
health care provider should be assessing the client for which pathophysiological end result?
A) Damage to cellular mitochondria
B) Increased ATP levels
C) Activation of the p53 protein
D) Apoptosis - Answer Ans: D) Apoptosis
,A) Release growth factors that stimulate epithelial cell growth
B) Facilitate the body's ability to grow new vessels in the injured area
C) Remove debris from the wound
D) Synthesize and secrete collagen
E) Proliferate to form the granulation tissue to serve as a foundation for scar tissue to form -
Answer Ans: A, B, C
A) Release growth factors that stimulate epithelial cell growth
B) Facilitate the body's ability to grow new vessels in the injured area
C) Remove debris from the wound
A client underwent an open cholecystectomy 4 days ago, and her incision is now in the
proliferative phase of healing. What is the dominant cellular process that characterizes this
phase of the client's healing?
A) Hemostasis and vasoconstriction
B) Keloid formation
C) Collagen secretion by fibroblasts
D) Phagocytosis by neutrophils - Answer Ans: C) Collagen secretion by fibroblasts
Epithelialization, the first component of the proliferative phase of wound healing, is delayed in
open wounds until what type of tissue has formed?
A) Granulation tissue
B) Fibrinous meshwork
C) Capillary circulation
D) Collagenous layers - Answer Ans: A) Granulation tissue
A client presents to the clinic with a swollen, painful "hang nail" on the index finger. There is a
large pustule over the site that needs to be lanced. The health care worker knows that which
mediator of inflammation causes this increase in capillary permeability and pain?
A) Serotonin
B) Histamine
C) Bradykinin
D) Nitric oxide - Answer Ans: C) Bradykinin
,Following a kitchen accident with a knife, the client's cut has experienced a decrease in the
amount of bleeding and has developed a clot. The nurse knows this is primarily a result of
humoral control of blood flow with the release of:
A) Histamine
B) Bradykinin
C) Serotonin
D) Prostaglandin E2 - Answer Ans: C) Serotonin
Feedback: Serotonin release causes vasoconstriction of blood vessels and plays a major role in
control of bleeding. Histamine, bradykinin, and prostaglandin E2 cause vasodilation of blood
vessels.
A client who lives with angina pectoris has taken a sublingual dose of nitroglycerin to treat the
chest pain he experiences while mowing his lawn. This drug facilitates release of nitric oxide,
which will have what physiologic effect?
A) Smooth muscle relaxation of vessels
B) Decreased heart rate and increased stroke volume
C) Increased preload
D) Reduction of cardiac refractory periods - Answer Ans: A) Smooth muscle relaxation of
vessels
Feedback: Nitroglycerin produces its effects by releasing nitric oxide in vascular smooth muscle
of the target tissues, resulting in relaxation of this muscle and increased blood flow. This drug
does not decrease heart rate. Because it vasodilates, it decreases preload. Nitroglycerine does
not affect cardiac refractory periods.
Which of the following clients would be an example of cellular atrophy?
A) A middle-aged femal experiencing menopause due to loss of estrogen stimulation
B) A postnephrectomy client whose remaining kidney enlarges to compensate for the loss
C) A hypertensive, noncompliant client who has developed a progressive increase in left
ventricular mass
D) A female client with the change in uterine size as a result of pregnancy - Answer Ans: A) A
middle-aged femal experiencing menopause due to loss of estrogen stimulation
A client has experienced significant decreases in mobility and stamina during a 3-week hospital
, C) Disuse atrophy of muscle cells during a prolonged period of immobility
D) Ischemic atrophy resulting from vascular changes while on bedrest - Answer Ans: C) Disuse
atrophy of muscle cells during a prolonged period of immobility
The client is found to have liver disease, resulting in the removal of a lobe of his liver.
Adaptation to be reduced size of the liver leads to which phenomenon in the remaining liver
cells?
A) Metaplasia
B) Organ atrophy
C) Compensatory hyperplasia
D) Physiologic hypertrophy - Answer Ans: C) Compensatory hyperplasia
A client presents for a scheduled Papanicolaou (Pap) smear. The clinician who will interpret the
smear will examine cell samples for evidence of:
A) Changes in cell shape, size, and organization
B) The presence of unexpected cell types
C) Ischemic changes in cell samples
D) Abnormally high numbers of cells in a specified field - Answer Ans: A) Changes in cell shape,
size, and organization
Ischemia and other toxic injuries increase the accumulation of intracellular calcium as a result
of:
A) Release of stored calcium from the mitochondria
B) Improved intracellular volume regulation
C) Decreased influx across the cell membrane
D) Attraction of calcium to fatty infiltrates - Answer ANS: A) Release of stored calcium from the
mitochondria
In the ICU setting, clients who develop shock need thorough head-to-toe assessments. Which of
the following clinical manifestations would alert the health care provider that client may be
developing ischemia associated with gastrointestinal redistribution of blood flow?
A) Gastric bleeding
B) Nausea and vomiting
C) Irritable bowel syndrome
