NR 283 Pathophysiology Actual Exam / Most Tested
2026/2027 | Chamberlain NR283 Exam 1-3 & Final Exam
Questions | NGN-Style Practice | Expert Verified Answers |
Comprehensive Test Bank | Already Graded A+
EXAM 1: FOUNDATIONS OF PATHOPHYSIOLOGY
Q1: A 68-year-old patient with chronic gastroesophageal reflux disease (GERD) has undergone repeated
endoscopies showing changes in the esophageal tissue from normal stratified squamous epithelium to
columnar epithelium. The nurse recognizes this adaptive cellular change as:
A. Dysplasia
B. Hyperplasia
C. Metaplasia
D. Anaplasia
Correct Answer: C
Rationale: Metaplasia is the reversible replacement of one mature cell type (stratified squamous) by another
mature cell type (columnar) in response to chronic irritation. Dysplasia refers to abnormal cell growth and
maturation; hyperplasia is increased cell number; anaplasia is loss of differentiation. Barrett's esophagus,
described in this scenario, is a classic example of metaplasia that increases esophageal cancer risk.
Q2: A patient with a history of heavy smoking presents with chronic bronchitis. The nurse understands that
the characteristic hyperplasia of the mucus-secreting goblet cells in this patient is an example of:
A. Pathologic hyperplasia
B. Physiologic hyperplasia
C. Compensatory hyperplasia
D. Hormonal hyperplasia
Correct Answer: A
Rationale: Pathologic hyperplasia occurs as an abnormal response to excessive stimulation, such as the
irritation from smoking causing goblet cell hyperplasia. Physiologic hyperplasia (e.g., breast development
during puberty) and compensatory hyperplasia (e.g., liver regeneration) serve functional purposes. Hormonal
hyperplasia is usually a normal response to hormonal signals.
Q3: Following a myocardial infarction, a patient’s heart tissue shows nuclear fragmentation and dissolution of
the cell membrane. The nurse identifies this process as:
A. Apoptosis
B. Coagulative necrosis
1
, NR 283 Pathophysiology Actual Exam / Most Tested
2026/2027 | Chamberlain NR283 Exam 1-3 & Final Exam
Questions | NGN-Style Practice | Expert Verified Answers |
Comprehensive Test Bank | Already Graded A+
C. Liquefactive necrosis
D. Caseous necrosis
Correct Answer: B
Rationale: Coagulative necrosis is characteristic of ischemic injury in all tissues except the brain. It results in
protein denaturation, causing firm tissue architecture preservation initially. Apoptosis is programmed cell
death; liquefactive necrosis occurs in the brain or bacterial infections; caseous necrosis is associated with TB
infections.
Q4: A patient is brought to the ER with suspected carbon monoxide poisoning. The nurse understands that
the primary mechanism of cellular injury in this scenario is:
A. Free radical injury
B. Hypoxic injury due to decreased oxygen-carrying capacity
C. Chemical toxicity binding to cell membranes
D. Immune-mediated injury
Correct Answer: B
Rationale: Carbon monoxide (CO) binds to hemoglobin with an affinity 200x greater than oxygen, forming
carboxyhemoglobin. This reduces the oxygen-carrying capacity of blood, leading to systemic hypoxia. While
free radicals are involved in reperfusion injury, the primary mechanism here is hypoxia.
Q5: A nurse is teaching a patient about the "cardinal signs" of inflammation. Which of the following should
the nurse include? (Select all that apply)
A. Heat
B. Redness
C. Swelling
D. Pain
E. Loss of function
Correct Answer: A, B, C, D, E
2
, NR 283 Pathophysiology Actual Exam / Most Tested
2026/2027 | Chamberlain NR283 Exam 1-3 & Final Exam
Questions | NGN-Style Practice | Expert Verified Answers |
Comprehensive Test Bank | Already Graded A+
Rationale: The five cardinal signs of inflammation are rubor (redness), calor (heat), tumor (swelling), dolor
(pain), and functio laesa (loss of function). These result from vasodilation, increased vascular permeability,
and the action of inflammatory mediators like histamine and bradykinin.
Q6: A patient has a serum potassium level of 6.8 mEq/L. Which ECG change should the nurse anticipate?
A. Flattened T waves
B. Peaked T waves
C. Prolonged PR interval
D. Prominent U waves
Correct Answer: B
Rationale: Hyperkalemia increases the rate of repolarization, leading to the classic ECG sign of peaked, narrow
T waves. Flattened T waves and prominent U waves are signs of hypokalemia. Prolonged PR interval may
occur in severe hyperkalemia but peaked T waves are the earliest and most specific sign.
Q7: A patient with severe vomiting has lost a significant amount of gastric acid. Which acid-base imbalance
should the nurse suspect?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Correct Answer: D
Rationale: Gastric secretions are highly acidic. Excessive vomiting leads to a loss of hydrogen ions and
chloride, resulting in metabolic alkalosis. Respiratory imbalances are related to CO2 retention or exhalation,
not gastric fluid loss.
Q8: A 19-year-old male with cystic fibrosis asks why he has thick mucus blocking his lungs. The nurse
explains that this is due to a defect in:
A. Autosomal dominant inheritance
B. X-linked recessive inheritance
3
, NR 283 Pathophysiology Actual Exam / Most Tested
2026/2027 | Chamberlain NR283 Exam 1-3 & Final Exam
Questions | NGN-Style Practice | Expert Verified Answers |
Comprehensive Test Bank | Already Graded A+
C. Chloride channel transport protein
D. Hemoglobin structure
Correct Answer: C
Rationale: Cystic fibrosis is an autosomal recessive disorder caused by a mutation in the CFTR gene, which
encodes a chloride channel. This defect leads to thick, viscous secretions. It is not X-linked or related to
hemoglobin.
Q9: Which cellular component is most susceptible to injury from hypoxia?
A. Nucleus
B. Mitochondria
C. Ribosomes
D. Lysosomes
Correct Answer: B
Rationale: The mitochondria are the powerhouses of the cell and require oxygen for aerobic metabolism
(oxidative phosphorylation). Hypoxia impairs ATP production, leading to cellular swelling and eventual
failure of membrane pumps.
Q10: A patient presents with a large abscess on their leg. The provider states the necrosis is liquefactive. The
nurse explains this is due to:
A. Enzymatic digestion of tissue by leukocytes
B. Protein denaturation with preservation of tissue outline
C. Cheese-like appearance caused by mycobacteria
D. Ischemic injury to the heart muscle
Correct Answer: A
Rationale: Liquefactive necrosis occurs when enzymatic digestion (hydrolases from neutrophils) liquefies the
tissue, commonly seen in brain infarcts and bacterial abscesses. Coagulative necrosis (B) preserves tissue
outlines. Caseous (C) is specific to TB.
4
2026/2027 | Chamberlain NR283 Exam 1-3 & Final Exam
Questions | NGN-Style Practice | Expert Verified Answers |
Comprehensive Test Bank | Already Graded A+
EXAM 1: FOUNDATIONS OF PATHOPHYSIOLOGY
Q1: A 68-year-old patient with chronic gastroesophageal reflux disease (GERD) has undergone repeated
endoscopies showing changes in the esophageal tissue from normal stratified squamous epithelium to
columnar epithelium. The nurse recognizes this adaptive cellular change as:
A. Dysplasia
B. Hyperplasia
C. Metaplasia
D. Anaplasia
Correct Answer: C
Rationale: Metaplasia is the reversible replacement of one mature cell type (stratified squamous) by another
mature cell type (columnar) in response to chronic irritation. Dysplasia refers to abnormal cell growth and
maturation; hyperplasia is increased cell number; anaplasia is loss of differentiation. Barrett's esophagus,
described in this scenario, is a classic example of metaplasia that increases esophageal cancer risk.
Q2: A patient with a history of heavy smoking presents with chronic bronchitis. The nurse understands that
the characteristic hyperplasia of the mucus-secreting goblet cells in this patient is an example of:
A. Pathologic hyperplasia
B. Physiologic hyperplasia
C. Compensatory hyperplasia
D. Hormonal hyperplasia
Correct Answer: A
Rationale: Pathologic hyperplasia occurs as an abnormal response to excessive stimulation, such as the
irritation from smoking causing goblet cell hyperplasia. Physiologic hyperplasia (e.g., breast development
during puberty) and compensatory hyperplasia (e.g., liver regeneration) serve functional purposes. Hormonal
hyperplasia is usually a normal response to hormonal signals.
Q3: Following a myocardial infarction, a patient’s heart tissue shows nuclear fragmentation and dissolution of
the cell membrane. The nurse identifies this process as:
A. Apoptosis
B. Coagulative necrosis
1
, NR 283 Pathophysiology Actual Exam / Most Tested
2026/2027 | Chamberlain NR283 Exam 1-3 & Final Exam
Questions | NGN-Style Practice | Expert Verified Answers |
Comprehensive Test Bank | Already Graded A+
C. Liquefactive necrosis
D. Caseous necrosis
Correct Answer: B
Rationale: Coagulative necrosis is characteristic of ischemic injury in all tissues except the brain. It results in
protein denaturation, causing firm tissue architecture preservation initially. Apoptosis is programmed cell
death; liquefactive necrosis occurs in the brain or bacterial infections; caseous necrosis is associated with TB
infections.
Q4: A patient is brought to the ER with suspected carbon monoxide poisoning. The nurse understands that
the primary mechanism of cellular injury in this scenario is:
A. Free radical injury
B. Hypoxic injury due to decreased oxygen-carrying capacity
C. Chemical toxicity binding to cell membranes
D. Immune-mediated injury
Correct Answer: B
Rationale: Carbon monoxide (CO) binds to hemoglobin with an affinity 200x greater than oxygen, forming
carboxyhemoglobin. This reduces the oxygen-carrying capacity of blood, leading to systemic hypoxia. While
free radicals are involved in reperfusion injury, the primary mechanism here is hypoxia.
Q5: A nurse is teaching a patient about the "cardinal signs" of inflammation. Which of the following should
the nurse include? (Select all that apply)
A. Heat
B. Redness
C. Swelling
D. Pain
E. Loss of function
Correct Answer: A, B, C, D, E
2
, NR 283 Pathophysiology Actual Exam / Most Tested
2026/2027 | Chamberlain NR283 Exam 1-3 & Final Exam
Questions | NGN-Style Practice | Expert Verified Answers |
Comprehensive Test Bank | Already Graded A+
Rationale: The five cardinal signs of inflammation are rubor (redness), calor (heat), tumor (swelling), dolor
(pain), and functio laesa (loss of function). These result from vasodilation, increased vascular permeability,
and the action of inflammatory mediators like histamine and bradykinin.
Q6: A patient has a serum potassium level of 6.8 mEq/L. Which ECG change should the nurse anticipate?
A. Flattened T waves
B. Peaked T waves
C. Prolonged PR interval
D. Prominent U waves
Correct Answer: B
Rationale: Hyperkalemia increases the rate of repolarization, leading to the classic ECG sign of peaked, narrow
T waves. Flattened T waves and prominent U waves are signs of hypokalemia. Prolonged PR interval may
occur in severe hyperkalemia but peaked T waves are the earliest and most specific sign.
Q7: A patient with severe vomiting has lost a significant amount of gastric acid. Which acid-base imbalance
should the nurse suspect?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Correct Answer: D
Rationale: Gastric secretions are highly acidic. Excessive vomiting leads to a loss of hydrogen ions and
chloride, resulting in metabolic alkalosis. Respiratory imbalances are related to CO2 retention or exhalation,
not gastric fluid loss.
Q8: A 19-year-old male with cystic fibrosis asks why he has thick mucus blocking his lungs. The nurse
explains that this is due to a defect in:
A. Autosomal dominant inheritance
B. X-linked recessive inheritance
3
, NR 283 Pathophysiology Actual Exam / Most Tested
2026/2027 | Chamberlain NR283 Exam 1-3 & Final Exam
Questions | NGN-Style Practice | Expert Verified Answers |
Comprehensive Test Bank | Already Graded A+
C. Chloride channel transport protein
D. Hemoglobin structure
Correct Answer: C
Rationale: Cystic fibrosis is an autosomal recessive disorder caused by a mutation in the CFTR gene, which
encodes a chloride channel. This defect leads to thick, viscous secretions. It is not X-linked or related to
hemoglobin.
Q9: Which cellular component is most susceptible to injury from hypoxia?
A. Nucleus
B. Mitochondria
C. Ribosomes
D. Lysosomes
Correct Answer: B
Rationale: The mitochondria are the powerhouses of the cell and require oxygen for aerobic metabolism
(oxidative phosphorylation). Hypoxia impairs ATP production, leading to cellular swelling and eventual
failure of membrane pumps.
Q10: A patient presents with a large abscess on their leg. The provider states the necrosis is liquefactive. The
nurse explains this is due to:
A. Enzymatic digestion of tissue by leukocytes
B. Protein denaturation with preservation of tissue outline
C. Cheese-like appearance caused by mycobacteria
D. Ischemic injury to the heart muscle
Correct Answer: A
Rationale: Liquefactive necrosis occurs when enzymatic digestion (hydrolases from neutrophils) liquefies the
tissue, commonly seen in brain infarcts and bacterial abscesses. Coagulative necrosis (B) preserves tissue
outlines. Caseous (C) is specific to TB.
4
