NURS231/ NURS 231 Exam 2: (Latest 2026/ 2027 Update) Pathophysiology: Cellular Adaptation, Neoplasia, and Inflammation Review| Practice Questions with Verified Answers and Detailed Rationales| Grade A| 100% Correct (Verified Solutions) – Portage Learning

INSTANT PDF DOWNLOAD — This comprehensive practice test for NURS 231 Exam 2 at Portage Learning covers Pathophysiology for the 2026/2027 academic year second examination. It features practice questions with verified answers and detailed rationales in multiple-choice, select-all-that-apply, and short answer formats aligned with the Portage Learning nursing curriculum. CELLULAR ADAPTATION (EXAM 2 FOCUS) Question 1: Atrophy A patient who has been in a leg cast for 8 weeks following a fracture shows decreased muscle mass in the affected leg. This represents which form of cellular adaptation? A) Hyperplasia B) Hypertrophy C) Atrophy D) Metaplasia Correct Answer: C Rationale: Atrophy is a decrease in the size of cells, resulting in reduced tissue mass. It occurs when there is decreased workload, disuse, denervation, ischemia, or inadequate nutrition. The muscle cells decrease in size due to reduced protein synthesis and increased protein degradation. The condition is reversible if the cast is removed and physical therapy restores normal use. Hyperplasia (A) is increased cell number. Hypertrophy (B) is increased cell size. Metaplasia (D) is replacement of one cell type with another. Portage Learning Alignment: Atrophy from disuse is a classic example of physiologic atrophy. Question 2: Hypertrophy A bodybuilder's enlarged muscles are the result of: A) Hyperplasia of muscle fibers B) Hypertrophy of existing muscle fibers C) Metaplasia of connective tissue into muscle D) Dysplasia of muscle cell nuclei Correct Answer: B Rationale: Bodybuilders develop larger muscles through hypertrophy (increase in the SIZE of existing muscle fibers), not an increase in the number of muscle fibers. Hyperplasia (increase in cell number) does not occur in adult skeletal muscle in response to weight training. The existing muscle cells enlarge due to increased protein synthesis (actin and myosin filaments) in response to increased workload. Physiologic hypertrophy is a normal adaptive response to increased demand. Portage Learning Alignment: Hypertrophy occurs in skeletal muscle with exercise and in cardiac muscle with hypertension. Question 3: Hyperplasia vs. Hypertrophy Which of the following is an example of physiologic hyperplasia? A) Enlargement of the heart due to chronic hypertension B) Uterine enlargement during pregnancy C) Thickening of the bladder wall due to urinary obstruction D) Increase in breast size during lactation Correct Answer: B Rationale: Uterine enlargement during pregnancy involves both hyperplasia (increase in the number of smooth muscle cells) and hypertrophy (increase in cell size). This is a physiologic adaptation to accommodate the growing fetus. Breast enlargement during lactation (D) also involves hyperplasia of glandular tissue. Pathologic hyperplasia (e.g., endometrial hyperplasia due to unopposed estrogen) is abnormal. Cardiac enlargement from hypertension (A) is hypertrophy, not hyperplasia (cardiomyocytes cannot divide). Bladder wall thickening from obstruction (C) is hypertrophy, not hyperplasia (smooth muscle can undergo both hyperplasia and hypertrophy, but the dominant response is hypertrophy). Both B and D are correct; the question asks for an example. Uterine enlargement during pregnancy is the classic Portage Learning example of physiologic hyperplasia. Question 4: Metaplasia Barrett's esophagus, in which the normal squamous epithelium of the esophagus is replaced by columnar epithelium, is an example of: A) Dysplasia B) Metaplasia C) Anaplasia D) Hypertrophy Correct Answer: B Rationale: Metaplasia is the reversible replacement of one differentiated cell type by another in response to chronic irritation or inflammation. In Barrett's esophagus, chronic gastroesophageal reflux disease (GERD) causes the stratified squamous epithelium of the lower esophagus to transform into columnar epithelium (similar to stomach or intestinal lining). This is an adaptive response to increased acidity. However, Barrett's metaplasia is a precancerous condition associated with an increased risk of esophageal adenocarcinoma. Portage Learning Alignment: Metaplasia is reversible if the irritant is removed, but persistent irritation can lead to dysplasia and eventually carcinoma. Question 5: Dysplasia The term for disordered growth in which cells vary in size, shape, and nuclear appearance but have not yet invaded surrounding tissue is: A) Metaplasia B) Anaplasia C) Dysplasia D) Hyperplasia Correct Answer: C