Applied Pathophysiology Advanced
Practice Nurse 2nd Edition Dlugasch
Story Test Bank Questions And Well
Graded Solutions With Rationales
Updated 2026-2027
Ace your graduate APRN exams with the complete official Test Bank for
Applied Pathophysiology for the Advanced Practice Nurse, 2nd Edition by
Lucie Dlugasch and Lachel Story. This comprehensive digital resource
includes all 14 chapters with verified multiple-choice questions, accurate
answers, and detailed clinical rationales. Ideal for Walden, Chamberlain, and
UTA students tracking disease mechanisms and cellular homeostasis.
Download instantly to optimize your study time and secure top grades
Table of Contents
• Chapter 1: Cellular Function
• Chapter 2: Immunity
• Chapter 3: Hematopoietic Function
• Chapter 4: Cardiovascular Function
• Chapter 5: Pulmonary Function
• Chapter 6: Fluid, Electrolyte, and Acid-Base Homeostasis
• Chapter 7: Urinary Function
• Chapter 8: Reproductive Function
• Chapter 9: Gastrointestinal Function
• Chapter 10: Endocrine Function
• Chapter 11: Neural Function
• Chapter 12: Musculoskeletal Function
• Chapter 13: Integumentary Function
,• Chapter 14: Sensory Function
Part 1: Chapters 1 & 2 (Questions 1–60)
Chapter 1: Cellular Function (Questions 1–30)
1. A patient with long-standing, untreated hypertension shows an increase in left
ventricular mass on an echocardiogram. This is an example of which cellular
adaptation?
• A. Hyperplasia
• B. Hypertrophy
• C. Metaplasia
• D. Dysplasia
• Rationale: Hypertrophy is an increase in cell size due to increased mechanical
demand, common in cardiac muscle exposed to high systemic pressure.
2. A tissue biopsy of the cervix reveals abnormal variations in cellular size, shape, and
developmental organization. How should the nurse practitioner document this
finding?
• A. Metaplasia
• B. Hypertrophy
• C. Dysplasia
• D. Anaplasia
• Rationale: Dysplasia refers to deranged cellular growth characterized by atypical
size, shape, and arrangement, often preceding malignancy.
3. A chronic smoker's respiratory tract biopsy shows stratified squamous epithelial cells
replacing normal ciliated columnar cells. This represents:
• A. Atrophy
• B. Hyperplasia
• C. Metaplasia
• D. Anaplasia
• Rationale: Metaplasia is the reversible replacement of one mature cell type by
another mature cell type better suited to withstand chronic irritation.
4. During an ischemic event to the myocardium, what is the direct cause of intracellular
fluid accumulation?
• A. Osmotic shifts from an increase in extracellular sodium
• B. Failure of the ATP-dependent sodium-potassium pump
,• C. Increased permeability of the outer nuclear membrane
• D. Accelerated synthesis of intracellular proteins
• Rationale: Ischemia depletes ATP, disabling the Na+/K+ pump. Sodium accumulates
inside the cell, pulling water inward via osmosis and causing swelling.
5. Which mechanism describes how reactive oxygen species (ROS) or free radicals
primarily cause damage to the cell membrane?
• A. Lipid peroxidation
• B. Ribosomal detachment
• C. Protein methylation
• D. Lysosomal stabilization
• Rationale: Free radicals attack the double bonds in polyunsaturated membrane
lipids, initiating a destructive chain reaction known as lipid peroxidation.
6. What type of cellular necrosis occurs most frequently in brain tissue following a
hypoxic stroke?
• A. Coagulative necrosis
• B. Liquefactive necrosis
• C. Caseous necrosis
• D. Fat necrosis
• Rationale: Brain tissue contains abundant lipids and hydrolytic enzymes, which
rapidly liquefy dead tissue into a soft, fluid-filled mass.
7. A patient with tuberculosis has a lung biopsy showing a crumbly, cheese-like area of
dead tissue. This is classified as:
• A. Coagulative necrosis
• B. Liquefactive necrosis
• C. Caseous necrosis
• D. Fibrinoid necrosis
• Rationale: Caseous necrosis is typical of tuberculosis infections, where dead cells
disintegrate but are incompletely digested, resembling cheese.
8. Which feature uniquely characterizes apoptosis rather than necrosis?
• A. Disruption of plasma membrane integrity
• B. Passive cell swelling and lysis
• C. Active, programmed cell destruction without inflammation
• D. Massive leakage of intracellular enzymes into surrounding tissue
• Rationale: Apoptosis is a highly regulated, energy-dependent process of cell suicide
that cleanly disposes of cellular debris without causing inflammation.
9. A patient develops dry gangrene of the left great toe due to peripheral artery
disease. What underlying process caused this?
• A. Coagulative necrosis from a lack of arterial blood supply
• B. Liquefactive necrosis from a severe bacterial infection
• C. Massive venous congestion leading to liquid exudate
• D. Autoimmune destruction of small digital joints
• Rationale: Dry gangrene results from prolonged arterial occlusion leading to
coagulative necrosis, making tissue dry, black, and shriveled.
10. Wet gangrene is primarily differentiated from dry gangrene by the presence of:
• A. Complete line of demarcation
• B. Liquefactive necrosis and secondary bacterial invasion
• C. Extensive calcium deposition within the vascular wall
• D. Intact arterial blood supply
• Rationale: Wet gangrene involves bacterial infection superimposed on ischemia,
causing neutrophils to release hydrolytic enzymes that produce liquefaction.
, 11. What occurs during the process of autophagy?
• A. Extracellular microbes are engulfed by dendritic cells
• B. The cell degrades its own damaged proteins and organelles for survival
• C. Intracellular calcium is actively pumped into the extracellular matrix
• D. Neighboring cells merge their cytoplasm to share nutrients
• Rationale: Autophagy is a self-destructive survival mechanism where cells recycle
their own damaged contents during starvation or stress.
12. Which intracellular organelle is primarily responsible for generating the majority of
cellular adenosine triphosphate (ATP)?
• A. Rough endoplasmic reticulum
• B. Golgi apparatus
• C. Mitochondria
• D. Peroxisome
• Rationale: Mitochondria generate ATP through oxidative phosphorylation using
oxygen and metabolic substrates.
13. During anaerobic glycolysis, what waste product accumulates within the cytoplasm,
lowering intracellular pH?
• A. Pyruvate
• B. Lactic acid
• C. Citric acid
• D. Carbon dioxide
• Rationale: In the absence of oxygen, pyruvate is converted into lactic acid to
regenerate NAD+, which lowers the cell's pH.
14. How does an influx of extracellular calcium into the cytoplasm during an ischemic
event promote cell death?
• A. It inappropriately activates destructive intracellular enzymes
• B. It stabilizes the mitochondrial membrane potential
• C. It inhibits cellular proteases and endonucleases
• D. It causes the immediate alkalinization of the cytoplasm
• Rationale: Excess cytoplasmic calcium activates harmful enzymes like proteases,
phospholipases, and endonucleases that degrade cellular structures.
15. Carbon monoxide causes cellular injury primarily through which mechanism?
• A. Direct chemical destruction of the cell membrane
• B. Binding to hemoglobin and causing severe systemic hypoxia
• C. Inhibiting the release of antidiuretic hormone
• D. Inducing rapid intracellular calcium extrusion
• Rationale: Carbon monoxide has a high affinity for hemoglobin, blocking oxygen
transport and inducing cellular hypoxia.
16. What occurs when a cell undergoes anaplasia?
• A. It transforms from one mature type to another
• B. It loses differentiation and reverts to a primitive, unspecialized form
• C. It shrinks in size due to decreased hormone stimulation
• D. It multiplies rapidly while maintaining normal structural features
• Rationale: Anaplasia is a hallmark of malignancy where cells lose their structural and
functional differentiation.
17. Which cellular organelle contains digestive enzymes that degrade old organelles and
foreign substances engulfed by phagocytosis?
• A. Lysosome
• B. Ribosome
• C. Nucleolus
Practice Nurse 2nd Edition Dlugasch
Story Test Bank Questions And Well
Graded Solutions With Rationales
Updated 2026-2027
Ace your graduate APRN exams with the complete official Test Bank for
Applied Pathophysiology for the Advanced Practice Nurse, 2nd Edition by
Lucie Dlugasch and Lachel Story. This comprehensive digital resource
includes all 14 chapters with verified multiple-choice questions, accurate
answers, and detailed clinical rationales. Ideal for Walden, Chamberlain, and
UTA students tracking disease mechanisms and cellular homeostasis.
Download instantly to optimize your study time and secure top grades
Table of Contents
• Chapter 1: Cellular Function
• Chapter 2: Immunity
• Chapter 3: Hematopoietic Function
• Chapter 4: Cardiovascular Function
• Chapter 5: Pulmonary Function
• Chapter 6: Fluid, Electrolyte, and Acid-Base Homeostasis
• Chapter 7: Urinary Function
• Chapter 8: Reproductive Function
• Chapter 9: Gastrointestinal Function
• Chapter 10: Endocrine Function
• Chapter 11: Neural Function
• Chapter 12: Musculoskeletal Function
• Chapter 13: Integumentary Function
,• Chapter 14: Sensory Function
Part 1: Chapters 1 & 2 (Questions 1–60)
Chapter 1: Cellular Function (Questions 1–30)
1. A patient with long-standing, untreated hypertension shows an increase in left
ventricular mass on an echocardiogram. This is an example of which cellular
adaptation?
• A. Hyperplasia
• B. Hypertrophy
• C. Metaplasia
• D. Dysplasia
• Rationale: Hypertrophy is an increase in cell size due to increased mechanical
demand, common in cardiac muscle exposed to high systemic pressure.
2. A tissue biopsy of the cervix reveals abnormal variations in cellular size, shape, and
developmental organization. How should the nurse practitioner document this
finding?
• A. Metaplasia
• B. Hypertrophy
• C. Dysplasia
• D. Anaplasia
• Rationale: Dysplasia refers to deranged cellular growth characterized by atypical
size, shape, and arrangement, often preceding malignancy.
3. A chronic smoker's respiratory tract biopsy shows stratified squamous epithelial cells
replacing normal ciliated columnar cells. This represents:
• A. Atrophy
• B. Hyperplasia
• C. Metaplasia
• D. Anaplasia
• Rationale: Metaplasia is the reversible replacement of one mature cell type by
another mature cell type better suited to withstand chronic irritation.
4. During an ischemic event to the myocardium, what is the direct cause of intracellular
fluid accumulation?
• A. Osmotic shifts from an increase in extracellular sodium
• B. Failure of the ATP-dependent sodium-potassium pump
,• C. Increased permeability of the outer nuclear membrane
• D. Accelerated synthesis of intracellular proteins
• Rationale: Ischemia depletes ATP, disabling the Na+/K+ pump. Sodium accumulates
inside the cell, pulling water inward via osmosis and causing swelling.
5. Which mechanism describes how reactive oxygen species (ROS) or free radicals
primarily cause damage to the cell membrane?
• A. Lipid peroxidation
• B. Ribosomal detachment
• C. Protein methylation
• D. Lysosomal stabilization
• Rationale: Free radicals attack the double bonds in polyunsaturated membrane
lipids, initiating a destructive chain reaction known as lipid peroxidation.
6. What type of cellular necrosis occurs most frequently in brain tissue following a
hypoxic stroke?
• A. Coagulative necrosis
• B. Liquefactive necrosis
• C. Caseous necrosis
• D. Fat necrosis
• Rationale: Brain tissue contains abundant lipids and hydrolytic enzymes, which
rapidly liquefy dead tissue into a soft, fluid-filled mass.
7. A patient with tuberculosis has a lung biopsy showing a crumbly, cheese-like area of
dead tissue. This is classified as:
• A. Coagulative necrosis
• B. Liquefactive necrosis
• C. Caseous necrosis
• D. Fibrinoid necrosis
• Rationale: Caseous necrosis is typical of tuberculosis infections, where dead cells
disintegrate but are incompletely digested, resembling cheese.
8. Which feature uniquely characterizes apoptosis rather than necrosis?
• A. Disruption of plasma membrane integrity
• B. Passive cell swelling and lysis
• C. Active, programmed cell destruction without inflammation
• D. Massive leakage of intracellular enzymes into surrounding tissue
• Rationale: Apoptosis is a highly regulated, energy-dependent process of cell suicide
that cleanly disposes of cellular debris without causing inflammation.
9. A patient develops dry gangrene of the left great toe due to peripheral artery
disease. What underlying process caused this?
• A. Coagulative necrosis from a lack of arterial blood supply
• B. Liquefactive necrosis from a severe bacterial infection
• C. Massive venous congestion leading to liquid exudate
• D. Autoimmune destruction of small digital joints
• Rationale: Dry gangrene results from prolonged arterial occlusion leading to
coagulative necrosis, making tissue dry, black, and shriveled.
10. Wet gangrene is primarily differentiated from dry gangrene by the presence of:
• A. Complete line of demarcation
• B. Liquefactive necrosis and secondary bacterial invasion
• C. Extensive calcium deposition within the vascular wall
• D. Intact arterial blood supply
• Rationale: Wet gangrene involves bacterial infection superimposed on ischemia,
causing neutrophils to release hydrolytic enzymes that produce liquefaction.
, 11. What occurs during the process of autophagy?
• A. Extracellular microbes are engulfed by dendritic cells
• B. The cell degrades its own damaged proteins and organelles for survival
• C. Intracellular calcium is actively pumped into the extracellular matrix
• D. Neighboring cells merge their cytoplasm to share nutrients
• Rationale: Autophagy is a self-destructive survival mechanism where cells recycle
their own damaged contents during starvation or stress.
12. Which intracellular organelle is primarily responsible for generating the majority of
cellular adenosine triphosphate (ATP)?
• A. Rough endoplasmic reticulum
• B. Golgi apparatus
• C. Mitochondria
• D. Peroxisome
• Rationale: Mitochondria generate ATP through oxidative phosphorylation using
oxygen and metabolic substrates.
13. During anaerobic glycolysis, what waste product accumulates within the cytoplasm,
lowering intracellular pH?
• A. Pyruvate
• B. Lactic acid
• C. Citric acid
• D. Carbon dioxide
• Rationale: In the absence of oxygen, pyruvate is converted into lactic acid to
regenerate NAD+, which lowers the cell's pH.
14. How does an influx of extracellular calcium into the cytoplasm during an ischemic
event promote cell death?
• A. It inappropriately activates destructive intracellular enzymes
• B. It stabilizes the mitochondrial membrane potential
• C. It inhibits cellular proteases and endonucleases
• D. It causes the immediate alkalinization of the cytoplasm
• Rationale: Excess cytoplasmic calcium activates harmful enzymes like proteases,
phospholipases, and endonucleases that degrade cellular structures.
15. Carbon monoxide causes cellular injury primarily through which mechanism?
• A. Direct chemical destruction of the cell membrane
• B. Binding to hemoglobin and causing severe systemic hypoxia
• C. Inhibiting the release of antidiuretic hormone
• D. Inducing rapid intracellular calcium extrusion
• Rationale: Carbon monoxide has a high affinity for hemoglobin, blocking oxygen
transport and inducing cellular hypoxia.
16. What occurs when a cell undergoes anaplasia?
• A. It transforms from one mature type to another
• B. It loses differentiation and reverts to a primitive, unspecialized form
• C. It shrinks in size due to decreased hormone stimulation
• D. It multiplies rapidly while maintaining normal structural features
• Rationale: Anaplasia is a hallmark of malignancy where cells lose their structural and
functional differentiation.
17. Which cellular organelle contains digestive enzymes that degrade old organelles and
foreign substances engulfed by phagocytosis?
• A. Lysosome
• B. Ribosome
• C. Nucleolus
