1
NURS 6501 ADVANCED PATHOPHYSIOLOGY MIDTERM
2026/2027 | All 100 Questions with Correct Answers |
NURS6501 Latest Exam | Pass Guaranteed - A+ Graded
[Section 1: Cellular Adaptation, Injury, Necrosis & Apoptosis
(Q1-15)]
Q1. A 68-year-old male with CHF has decreased muscle mass in his legs due to
prolonged bed rest. This cellular change is an example of?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
C. Atrophy [CORRECT]
Rationale: Atrophy is decreased cell size due to decreased workload, blood supply,
nutrition, or innervation. Prolonged bed rest reduces skeletal muscle workload
causing disuse atrophy. Hypertrophy is increased size, hyperplasia is increased
number, and metaplasia is reversible change to another cell type.
Correct Answer: C
Q2. Which cellular adaptation occurs in the myocardium of a patient with poorly
controlled hypertension?
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Dysplasia
B. Hypertrophy [CORRECT]
,2
Rationale: Cardiac muscle cells undergo hypertrophy (increased cell size) in response
to increased workload from chronic pressure overload in hypertension. Cardiac
muscle cannot undergo hyperplasia. Atrophy occurs with decreased demand, and
dysplasia is disordered pre-neoplastic growth.
Correct Answer: B
Q3. A 45-year-old female with chronic gastroesophageal reflux is found to have
columnar epithelium in the distal esophagus on endoscopy. This cellular adaptation
is called?
A. Metaplasia
B. Dysplasia
C. Hyperplasia
D. Anaplasia
A. Metaplasia [CORRECT]
Rationale: Barrett's esophagus represents metaplasia—replacement of stratified
squamous epithelium with intestinal-type columnar epithelium due to chronic
irritation from reflux. Dysplasia is disordered growth, hyperplasia is increased cell
number, and anaplasia is loss of differentiation in malignancy.
Correct Answer: A
Q4. A pathologist examines a cervical biopsy and finds disordered squamous
epithelial growth with nuclear pleomorphism, loss of polarity, and failure of normal
maturation. This is best described as?
A. Atrophy
B. Hyperplasia
C. Dysplasia
D. Metaplasia
C. Dysplasia [CORRECT]
,3
Rationale: Dysplasia is disordered epithelial growth with nuclear pleomorphism,
hyperchromatism, and loss of normal maturation and polarity; it is considered pre-
neoplastic. Atrophy is decreased size, hyperplasia is increased cell number, and
metaplasia is cell type replacement.
Correct Answer: C
Q5. A postmenopausal woman taking estrogen replacement therapy develops
endometrial thickening. The cellular mechanism responsible is?
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Apoptosis
B. Hyperplasia [CORRECT]
Rationale: Estrogen stimulation causes endometrial hyperplasia—increased cell
number in response to hormonal stimulation. Hypertrophy involves increased cell
size, metaplasia is cell type change, and apoptosis is programmed cell death.
Correct Answer: B
Q6. A patient with severe anemia and hypotension develops cellular swelling, loss of
microvilli, and mitochondrial swelling on electron microscopy. The most likely
underlying cause of this reversible cell injury is?
A. Hypoxia
B. Bacterial toxins
C. Chemical poisons
D. Genetic mutations
A. Hypoxia [CORRECT]
Rationale: Hypoxia is the most common cause of cell injury, producing the described
reversible changes including ATP depletion, cellular swelling, and organelle
, 4
dysfunction. Anemia with hypotension causes tissue hypoxia. While toxins and
chemicals cause injury, hypoxia is the predominant mechanism in this clinical context.
Correct Answer: A
Q7. A patient with carbon monoxide poisoning presents with cellular injury. The
primary mechanism of injury involves?
A. Direct membrane damage by carbon monoxide
B. Impaired oxygen delivery and utilization causing ATP depletion and hypoxia
C. Activation of caspase enzymes
D. Lysosomal enzyme release
B. Impaired oxygen delivery and utilization causing ATP depletion and hypoxia
[CORRECT]
Rationale: Carbon monoxide binds hemoglobin with high affinity, impairing oxygen
transport and causing tissue hypoxia. This leads to ATP depletion, anaerobic
metabolism, and cellular injury. Caspase activation occurs in apoptosis, and
lysosomal release is a feature of necrosis.
Correct Answer: B
Q8. A patient with thrombotic stroke receives tissue plasminogen activator and
develops cerebral edema. Reperfusion injury in this setting is primarily mediated by?
A. Decreased calcium influx
B. Generation of reactive oxygen species and oxidative stress
C. Increased intracellular pH
D. Enhanced ATP synthesis
B. Generation of reactive oxygen species and oxidative stress [CORRECT]
Rationale: Reperfusion of ischemic tissue generates reactive oxygen species (free
radicals) that damage lipids, proteins, and DNA through oxidative stress. Ischemia
NURS 6501 ADVANCED PATHOPHYSIOLOGY MIDTERM
2026/2027 | All 100 Questions with Correct Answers |
NURS6501 Latest Exam | Pass Guaranteed - A+ Graded
[Section 1: Cellular Adaptation, Injury, Necrosis & Apoptosis
(Q1-15)]
Q1. A 68-year-old male with CHF has decreased muscle mass in his legs due to
prolonged bed rest. This cellular change is an example of?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
C. Atrophy [CORRECT]
Rationale: Atrophy is decreased cell size due to decreased workload, blood supply,
nutrition, or innervation. Prolonged bed rest reduces skeletal muscle workload
causing disuse atrophy. Hypertrophy is increased size, hyperplasia is increased
number, and metaplasia is reversible change to another cell type.
Correct Answer: C
Q2. Which cellular adaptation occurs in the myocardium of a patient with poorly
controlled hypertension?
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Dysplasia
B. Hypertrophy [CORRECT]
,2
Rationale: Cardiac muscle cells undergo hypertrophy (increased cell size) in response
to increased workload from chronic pressure overload in hypertension. Cardiac
muscle cannot undergo hyperplasia. Atrophy occurs with decreased demand, and
dysplasia is disordered pre-neoplastic growth.
Correct Answer: B
Q3. A 45-year-old female with chronic gastroesophageal reflux is found to have
columnar epithelium in the distal esophagus on endoscopy. This cellular adaptation
is called?
A. Metaplasia
B. Dysplasia
C. Hyperplasia
D. Anaplasia
A. Metaplasia [CORRECT]
Rationale: Barrett's esophagus represents metaplasia—replacement of stratified
squamous epithelium with intestinal-type columnar epithelium due to chronic
irritation from reflux. Dysplasia is disordered growth, hyperplasia is increased cell
number, and anaplasia is loss of differentiation in malignancy.
Correct Answer: A
Q4. A pathologist examines a cervical biopsy and finds disordered squamous
epithelial growth with nuclear pleomorphism, loss of polarity, and failure of normal
maturation. This is best described as?
A. Atrophy
B. Hyperplasia
C. Dysplasia
D. Metaplasia
C. Dysplasia [CORRECT]
,3
Rationale: Dysplasia is disordered epithelial growth with nuclear pleomorphism,
hyperchromatism, and loss of normal maturation and polarity; it is considered pre-
neoplastic. Atrophy is decreased size, hyperplasia is increased cell number, and
metaplasia is cell type replacement.
Correct Answer: C
Q5. A postmenopausal woman taking estrogen replacement therapy develops
endometrial thickening. The cellular mechanism responsible is?
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Apoptosis
B. Hyperplasia [CORRECT]
Rationale: Estrogen stimulation causes endometrial hyperplasia—increased cell
number in response to hormonal stimulation. Hypertrophy involves increased cell
size, metaplasia is cell type change, and apoptosis is programmed cell death.
Correct Answer: B
Q6. A patient with severe anemia and hypotension develops cellular swelling, loss of
microvilli, and mitochondrial swelling on electron microscopy. The most likely
underlying cause of this reversible cell injury is?
A. Hypoxia
B. Bacterial toxins
C. Chemical poisons
D. Genetic mutations
A. Hypoxia [CORRECT]
Rationale: Hypoxia is the most common cause of cell injury, producing the described
reversible changes including ATP depletion, cellular swelling, and organelle
, 4
dysfunction. Anemia with hypotension causes tissue hypoxia. While toxins and
chemicals cause injury, hypoxia is the predominant mechanism in this clinical context.
Correct Answer: A
Q7. A patient with carbon monoxide poisoning presents with cellular injury. The
primary mechanism of injury involves?
A. Direct membrane damage by carbon monoxide
B. Impaired oxygen delivery and utilization causing ATP depletion and hypoxia
C. Activation of caspase enzymes
D. Lysosomal enzyme release
B. Impaired oxygen delivery and utilization causing ATP depletion and hypoxia
[CORRECT]
Rationale: Carbon monoxide binds hemoglobin with high affinity, impairing oxygen
transport and causing tissue hypoxia. This leads to ATP depletion, anaerobic
metabolism, and cellular injury. Caspase activation occurs in apoptosis, and
lysosomal release is a feature of necrosis.
Correct Answer: B
Q8. A patient with thrombotic stroke receives tissue plasminogen activator and
develops cerebral edema. Reperfusion injury in this setting is primarily mediated by?
A. Decreased calcium influx
B. Generation of reactive oxygen species and oxidative stress
C. Increased intracellular pH
D. Enhanced ATP synthesis
B. Generation of reactive oxygen species and oxidative stress [CORRECT]
Rationale: Reperfusion of ischemic tissue generates reactive oxygen species (free
radicals) that damage lipids, proteins, and DNA through oxidative stress. Ischemia
