Pathophysiology (NR 283) Exam 1 – Chamberlain University Study
Guide, Practice Questions & Exam Review 3 versions
Comprehensive study resource for NR 283 Pathophysiology Exam 1 at Chamberlain
University. Covers foundational concepts including cellular adaptation, cellular injury,
inflammation, immunity, genetics, stress responses, fluid and electrolyte balance, acid-base
regulation, and mechanisms of disease. Includes practice questions, answer explanations, concept
reviews, and exam-focused study material designed to help nursing students strengthen critical-
thinking skills and prepare for success on Exam 1.
Question 1
A patient's cardiac muscle cells enlarge in response to chronic hypertension. This cellular
change is best described as:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Rationale: Hypertrophy is an increase in cell size due to increased workload. Chronic
hypertension increases afterload, causing cardiac myocytes to enlarge. Hyperplasia is
increased cell number. Atrophy is decreased cell size. Metaplasia is one cell type replacing
another.
Question 2
A patient who smokes cigarettes develops squamous cell metaplasia in the bronchial
lining. Which statement best explains this change?
A) Ciliated columnar epithelium is replaced by stratified squamous epithelium as
an adaptive response to chronic irritation
B) Bronchial cells undergo hyperplasia due to nicotine stimulation
C) Alveolar macrophages become engorged with carbon particles
D) Ciliated cells undergo hypertrophy to improve mucus clearance
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with
another. Chronic irritation from smoking causes ciliated columnar epithelium to change to
stratified squamous epithelium, which is more resistant but loses ciliary function.
,Question 3
A patient with a casted leg develops muscle atrophy. The nurse understands that this
atrophy is most likely caused by:
A) Decreased blood flow to the muscle
B) Disuse due to immobilization
C) Denervation from nerve compression
D) Malnutrition from decreased appetite
Rationale: Disuse atrophy occurs when muscles are not used due to immobilization,
casting, or prolonged bed rest. Denervation atrophy follows nerve damage. Ischemia
causes necrosis. Nutrition contributes but is not the primary cause in this scenario.
Question 4
Which statement correctly describes apoptosis?
A) Unregulated cell death causing inflammation
B) Programmed cell death that eliminates damaged or unwanted cells without
inflammation
C) Cell death caused by acute injury such as trauma or toxins
D) Rapid cell division leading to tumor formation
Rationale: Apoptosis is programmed, energy-dependent cell death that removes cells
without triggering inflammation. Necrosis is unregulated, caused by injury, and does cause
inflammation. Apoptosis is normal in development and removal of damaged cells.
Question 5
A patient experiences a myocardial infarction. The type of necrosis seen in the affected
heart tissue is:
,A) Liquefactive necrosis
B) Caseous necrosis
C) Fat necrosis
D) Coagulative necrosis
Rationale: Coagulative necrosis is characteristic of ischemic injury in solid organs (heart,
kidney, liver) except the brain. Protein denaturation preserves tissue architecture for days.
Liquefactive necrosis occurs in brain. Caseous is in TB. Fat necrosis occurs in pancreas or
breast.
Question 6
A patient with tuberculosis has a lung lesion containing soft, cheese-like material. This is
an example of:
A) Coagulative necrosis
B) Caseous necrosis
C) Liquefactive necrosis
D) Gangrenous necrosis
Rationale: Caseous necrosis has a soft, cheese-like (caseous) appearance and is
characteristic of tuberculosis. Coagulative necrosis is firm. Liquefactive necrosis is liquid.
Gangrenous necrosis involves superadded bacterial infection.
Question 7
A patient has a bacterial infection in the brain. The necrotic tissue becomes liquid and is
removed by macrophages. This is:
A) Coagulative necrosis
B) Liquefactive necrosis
C) Fat necrosis
D) Caseous necrosis
, Rationale: The brain has high lipid content and few connective tissue cells. Ischemic or
bacterial injury triggers enzymatic digestion, turning tissue into liquid (liquefactive
necrosis). Coagulative necrosis does not occur in brain tissue.
Question 8
A patient with pancreatitis develops areas of necrotic fat tissue in the abdomen. This is:
A) Coagulative necrosis
B) Caseous necrosis
C) Fat necrosis
D) Apoptosis
Rationale: Fat necrosis occurs when pancreatic lipases leak into surrounding tissue,
digesting fat into fatty acids that bind calcium (saponification). It appears as chalky white
areas. This is specific to pancreatic injury or breast trauma.
Question 9
Which cellular change is considered reversible?
A) Karyolysis
B) Pyknosis
C) Cellular swelling
D) Karyorrhexis
Rationale: Cellular swelling (hydropic change) is reversible with restoration of blood flow
and oxygen. Pyknosis (nuclear shrinkage), karyorrhexis (nuclear fragmentation), and
karyolysis (nuclear dissolution) are irreversible changes indicating cell death.
Question 10
A patient's cells are exposed to hypoxia. Which intracellular event occurs first?
Guide, Practice Questions & Exam Review 3 versions
Comprehensive study resource for NR 283 Pathophysiology Exam 1 at Chamberlain
University. Covers foundational concepts including cellular adaptation, cellular injury,
inflammation, immunity, genetics, stress responses, fluid and electrolyte balance, acid-base
regulation, and mechanisms of disease. Includes practice questions, answer explanations, concept
reviews, and exam-focused study material designed to help nursing students strengthen critical-
thinking skills and prepare for success on Exam 1.
Question 1
A patient's cardiac muscle cells enlarge in response to chronic hypertension. This cellular
change is best described as:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Rationale: Hypertrophy is an increase in cell size due to increased workload. Chronic
hypertension increases afterload, causing cardiac myocytes to enlarge. Hyperplasia is
increased cell number. Atrophy is decreased cell size. Metaplasia is one cell type replacing
another.
Question 2
A patient who smokes cigarettes develops squamous cell metaplasia in the bronchial
lining. Which statement best explains this change?
A) Ciliated columnar epithelium is replaced by stratified squamous epithelium as
an adaptive response to chronic irritation
B) Bronchial cells undergo hyperplasia due to nicotine stimulation
C) Alveolar macrophages become engorged with carbon particles
D) Ciliated cells undergo hypertrophy to improve mucus clearance
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with
another. Chronic irritation from smoking causes ciliated columnar epithelium to change to
stratified squamous epithelium, which is more resistant but loses ciliary function.
,Question 3
A patient with a casted leg develops muscle atrophy. The nurse understands that this
atrophy is most likely caused by:
A) Decreased blood flow to the muscle
B) Disuse due to immobilization
C) Denervation from nerve compression
D) Malnutrition from decreased appetite
Rationale: Disuse atrophy occurs when muscles are not used due to immobilization,
casting, or prolonged bed rest. Denervation atrophy follows nerve damage. Ischemia
causes necrosis. Nutrition contributes but is not the primary cause in this scenario.
Question 4
Which statement correctly describes apoptosis?
A) Unregulated cell death causing inflammation
B) Programmed cell death that eliminates damaged or unwanted cells without
inflammation
C) Cell death caused by acute injury such as trauma or toxins
D) Rapid cell division leading to tumor formation
Rationale: Apoptosis is programmed, energy-dependent cell death that removes cells
without triggering inflammation. Necrosis is unregulated, caused by injury, and does cause
inflammation. Apoptosis is normal in development and removal of damaged cells.
Question 5
A patient experiences a myocardial infarction. The type of necrosis seen in the affected
heart tissue is:
,A) Liquefactive necrosis
B) Caseous necrosis
C) Fat necrosis
D) Coagulative necrosis
Rationale: Coagulative necrosis is characteristic of ischemic injury in solid organs (heart,
kidney, liver) except the brain. Protein denaturation preserves tissue architecture for days.
Liquefactive necrosis occurs in brain. Caseous is in TB. Fat necrosis occurs in pancreas or
breast.
Question 6
A patient with tuberculosis has a lung lesion containing soft, cheese-like material. This is
an example of:
A) Coagulative necrosis
B) Caseous necrosis
C) Liquefactive necrosis
D) Gangrenous necrosis
Rationale: Caseous necrosis has a soft, cheese-like (caseous) appearance and is
characteristic of tuberculosis. Coagulative necrosis is firm. Liquefactive necrosis is liquid.
Gangrenous necrosis involves superadded bacterial infection.
Question 7
A patient has a bacterial infection in the brain. The necrotic tissue becomes liquid and is
removed by macrophages. This is:
A) Coagulative necrosis
B) Liquefactive necrosis
C) Fat necrosis
D) Caseous necrosis
, Rationale: The brain has high lipid content and few connective tissue cells. Ischemic or
bacterial injury triggers enzymatic digestion, turning tissue into liquid (liquefactive
necrosis). Coagulative necrosis does not occur in brain tissue.
Question 8
A patient with pancreatitis develops areas of necrotic fat tissue in the abdomen. This is:
A) Coagulative necrosis
B) Caseous necrosis
C) Fat necrosis
D) Apoptosis
Rationale: Fat necrosis occurs when pancreatic lipases leak into surrounding tissue,
digesting fat into fatty acids that bind calcium (saponification). It appears as chalky white
areas. This is specific to pancreatic injury or breast trauma.
Question 9
Which cellular change is considered reversible?
A) Karyolysis
B) Pyknosis
C) Cellular swelling
D) Karyorrhexis
Rationale: Cellular swelling (hydropic change) is reversible with restoration of blood flow
and oxygen. Pyknosis (nuclear shrinkage), karyorrhexis (nuclear fragmentation), and
karyolysis (nuclear dissolution) are irreversible changes indicating cell death.
Question 10
A patient's cells are exposed to hypoxia. Which intracellular event occurs first?
