Chamberlain NR283 Final Exam Guide:
Pathophysiology Questions And Well Graded
Solutions With Rationales Updated 2026-
2027
Master your NR283 Pathophysiology final exam with this comprehensive study bundle.
Features high-yield multiple-choice questions complete with verified answers and in-depth
clinical rationales. Covers essential topics including cellular adaptations, acute inflammation
cascades, fluid imbalances, and advanced systemic disorders. Perfect for Chamberlain
University nursing students looking to ace their eDapt modules and final assessments. Boost
your test confidence and pass on your first try!
Unit 1: Cellular Alterations & Genetics (Questions 1-15)
1. A patient with long-standing, untreated hypertension shows an increase in the size of
myocardial cells without an increase in cell number. Which term describes this
adaptation?
A) Atrophy
B) Hypertrophy
C) Hyperplasia
D) Metaplasia
Answer: B) Hypertrophy
Rationale: Hypertrophy is an increase in individual cell size, typically caused by
increased mechanical demand or workload, as seen in the left ventricle of
hypertensive patients.
2. A chronic smoker undergoes a bronchoscopy, and the biopsy shows that normal
ciliated columnar epithelial cells in the trachea have been replaced by stratified
squamous epithelial cells. This represents which cellular adaptation?
A) Dysplasia
B) Anaplasia
C) Metaplasia
D) Hyperplasia
Answer: C) Metaplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type by
another mature cell type, usually in response to chronic irritation or inflammation.
3. A Pap smear report notes the presence of abnormal, disordered cellular growth with
variations in cell size, shape, and organization in the cervix. What is the correct term
for this finding?
A) Metaplasia
B) Dysplasia
C) Hypertrophy
D) Atrophy
Answer: B) Dysplasia
Rationale: Dysplasia refers to abnormal, disordered cell growth and maturation.
While it is not true cancer, it is considered a precancerous change that requires
close monitoring.
4. A patient experiences a prolonged period of ischemia to the lower extremity due to
an arterial occlusion. Which cellular change occurs first due to the lack of oxygen?
A) Increased intracellular pH
1|Page
, B) Failure of the sodium-potassium pump
C) Direct rupture of the cell membrane
D) Accelerated oxidative phosphorylation
Answer: B) Failure of the sodium-potassium pump
Rationale: Ischemia decreases ATP production via oxidative phosphorylation.
Without ATP, the sodium-potassium (Na⁺/K⁺) ATPase pump fails, causing sodium
and water to flood into the cell, resulting in cellular swelling.
5. During ischemic cell injury, an influx of which intracellular ion activates destructive
enzymes like proteases, endonucleases, and phospholipases?
A) Potassium
B) Sodium
C) Calcium
D) Magnesium
Answer: C) Calcium
Rationale: Ischemia causes a failure of calcium pumps, leading to a massive influx of
extracellular calcium into the cytoplasm. Free calcium activates enzymes that
degrade cellular structures, causing irreversible damage.
6. Which type of cell death is a genetically programmed, orderly process that eliminates
worn-out or damaged cells without triggering an inflammatory response?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Apoptosis
D) Caseous necrosis
Answer: C) Apoptosis
Rationale: Apoptosis is programmed cell death or "cellular suicide." It is a neat,
controlled process that does not spill cellular contents into surrounding tissues,
avoiding inflammation.
7. A patient is diagnosed with an infarction of the brain following a stroke. Which type of
necrosis is characteristically seen in central nervous system injuries?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
Answer: B) Liquefactive necrosis
Rationale: Liquefactive necrosis occurs in the brain because neurons and glial cells
contain high amounts of digestive lysosomal enzymes, which completely dissolve
dead tissue into a liquid mass.
8. Which type of necrosis is uniquely associated with pulmonary tuberculosis lesions
and resembles a grayish-white, cheesy substance?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Gangrenous necrosis
Answer: C) Caseous necrosis
Rationale: Caseous necrosis is characteristic of tuberculosis infections in the lungs.
It is a combination of coagulative and liquefactive necrosis where dead cells
disintegrate but are not completely digested, leaving a cheese-like appearance.
9. An elderly patient is bedridden following a hip fracture, leading to a significant
reduction in the muscle mass of both legs. This muscle shrinkage is an example of
which adaptation?
2|Page
, A) Denervation atrophy
B) Disuse atrophy
C) Senile atrophy
D) Ischemic atrophy
Answer: B) Disuse atrophy
Rationale: Disuse atrophy occurs when skeletal muscle workload decreases due to
prolonged immobility, leading to a down-regulation of protein synthesis and cell
shrinkage.
10. A physical assessment reveals a genetic disorder caused by the presence of three
copies of chromosome 21. What is the clinical name for this condition?
A) Turner syndrome
B) Klinefelter syndrome
C) Down syndrome
D) Marfan syndrome
Answer: C) Down syndrome
Rationale: Down syndrome is caused by chromosomal nondisjunction resulting in
Trisomy 21. Clinical features include intellectual disability, distinct facial features, and
congenital heart defects.
11. A female patient presents with short stature, a webbed neck, and primary
amenorrhea due to a karyotype showing only one functional X chromosome (45,X).
Which condition does she have?
A) Klinefelter syndrome
B) Turner syndrome
C) Fragile X syndrome
D) Down syndrome
Answer: B) Turner syndrome
Rationale: Turner syndrome is a female monosomy condition (45,X) characterized by
ovarian dysgenesis (resulting in amenorrhea and infertility), short stature, and a
webbed neck.
12. A male patient is diagnosed with an inherited disorder that affects connective tissue,
leading to long, slender limbs, arachnodactyly, and a high risk for aortic aneurysm.
What is this autosomal dominant condition?
A) Cystic fibrosis
B) Tay-Sachs disease
C) Marfan syndrome
D) Huntington disease
Answer: C) Marfan syndrome
Rationale: Marfan syndrome is an autosomal dominant genetic defect in the FBN1
gene, which codes for fibrillin-1. It alters connective tissue development, drastically
impacting the skeletal, ocular, and cardiovascular systems.
13. A genetic screen confirms that a patient has Klinefelter syndrome. Which
chromosomal pattern aligns with this diagnosis?
A) 45, X
B) 47, XXY
C) 47, XYY
D) 46, XY, del(5p)
Answer: B) 47, XXY
Rationale: Klinefelter syndrome occurs in males who inherit an extra X chromosome
(47,XXY). It typically causes testicular atrophy, infertility, gynecomastia, and a tall
stature.
3|Page
, 14. Which autosomal recessive genetic disorder is characterized by a defect in chloride
channels, leading to abnormally thick mucus secretions that obstruct the lungs and
pancreas?
A) Marfan syndrome
B) Huntington disease
C) Cystic fibrosis
D) Sickle cell anemia
Answer: C) Cystic fibrosis
Rationale: Cystic fibrosis is caused by mutations in the CFTR gene. This impairs
chloride transport across epithelial membranes, creating thick, dehydrated secretions
that block respiratory and digestive pathways.
15. A patient has a progressive, fatal neurodegenerative disorder that exhibits autosomal
dominant inheritance, with symptoms typically appearing in mid-adulthood. Which
disease matches this description?
A) Phenylketonuria (PKU)
B) Huntington disease
C) Tay-Sachs disease
D) Duchenne muscular dystrophy
Answer: B) Huntington disease
Rationale: Huntington disease is an autosomal dominant condition characterized by
chorea (involuntary movements) and cognitive decline, caused by a triplet repeat
expansion (CAG) in the huntingtin gene.
Unit 2: Fluid, Electrolytes, & Acid-Base Balance (Questions 16-
30)
16. A patient presents with generalized edema due to severe malnutrition and low serum
albumin levels. Which capillary force alteration caused the fluid shift into the
interstitial space?
A) Increased capillary hydrostatic pressure
B) Decreased capillary colloidal osmotic pressure
C) Increased interstitial hydrostatic pressure
D) Decreased capillary permeability
Answer: B) Decreased capillary colloidal osmotic pressure
Rationale: Albumin is the primary plasma protein responsible for generating capillary
colloidal osmotic (oncotic) pressure, which pulls fluid back into blood vessels. Low
albumin reduces this pulling force, resulting in edema.
17. A patient with right-sided heart failure has significant pitting edema in the lower
extremities. What capillary dynamic explains this fluid movement?
A) Decreased capillary hydrostatic pressure
B) Increased capillary hydrostatic pressure
C) Increased plasma oncotic pressure
D) Decreased capillary permeability
Answer: B) Increased capillary hydrostatic pressure
Rationale: Right-sided heart failure causes blood to back up into the systemic
4|Page
Pathophysiology Questions And Well Graded
Solutions With Rationales Updated 2026-
2027
Master your NR283 Pathophysiology final exam with this comprehensive study bundle.
Features high-yield multiple-choice questions complete with verified answers and in-depth
clinical rationales. Covers essential topics including cellular adaptations, acute inflammation
cascades, fluid imbalances, and advanced systemic disorders. Perfect for Chamberlain
University nursing students looking to ace their eDapt modules and final assessments. Boost
your test confidence and pass on your first try!
Unit 1: Cellular Alterations & Genetics (Questions 1-15)
1. A patient with long-standing, untreated hypertension shows an increase in the size of
myocardial cells without an increase in cell number. Which term describes this
adaptation?
A) Atrophy
B) Hypertrophy
C) Hyperplasia
D) Metaplasia
Answer: B) Hypertrophy
Rationale: Hypertrophy is an increase in individual cell size, typically caused by
increased mechanical demand or workload, as seen in the left ventricle of
hypertensive patients.
2. A chronic smoker undergoes a bronchoscopy, and the biopsy shows that normal
ciliated columnar epithelial cells in the trachea have been replaced by stratified
squamous epithelial cells. This represents which cellular adaptation?
A) Dysplasia
B) Anaplasia
C) Metaplasia
D) Hyperplasia
Answer: C) Metaplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type by
another mature cell type, usually in response to chronic irritation or inflammation.
3. A Pap smear report notes the presence of abnormal, disordered cellular growth with
variations in cell size, shape, and organization in the cervix. What is the correct term
for this finding?
A) Metaplasia
B) Dysplasia
C) Hypertrophy
D) Atrophy
Answer: B) Dysplasia
Rationale: Dysplasia refers to abnormal, disordered cell growth and maturation.
While it is not true cancer, it is considered a precancerous change that requires
close monitoring.
4. A patient experiences a prolonged period of ischemia to the lower extremity due to
an arterial occlusion. Which cellular change occurs first due to the lack of oxygen?
A) Increased intracellular pH
1|Page
, B) Failure of the sodium-potassium pump
C) Direct rupture of the cell membrane
D) Accelerated oxidative phosphorylation
Answer: B) Failure of the sodium-potassium pump
Rationale: Ischemia decreases ATP production via oxidative phosphorylation.
Without ATP, the sodium-potassium (Na⁺/K⁺) ATPase pump fails, causing sodium
and water to flood into the cell, resulting in cellular swelling.
5. During ischemic cell injury, an influx of which intracellular ion activates destructive
enzymes like proteases, endonucleases, and phospholipases?
A) Potassium
B) Sodium
C) Calcium
D) Magnesium
Answer: C) Calcium
Rationale: Ischemia causes a failure of calcium pumps, leading to a massive influx of
extracellular calcium into the cytoplasm. Free calcium activates enzymes that
degrade cellular structures, causing irreversible damage.
6. Which type of cell death is a genetically programmed, orderly process that eliminates
worn-out or damaged cells without triggering an inflammatory response?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Apoptosis
D) Caseous necrosis
Answer: C) Apoptosis
Rationale: Apoptosis is programmed cell death or "cellular suicide." It is a neat,
controlled process that does not spill cellular contents into surrounding tissues,
avoiding inflammation.
7. A patient is diagnosed with an infarction of the brain following a stroke. Which type of
necrosis is characteristically seen in central nervous system injuries?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
Answer: B) Liquefactive necrosis
Rationale: Liquefactive necrosis occurs in the brain because neurons and glial cells
contain high amounts of digestive lysosomal enzymes, which completely dissolve
dead tissue into a liquid mass.
8. Which type of necrosis is uniquely associated with pulmonary tuberculosis lesions
and resembles a grayish-white, cheesy substance?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Gangrenous necrosis
Answer: C) Caseous necrosis
Rationale: Caseous necrosis is characteristic of tuberculosis infections in the lungs.
It is a combination of coagulative and liquefactive necrosis where dead cells
disintegrate but are not completely digested, leaving a cheese-like appearance.
9. An elderly patient is bedridden following a hip fracture, leading to a significant
reduction in the muscle mass of both legs. This muscle shrinkage is an example of
which adaptation?
2|Page
, A) Denervation atrophy
B) Disuse atrophy
C) Senile atrophy
D) Ischemic atrophy
Answer: B) Disuse atrophy
Rationale: Disuse atrophy occurs when skeletal muscle workload decreases due to
prolonged immobility, leading to a down-regulation of protein synthesis and cell
shrinkage.
10. A physical assessment reveals a genetic disorder caused by the presence of three
copies of chromosome 21. What is the clinical name for this condition?
A) Turner syndrome
B) Klinefelter syndrome
C) Down syndrome
D) Marfan syndrome
Answer: C) Down syndrome
Rationale: Down syndrome is caused by chromosomal nondisjunction resulting in
Trisomy 21. Clinical features include intellectual disability, distinct facial features, and
congenital heart defects.
11. A female patient presents with short stature, a webbed neck, and primary
amenorrhea due to a karyotype showing only one functional X chromosome (45,X).
Which condition does she have?
A) Klinefelter syndrome
B) Turner syndrome
C) Fragile X syndrome
D) Down syndrome
Answer: B) Turner syndrome
Rationale: Turner syndrome is a female monosomy condition (45,X) characterized by
ovarian dysgenesis (resulting in amenorrhea and infertility), short stature, and a
webbed neck.
12. A male patient is diagnosed with an inherited disorder that affects connective tissue,
leading to long, slender limbs, arachnodactyly, and a high risk for aortic aneurysm.
What is this autosomal dominant condition?
A) Cystic fibrosis
B) Tay-Sachs disease
C) Marfan syndrome
D) Huntington disease
Answer: C) Marfan syndrome
Rationale: Marfan syndrome is an autosomal dominant genetic defect in the FBN1
gene, which codes for fibrillin-1. It alters connective tissue development, drastically
impacting the skeletal, ocular, and cardiovascular systems.
13. A genetic screen confirms that a patient has Klinefelter syndrome. Which
chromosomal pattern aligns with this diagnosis?
A) 45, X
B) 47, XXY
C) 47, XYY
D) 46, XY, del(5p)
Answer: B) 47, XXY
Rationale: Klinefelter syndrome occurs in males who inherit an extra X chromosome
(47,XXY). It typically causes testicular atrophy, infertility, gynecomastia, and a tall
stature.
3|Page
, 14. Which autosomal recessive genetic disorder is characterized by a defect in chloride
channels, leading to abnormally thick mucus secretions that obstruct the lungs and
pancreas?
A) Marfan syndrome
B) Huntington disease
C) Cystic fibrosis
D) Sickle cell anemia
Answer: C) Cystic fibrosis
Rationale: Cystic fibrosis is caused by mutations in the CFTR gene. This impairs
chloride transport across epithelial membranes, creating thick, dehydrated secretions
that block respiratory and digestive pathways.
15. A patient has a progressive, fatal neurodegenerative disorder that exhibits autosomal
dominant inheritance, with symptoms typically appearing in mid-adulthood. Which
disease matches this description?
A) Phenylketonuria (PKU)
B) Huntington disease
C) Tay-Sachs disease
D) Duchenne muscular dystrophy
Answer: B) Huntington disease
Rationale: Huntington disease is an autosomal dominant condition characterized by
chorea (involuntary movements) and cognitive decline, caused by a triplet repeat
expansion (CAG) in the huntingtin gene.
Unit 2: Fluid, Electrolytes, & Acid-Base Balance (Questions 16-
30)
16. A patient presents with generalized edema due to severe malnutrition and low serum
albumin levels. Which capillary force alteration caused the fluid shift into the
interstitial space?
A) Increased capillary hydrostatic pressure
B) Decreased capillary colloidal osmotic pressure
C) Increased interstitial hydrostatic pressure
D) Decreased capillary permeability
Answer: B) Decreased capillary colloidal osmotic pressure
Rationale: Albumin is the primary plasma protein responsible for generating capillary
colloidal osmotic (oncotic) pressure, which pulls fluid back into blood vessels. Low
albumin reduces this pulling force, resulting in edema.
17. A patient with right-sided heart failure has significant pitting edema in the lower
extremities. What capillary dynamic explains this fluid movement?
A) Decreased capillary hydrostatic pressure
B) Increased capillary hydrostatic pressure
C) Increased plasma oncotic pressure
D) Decreased capillary permeability
Answer: B) Increased capillary hydrostatic pressure
Rationale: Right-sided heart failure causes blood to back up into the systemic
4|Page
