NSG 3280 Pathophysiology for Nurses I Exam 2
Practice Test Actual 2025/2026 with Detailed
Rationales | 100% Verified | Pass Guaranteed – A+
Graded
SECTION 1: Cellular Pathophysiology & Adaptation (Questions 1–10)
Q1: A nurse is reviewing cellular adaptation mechanisms. A client with chronic
hypertension develops an increase in the size of individual cardiac muscle cells. This
process is best described as:
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Correct Answer: B
Rationale: Correct because hypertrophy is an increase in the size of individual cells
(not cell number) in response to increased workload or demand, such as cardiac
muscle enlargement from chronic hypertension.
Q2: A client with chronic gastroesophageal reflux disease develops columnar
epithelium in the distal esophagus, replacing the normal squamous epithelium. The
nurse recognizes this cellular adaptation as:
,A. Atrophy
B. Hyperplasia
C. Metaplasia
D. Anaplasia
Correct Answer: C
Rationale: Correct because metaplasia is the reversible replacement of one
differentiated cell type with another, as seen in Barrett esophagus where squamous
epithelium is replaced by columnar epithelium in response to chronic acid exposure.
Q3: A nurse is explaining the difference between necrosis and apoptosis to a group
of students. Which statement best describes apoptosis?
A. It is always a pathologic process resulting from cellular injury
B. It is a programmed, energy-dependent form of cell death that does not trigger
inflammation
C. It causes cellular swelling and membrane rupture with release of intracellular
contents
D. It results in coagulative necrosis of surrounding tissues
Correct Answer: B
Rationale: Correct because apoptosis is a genetically programmed, ATP-dependent
process of cell death characterized by cell shrinkage, chromatin condensation, and
formation of apoptotic bodies without inflammation, unlike necrosis.
Q4: A client presents with a myocardial infarction. The nurse understands that the
area of dead myocardial tissue will most likely demonstrate which type of necrosis?
,A. Liquefactive necrosis
B. Caseous necrosis
C. Coagulative necrosis
D. Fat necrosis
Correct Answer: C
Rationale: Correct because coagulative necrosis is the most common type of
ischemic necrosis in solid organs such as the heart, kidney, and spleen, preserving
tissue architecture for several days due to denaturation of structural and enzymatic
proteins.
Q5: A nurse is reviewing the stages of cellular response to injury. During which stage
does the cell attempt to adapt to reversible injury by decreasing ATP consumption?
A. The stage of decreased ATP and cellular swelling
B. The stage of mitochondrial damage and calcium influx
C. The stage of membrane damage and lysosomal rupture
D. The stage of DNA and protein damage
Correct Answer: A
Rationale: Correct because the initial stage of reversible cell injury involves
decreased ATP production, failure of the sodium-potassium pump, cellular swelling,
and the cell's attempt to reduce metabolic activity to conserve energy.
Q6: A client with chronic obstructive pulmonary disease has reduced muscle mass in
the extremities. The nurse recognizes this cellular adaptation as:
, A. Hypertrophy from increased workload
B. Atrophy from disuse and malnutrition
C. Hyperplasia from chronic inflammation
D. Metaplasia from chronic irritation
Correct Answer: B
Rationale: Correct because atrophy is a decrease in cell size and number resulting
from decreased workload, disuse, inadequate nutrition, or decreased hormonal
stimulation, commonly seen in COPD-related muscle wasting.
Q7: A nurse is reviewing free radical injury. Which molecule is the primary source of
free radical generation during reperfusion of ischemic tissue?
A. Carbon dioxide
B. Nitric oxide
C. Oxygen
D. Hydrogen peroxide
Correct Answer: C
Rationale: Correct because molecular oxygen is the primary source of free radical
generation during reperfusion injury, as the sudden reintroduction of oxygen to
previously ischemic tissue leads to incomplete reduction of O₂ and formation of
superoxide and other reactive oxygen species.
Q8: A client is exposed to carbon tetrachloride, which damages hepatocytes by
forming free radicals. Which cellular structure is most directly affected by this type
of injury?
Practice Test Actual 2025/2026 with Detailed
Rationales | 100% Verified | Pass Guaranteed – A+
Graded
SECTION 1: Cellular Pathophysiology & Adaptation (Questions 1–10)
Q1: A nurse is reviewing cellular adaptation mechanisms. A client with chronic
hypertension develops an increase in the size of individual cardiac muscle cells. This
process is best described as:
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Correct Answer: B
Rationale: Correct because hypertrophy is an increase in the size of individual cells
(not cell number) in response to increased workload or demand, such as cardiac
muscle enlargement from chronic hypertension.
Q2: A client with chronic gastroesophageal reflux disease develops columnar
epithelium in the distal esophagus, replacing the normal squamous epithelium. The
nurse recognizes this cellular adaptation as:
,A. Atrophy
B. Hyperplasia
C. Metaplasia
D. Anaplasia
Correct Answer: C
Rationale: Correct because metaplasia is the reversible replacement of one
differentiated cell type with another, as seen in Barrett esophagus where squamous
epithelium is replaced by columnar epithelium in response to chronic acid exposure.
Q3: A nurse is explaining the difference between necrosis and apoptosis to a group
of students. Which statement best describes apoptosis?
A. It is always a pathologic process resulting from cellular injury
B. It is a programmed, energy-dependent form of cell death that does not trigger
inflammation
C. It causes cellular swelling and membrane rupture with release of intracellular
contents
D. It results in coagulative necrosis of surrounding tissues
Correct Answer: B
Rationale: Correct because apoptosis is a genetically programmed, ATP-dependent
process of cell death characterized by cell shrinkage, chromatin condensation, and
formation of apoptotic bodies without inflammation, unlike necrosis.
Q4: A client presents with a myocardial infarction. The nurse understands that the
area of dead myocardial tissue will most likely demonstrate which type of necrosis?
,A. Liquefactive necrosis
B. Caseous necrosis
C. Coagulative necrosis
D. Fat necrosis
Correct Answer: C
Rationale: Correct because coagulative necrosis is the most common type of
ischemic necrosis in solid organs such as the heart, kidney, and spleen, preserving
tissue architecture for several days due to denaturation of structural and enzymatic
proteins.
Q5: A nurse is reviewing the stages of cellular response to injury. During which stage
does the cell attempt to adapt to reversible injury by decreasing ATP consumption?
A. The stage of decreased ATP and cellular swelling
B. The stage of mitochondrial damage and calcium influx
C. The stage of membrane damage and lysosomal rupture
D. The stage of DNA and protein damage
Correct Answer: A
Rationale: Correct because the initial stage of reversible cell injury involves
decreased ATP production, failure of the sodium-potassium pump, cellular swelling,
and the cell's attempt to reduce metabolic activity to conserve energy.
Q6: A client with chronic obstructive pulmonary disease has reduced muscle mass in
the extremities. The nurse recognizes this cellular adaptation as:
, A. Hypertrophy from increased workload
B. Atrophy from disuse and malnutrition
C. Hyperplasia from chronic inflammation
D. Metaplasia from chronic irritation
Correct Answer: B
Rationale: Correct because atrophy is a decrease in cell size and number resulting
from decreased workload, disuse, inadequate nutrition, or decreased hormonal
stimulation, commonly seen in COPD-related muscle wasting.
Q7: A nurse is reviewing free radical injury. Which molecule is the primary source of
free radical generation during reperfusion of ischemic tissue?
A. Carbon dioxide
B. Nitric oxide
C. Oxygen
D. Hydrogen peroxide
Correct Answer: C
Rationale: Correct because molecular oxygen is the primary source of free radical
generation during reperfusion injury, as the sudden reintroduction of oxygen to
previously ischemic tissue leads to incomplete reduction of O₂ and formation of
superoxide and other reactive oxygen species.
Q8: A client is exposed to carbon tetrachloride, which damages hepatocytes by
forming free radicals. Which cellular structure is most directly affected by this type
of injury?
