NURS 3366 AO EXAM 1 BLUEPRINT AND CONTENT
SUMMARY | 2026 UPDATE | WITH COMPLETE
SOLUTIONS - UTA.
Section 1: Cellular Adaptation & Injury
1. A patient with chronic anemia experiences fatigue and pallor. The nurse
understands that anemia causes insufficient oxygen delivery to cells, which may
lead to:
• A) Cellular atrophy (Correct Answer)
• B) Cellular hypertrophy
• C) Cellular hyperplasia
• D) Cellular metaplasia
Rationale: Cellular atrophy is a decrease in cell size, often caused by decreased
workload, decreased blood flow, or inadequate nutrition/oxygen. Chronic anemia
reduces oxygen delivery to tissues, causing cells to shrink and function less
effectively. This is an adaptive response to decreased metabolic demand.
2. A patient with hypertension develops left ventricular hypertrophy. This is an
example of:
• A) Cellular hypertrophy (Correct Answer)
• B) Cellular atrophy
• C) Cellular hyperplasia
• D) Cellular metaplasia
,Rationale: Hypertrophy is an increase in cell size, which increases the size of the
affected organ. The heart's left ventricle enlarges in response to increased
workload (afterload) from hypertension. The myocardial cells enlarge to generate
more contractile force, though this adaptation can eventually become pathologic.
3. A woman who is 8 weeks pregnant experiences an increase in the size of her
uterus. This is primarily due to:
• A) Cellular hypertrophy and hyperplasia (Correct Answer)
• B) Cellular atrophy
• C) Cellular metaplasia
• D) Cellular dysplasia
Rationale: The uterus enlarges during pregnancy through a combination of
hypertrophy (enlargement of existing muscle cells) and hyperplasia (increase in the
number of cells). This is a normal physiologic adaptive response to increased
hormonal stimulation and mechanical stretch.
4. A patient who smokes cigarettes has developed squamous cell metaplasia in
the bronchial epithelium. The nurse understands that metaplasia is:
• A) A reversible replacement of one mature cell type by another (Correct
Answer)
• B) An irreversible change to a malignant cell
• C) A decrease in cell size
• D) An increase in cell number
Rationale: Metaplasia is a reversible change in which one adult cell type is
replaced by another adult cell type, usually in response to chronic irritation or
inflammation. In smokers, the normal columnar epithelial cells lining the bronchi
, are replaced by stratified squamous epithelial cells. This is an adaptive response,
though it can predispose to malignant transformation.
5. A patient with chronic gastroesophageal reflux disease (GERD) develops
Barrett's esophagus, where the normal squamous epithelium is replaced by
columnar epithelium. This is classified as:
• A) Metaplasia (Correct Answer)
• B) Dysplasia
• C) Hyperplasia
• D) Hypertrophy
Rationale: Barrett's esophagus is a classic example of metaplasia. Chronic acid
reflux damages the normal squamous epithelium of the esophagus, and it is
replaced by columnar epithelium (like that found in the stomach/intestines) to
better tolerate the acidic environment. This adaptive change increases the risk of
esophageal adenocarcinoma.
6. A biopsy of cervical tissue reveals abnormal cells with variation in size, shape,
and organization, but the changes do not extend through the full thickness of
the epithelium. This finding is consistent with:
• A) Dysplasia (Correct Answer)
• B) Metaplasia
• C) Hyperplasia
• D) Hypertrophy
Rationale: Dysplasia is characterized by deranged cell growth with abnormal
variation in size, shape, and arrangement (pleomorphism). It is often a precursor
to malignancy. When dysplasia involves the full thickness of the epithelium, it is
SUMMARY | 2026 UPDATE | WITH COMPLETE
SOLUTIONS - UTA.
Section 1: Cellular Adaptation & Injury
1. A patient with chronic anemia experiences fatigue and pallor. The nurse
understands that anemia causes insufficient oxygen delivery to cells, which may
lead to:
• A) Cellular atrophy (Correct Answer)
• B) Cellular hypertrophy
• C) Cellular hyperplasia
• D) Cellular metaplasia
Rationale: Cellular atrophy is a decrease in cell size, often caused by decreased
workload, decreased blood flow, or inadequate nutrition/oxygen. Chronic anemia
reduces oxygen delivery to tissues, causing cells to shrink and function less
effectively. This is an adaptive response to decreased metabolic demand.
2. A patient with hypertension develops left ventricular hypertrophy. This is an
example of:
• A) Cellular hypertrophy (Correct Answer)
• B) Cellular atrophy
• C) Cellular hyperplasia
• D) Cellular metaplasia
,Rationale: Hypertrophy is an increase in cell size, which increases the size of the
affected organ. The heart's left ventricle enlarges in response to increased
workload (afterload) from hypertension. The myocardial cells enlarge to generate
more contractile force, though this adaptation can eventually become pathologic.
3. A woman who is 8 weeks pregnant experiences an increase in the size of her
uterus. This is primarily due to:
• A) Cellular hypertrophy and hyperplasia (Correct Answer)
• B) Cellular atrophy
• C) Cellular metaplasia
• D) Cellular dysplasia
Rationale: The uterus enlarges during pregnancy through a combination of
hypertrophy (enlargement of existing muscle cells) and hyperplasia (increase in the
number of cells). This is a normal physiologic adaptive response to increased
hormonal stimulation and mechanical stretch.
4. A patient who smokes cigarettes has developed squamous cell metaplasia in
the bronchial epithelium. The nurse understands that metaplasia is:
• A) A reversible replacement of one mature cell type by another (Correct
Answer)
• B) An irreversible change to a malignant cell
• C) A decrease in cell size
• D) An increase in cell number
Rationale: Metaplasia is a reversible change in which one adult cell type is
replaced by another adult cell type, usually in response to chronic irritation or
inflammation. In smokers, the normal columnar epithelial cells lining the bronchi
, are replaced by stratified squamous epithelial cells. This is an adaptive response,
though it can predispose to malignant transformation.
5. A patient with chronic gastroesophageal reflux disease (GERD) develops
Barrett's esophagus, where the normal squamous epithelium is replaced by
columnar epithelium. This is classified as:
• A) Metaplasia (Correct Answer)
• B) Dysplasia
• C) Hyperplasia
• D) Hypertrophy
Rationale: Barrett's esophagus is a classic example of metaplasia. Chronic acid
reflux damages the normal squamous epithelium of the esophagus, and it is
replaced by columnar epithelium (like that found in the stomach/intestines) to
better tolerate the acidic environment. This adaptive change increases the risk of
esophageal adenocarcinoma.
6. A biopsy of cervical tissue reveals abnormal cells with variation in size, shape,
and organization, but the changes do not extend through the full thickness of
the epithelium. This finding is consistent with:
• A) Dysplasia (Correct Answer)
• B) Metaplasia
• C) Hyperplasia
• D) Hypertrophy
Rationale: Dysplasia is characterized by deranged cell growth with abnormal
variation in size, shape, and arrangement (pleomorphism). It is often a precursor
to malignancy. When dysplasia involves the full thickness of the epithelium, it is
