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WGU D115 – ADVANCED PATHOPHYSIOLOGY FOR THE APRN Cram Study Guide 5 | Latest
2026/2027 Update Questions with Detailed Rationales | A+ Graded
Question 1
A patient has a prolonged ischemic event. Which of the
following indicates irreversible cell injury?
A. Cellular swelling
B. Mitochondrial vacuolization
C. Nuclear karyolysis
D. Decreased ATP production
E. Ribosomal detachment
Answer: C
Rationale: Nuclear karyolysis (fading/loss of the nucleus) is a
hallmark of irreversible cell death. Cellular swelling, decreased
ATP, and ribosomal detachment are reversible changes.
Question 2
Which adaptive change involves an increase in the number of
cells in response to a stimulus?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
E. Dysplasia
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Answer: B
Rationale: Hyperplasia is an increase in cell number, often due
to hormonal stimulation or compensatory regeneration.
Hypertrophy is increase in cell size.
Question 3
A patient with chronic smoking has ciliated columnar
epithelium replaced by stratified squamous epithelium in the
bronchi. This is an example of:
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
E. Atrophy
Answer: C
Rationale: Metaplasia is a reversible replacement of one
mature cell type by another, often as an adaptive response to
chronic irritation, such as squamous metaplasia in smokers.
Question 4
Which type of necrosis is most characteristic of tuberculosis?
A. Coagulative necrosis
B. Liquefactive necrosis
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C. Caseous necrosis
D. Fat necrosis
E. Fibrinoid necrosis
Answer: C
Rationale: Caseous necrosis, a cheese-like gross appearance, is
typical of granulomatous inflammation in tuberculosis.
Question 5
What is the primary vasoactive mediator released by mast cells
during acute inflammation?
A. Thromboxane A2
B. Histamine
C. Interleukin-1
D. Tumor necrosis factor
E. Complement C5a
Answer: B
Rationale: Histamine, released by mast cells and basophils,
causes vasodilation and increased vascular permeability,
producing redness and swelling.
Question 6
Which leukocyte is most characteristic of parasitic infections
and allergic responses?
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A. Neutrophil
B. Basophil
C. Eosinophil
D. Monocyte
E. Lymphocyte
Answer: C
Rationale: Eosinophils are prominent in parasitic infections and
allergic (IgE-mediated) reactions, releasing major basic protein
that damages parasites.
Question 7
A patient with a type II hypersensitivity reaction is most likely to
have which condition?
A. Allergic rhinitis
B. Autoimmune hemolytic anemia
C. Serum sickness
D. Contact dermatitis
E. Tuberculin skin test reaction
Answer: B
Rationale: Type II hypersensitivity involves antibody-mediated
destruction of cells, such as autoimmune hemolytic anemia,
Graves disease, and myasthenia gravis.
WGU D115 – ADVANCED PATHOPHYSIOLOGY FOR THE APRN Cram Study Guide 5 | Latest
2026/2027 Update Questions with Detailed Rationales | A+ Graded
Question 1
A patient has a prolonged ischemic event. Which of the
following indicates irreversible cell injury?
A. Cellular swelling
B. Mitochondrial vacuolization
C. Nuclear karyolysis
D. Decreased ATP production
E. Ribosomal detachment
Answer: C
Rationale: Nuclear karyolysis (fading/loss of the nucleus) is a
hallmark of irreversible cell death. Cellular swelling, decreased
ATP, and ribosomal detachment are reversible changes.
Question 2
Which adaptive change involves an increase in the number of
cells in response to a stimulus?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
E. Dysplasia
, Page |2
Answer: B
Rationale: Hyperplasia is an increase in cell number, often due
to hormonal stimulation or compensatory regeneration.
Hypertrophy is increase in cell size.
Question 3
A patient with chronic smoking has ciliated columnar
epithelium replaced by stratified squamous epithelium in the
bronchi. This is an example of:
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
E. Atrophy
Answer: C
Rationale: Metaplasia is a reversible replacement of one
mature cell type by another, often as an adaptive response to
chronic irritation, such as squamous metaplasia in smokers.
Question 4
Which type of necrosis is most characteristic of tuberculosis?
A. Coagulative necrosis
B. Liquefactive necrosis
, Page |3
C. Caseous necrosis
D. Fat necrosis
E. Fibrinoid necrosis
Answer: C
Rationale: Caseous necrosis, a cheese-like gross appearance, is
typical of granulomatous inflammation in tuberculosis.
Question 5
What is the primary vasoactive mediator released by mast cells
during acute inflammation?
A. Thromboxane A2
B. Histamine
C. Interleukin-1
D. Tumor necrosis factor
E. Complement C5a
Answer: B
Rationale: Histamine, released by mast cells and basophils,
causes vasodilation and increased vascular permeability,
producing redness and swelling.
Question 6
Which leukocyte is most characteristic of parasitic infections
and allergic responses?
, Page |4
A. Neutrophil
B. Basophil
C. Eosinophil
D. Monocyte
E. Lymphocyte
Answer: C
Rationale: Eosinophils are prominent in parasitic infections and
allergic (IgE-mediated) reactions, releasing major basic protein
that damages parasites.
Question 7
A patient with a type II hypersensitivity reaction is most likely to
have which condition?
A. Allergic rhinitis
B. Autoimmune hemolytic anemia
C. Serum sickness
D. Contact dermatitis
E. Tuberculin skin test reaction
Answer: B
Rationale: Type II hypersensitivity involves antibody-mediated
destruction of cells, such as autoimmune hemolytic anemia,
Graves disease, and myasthenia gravis.
