NR 283 Pathophysiology Exam 2 Questions with
Answers| Latest Update| Guaranteed Pass
,1. A nurse notes that a patient's cardiac muscle cells have increased in size
following years of hypertension. This is an example of:
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Answer: B
Rationale: Hypertrophy is an increase in the SIZE of individual cells (common
in non-dividing cells like cardiac muscle), leading to increased organ size.
Hyperplasia is an increase in cell NUMBER, which cardiac muscle cannot do
because myocytes are largely post-mitotic.
2. The columnar epithelium of the bronchi converts to squamous epithelium in a
long-term smoker. This cellular adaptation is called:
A. Dysplasia
B. Metaplasia
C. Anaplasia
D. Hypertrophy
Answer: B
Rationale: Metaplasia is the reversible replacement of one differentiated cell
type with another, often in response to chronic irritation. It is an adaptive but
potentially pre-malignant change.
3. Which type of cellular adaptation is characterized by a decrease in cell size
and organ mass due to disuse, denervation, or reduced blood supply?
A. Atrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
Answer: A
Rationale: Atrophy is a decrease in cell size resulting from a decrease in
workload, use, blood supply, nutrition, or hormonal stimulation.
4. A patient's cervical biopsy reveals disordered cell growth with variation in cell
size and shape but no invasion. This finding is best described as:
, A. Metaplasia
B. Neoplasia
C. Dysplasia
D. Necrosis
Answer: C
Rationale: Dysplasia refers to abnormal changes in cell size, shape, and
organization; it is not cancer but is a precursor that can progress to
malignancy if the stimulus is not removed.
5. Hypoxia leads to cell injury primarily by impairing which cellular process first?
A. DNA replication
B. Protein synthesis
C. Aerobic (oxidative) respiration/ATP production
D. Membrane phospholipid synthesis
Answer: C
Rationale: Hypoxia interrupts oxidative phosphorylation in the mitochondria,
rapidly depleting ATP. This is the first and most critical injury because ATP is
needed to maintain the sodium-potassium pump and cellular homeostasis.
6. Loss of ATP during hypoxic cell injury causes the sodium-potassium pump to
fail, resulting in:
A. Cellular dehydration
B. Intracellular swelling (cellular edema)
C. Decreased intracellular calcium
D. Increased intracellular potassium
Answer: B
Rationale: Without ATP, the Na+/K+ ATPase pump fails, sodium accumulates
intracellularly, water follows osmotically, and the cell swells (hydropic/oncotic
swelling) — an early, potentially reversible sign of injury.
7. Which of the following is a hallmark of irreversible cell injury?
A. Cellular swelling
B. Fatty change
C. Massive influx of calcium into the cell with mitochondrial damage
D. Ribosomal detachment
, Answer: C
Rationale: A large, sustained increase in intracellular calcium activates
destructive enzymes (proteases, lipases, ATPases, endonucleases) and
severely damages mitochondria, marking the point of no return to cell death.
8. Coagulative necrosis is most typically seen following:
A. Bacterial infection of the lung
B. Ischemic injury to the heart or kidney (infarction)
C. Brain infarction
D. Chemical injury to the pancreas
Answer: B
Rationale: Coagulative necrosis preserves the basic tissue architecture
(protein denaturation dominates over enzymatic digestion) and is classic for
hypoxic/ischemic death in solid organs such as the heart and kidney.
9. Liquefactive necrosis is characteristic of injury to which organ due to high
enzyme/lipid content?
A. Heart
B. Kidney
C. Brain
D. Spleen
Answer: C
Rationale: Brain tissue is high in lipids and lacks substantial supportive
stroma, so ischemic injury there results in enzymatic digestion and
liquefaction rather than preserved (coagulative) architecture.
10. Caseous necrosis with a cheese-like, friable appearance is most classically
associated with:
A. Myocardial infarction
B. Tuberculosis infection
C. Pancreatic fat necrosis
D. Gangrene of the toe
Answer: B
Rationale: Caseous necrosis is a distinctive combination of coagulative and
liquefactive necrosis seen classically in tuberculosis granulomas.
Answers| Latest Update| Guaranteed Pass
,1. A nurse notes that a patient's cardiac muscle cells have increased in size
following years of hypertension. This is an example of:
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Answer: B
Rationale: Hypertrophy is an increase in the SIZE of individual cells (common
in non-dividing cells like cardiac muscle), leading to increased organ size.
Hyperplasia is an increase in cell NUMBER, which cardiac muscle cannot do
because myocytes are largely post-mitotic.
2. The columnar epithelium of the bronchi converts to squamous epithelium in a
long-term smoker. This cellular adaptation is called:
A. Dysplasia
B. Metaplasia
C. Anaplasia
D. Hypertrophy
Answer: B
Rationale: Metaplasia is the reversible replacement of one differentiated cell
type with another, often in response to chronic irritation. It is an adaptive but
potentially pre-malignant change.
3. Which type of cellular adaptation is characterized by a decrease in cell size
and organ mass due to disuse, denervation, or reduced blood supply?
A. Atrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
Answer: A
Rationale: Atrophy is a decrease in cell size resulting from a decrease in
workload, use, blood supply, nutrition, or hormonal stimulation.
4. A patient's cervical biopsy reveals disordered cell growth with variation in cell
size and shape but no invasion. This finding is best described as:
, A. Metaplasia
B. Neoplasia
C. Dysplasia
D. Necrosis
Answer: C
Rationale: Dysplasia refers to abnormal changes in cell size, shape, and
organization; it is not cancer but is a precursor that can progress to
malignancy if the stimulus is not removed.
5. Hypoxia leads to cell injury primarily by impairing which cellular process first?
A. DNA replication
B. Protein synthesis
C. Aerobic (oxidative) respiration/ATP production
D. Membrane phospholipid synthesis
Answer: C
Rationale: Hypoxia interrupts oxidative phosphorylation in the mitochondria,
rapidly depleting ATP. This is the first and most critical injury because ATP is
needed to maintain the sodium-potassium pump and cellular homeostasis.
6. Loss of ATP during hypoxic cell injury causes the sodium-potassium pump to
fail, resulting in:
A. Cellular dehydration
B. Intracellular swelling (cellular edema)
C. Decreased intracellular calcium
D. Increased intracellular potassium
Answer: B
Rationale: Without ATP, the Na+/K+ ATPase pump fails, sodium accumulates
intracellularly, water follows osmotically, and the cell swells (hydropic/oncotic
swelling) — an early, potentially reversible sign of injury.
7. Which of the following is a hallmark of irreversible cell injury?
A. Cellular swelling
B. Fatty change
C. Massive influx of calcium into the cell with mitochondrial damage
D. Ribosomal detachment
, Answer: C
Rationale: A large, sustained increase in intracellular calcium activates
destructive enzymes (proteases, lipases, ATPases, endonucleases) and
severely damages mitochondria, marking the point of no return to cell death.
8. Coagulative necrosis is most typically seen following:
A. Bacterial infection of the lung
B. Ischemic injury to the heart or kidney (infarction)
C. Brain infarction
D. Chemical injury to the pancreas
Answer: B
Rationale: Coagulative necrosis preserves the basic tissue architecture
(protein denaturation dominates over enzymatic digestion) and is classic for
hypoxic/ischemic death in solid organs such as the heart and kidney.
9. Liquefactive necrosis is characteristic of injury to which organ due to high
enzyme/lipid content?
A. Heart
B. Kidney
C. Brain
D. Spleen
Answer: C
Rationale: Brain tissue is high in lipids and lacks substantial supportive
stroma, so ischemic injury there results in enzymatic digestion and
liquefaction rather than preserved (coagulative) architecture.
10. Caseous necrosis with a cheese-like, friable appearance is most classically
associated with:
A. Myocardial infarction
B. Tuberculosis infection
C. Pancreatic fat necrosis
D. Gangrene of the toe
Answer: B
Rationale: Caseous necrosis is a distinctive combination of coagulative and
liquefactive necrosis seen classically in tuberculosis granulomas.
