HERTZING UNIVERSITY NSG 120 PATHOPHYSIOLOGY EXAM 1
2026/2027 ACCURATE REAL EXAM QUESTIONS AND VERIFIED
ANSWERS WITH DETAILED RATIONALES EACH | CURRENTLY TESTING
AND FREQUENTLY TESTED QUESTIONS |
GRADED A+
SECTION 1: CELLULAR ADAPTATION, INJURY & DEATH (Questions 1-40)
QUESTION 1:
A patient's cells are exposed to a mild, sublethal stressor. The cells respond
by decreasing their size and metabolic activity. This process is called:
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
ANSWER: C
RATIONALE: Atrophy is a decrease in cellular size and metabolic activity in
response to decreased workload, loss of innervation, diminished blood supply,
inadequate nutrition, or aging. Hypertrophy is an increase in cell size,
hyperplasia is an increase in cell number, and metaplasia is the replacement
of one differentiated cell type with another.
QUESTION 2:
A 55-year-old male with a history of hypertension develops left ventricular
enlargement. This cardiac adaptation is best described as:
A. Pathologic hypertrophy
B. Physiologic hypertrophy
C. Hyperplasia
D. Dysplasia
ANSWER: A
1
,RATIONALE: Pathologic hypertrophy occurs in response to increased workload
from conditions such as hypertension or valvular disease. In this case, the
heart muscle cells enlarge to compensate for increased afterload, but this
adaptation is maladaptive and can lead to heart failure over time.
QUESTION 3:
A woman who begins a rigorous exercise program develops increased muscle
mass.
This adaptation is best described as:
A. Pathologic hypertrophy
B. Physiologic hypertrophy
C. Hyperplasia
D. Metaplasia
ANSWER: B
RATIONALE: Physiologic hypertrophy occurs in response to increased functional
demand, such as exercise-induced muscle enlargement or uterine enlargement
during pregnancy. This adaptation is normal and reversible.
QUESTION 4:
Chronic irritation from cigarette smoking causes the normal pseudostratified
columnar epithelium of the bronchi to be replaced by stratified squamous
epithelium. This process is called:
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Dysplasia
ANSWER: C
RATIONALE: Metaplasia is the reversible replacement of one differentiated cell
2
,type with another in response to chronic irritation or inflammation. This
adaptation is protective but can increase cancer risk. Dysplasia, while also
associated with chronic irritation, involves abnormal cellular changes and is
considered preneoplastic.
QUESTION 5:
The cellular response to increased workload that results in an increase in
organ size due to an increase in cell number is called:
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
ANSWER: B
RATIONALE: Hyperplasia is an increase in the number of cells in an organ or
tissue. It can be physiologic (hormonal or compensatory) or pathologic.
Hypertrophy involves increased cell size, not cell number.
QUESTION 6:
Which of the following best describes the cellular changes in dysplasia?
A. Increased cell size only
B. Increased cell number only
C. Disordered cellular growth with abnormal size, shape, and organization
D. Replacement of one cell type with another
ANSWER: C
RATIONALE: Dysplasia is characterized by disordered cellular growth with
abnormal cell size, shape, and tissue organization. It is often associated
with chronic irritation and is considered a preneoplastic condition. Unlike
hyperplasia or metaplasia, dysplasia involves cellular atypia.
3
, QUESTION 7:
Reperfusion injury occurs when:
A. Blood flow to tissue is permanently lost
B. Blood flow is restored to ischemic tissue, causing additional damage
C. Tissue adapts to chronic hypoxia
D. Cells undergo apoptosis
ANSWER: B
RATIONALE: Reperfusion injury occurs when blood flow is restored to ischemic
tissue. The reintroduction of oxygen leads to the generation of reactive
oxygen species (ROS) and inflammation, causing additional cellular damage
beyond that caused by the initial ischemic event.
QUESTION 8:
What is the most common cause of cellular injury leading to necrosis?
A. Hypoxia
B. Genetic mutations
C. Immune reactions
D. Nutritional imbalances
ANSWER: A
RATIONALE: Hypoxia (oxygen deprivation) is the most common cause of cellular
injury. It results from ischemia, anemia, pulmonary disease, or carbon
monoxide poisoning. Hypoxia impairs ATP production, leading to cellular
dysfunction and eventually necrosis.
QUESTION 9:
4
2026/2027 ACCURATE REAL EXAM QUESTIONS AND VERIFIED
ANSWERS WITH DETAILED RATIONALES EACH | CURRENTLY TESTING
AND FREQUENTLY TESTED QUESTIONS |
GRADED A+
SECTION 1: CELLULAR ADAPTATION, INJURY & DEATH (Questions 1-40)
QUESTION 1:
A patient's cells are exposed to a mild, sublethal stressor. The cells respond
by decreasing their size and metabolic activity. This process is called:
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
ANSWER: C
RATIONALE: Atrophy is a decrease in cellular size and metabolic activity in
response to decreased workload, loss of innervation, diminished blood supply,
inadequate nutrition, or aging. Hypertrophy is an increase in cell size,
hyperplasia is an increase in cell number, and metaplasia is the replacement
of one differentiated cell type with another.
QUESTION 2:
A 55-year-old male with a history of hypertension develops left ventricular
enlargement. This cardiac adaptation is best described as:
A. Pathologic hypertrophy
B. Physiologic hypertrophy
C. Hyperplasia
D. Dysplasia
ANSWER: A
1
,RATIONALE: Pathologic hypertrophy occurs in response to increased workload
from conditions such as hypertension or valvular disease. In this case, the
heart muscle cells enlarge to compensate for increased afterload, but this
adaptation is maladaptive and can lead to heart failure over time.
QUESTION 3:
A woman who begins a rigorous exercise program develops increased muscle
mass.
This adaptation is best described as:
A. Pathologic hypertrophy
B. Physiologic hypertrophy
C. Hyperplasia
D. Metaplasia
ANSWER: B
RATIONALE: Physiologic hypertrophy occurs in response to increased functional
demand, such as exercise-induced muscle enlargement or uterine enlargement
during pregnancy. This adaptation is normal and reversible.
QUESTION 4:
Chronic irritation from cigarette smoking causes the normal pseudostratified
columnar epithelium of the bronchi to be replaced by stratified squamous
epithelium. This process is called:
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Dysplasia
ANSWER: C
RATIONALE: Metaplasia is the reversible replacement of one differentiated cell
2
,type with another in response to chronic irritation or inflammation. This
adaptation is protective but can increase cancer risk. Dysplasia, while also
associated with chronic irritation, involves abnormal cellular changes and is
considered preneoplastic.
QUESTION 5:
The cellular response to increased workload that results in an increase in
organ size due to an increase in cell number is called:
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
ANSWER: B
RATIONALE: Hyperplasia is an increase in the number of cells in an organ or
tissue. It can be physiologic (hormonal or compensatory) or pathologic.
Hypertrophy involves increased cell size, not cell number.
QUESTION 6:
Which of the following best describes the cellular changes in dysplasia?
A. Increased cell size only
B. Increased cell number only
C. Disordered cellular growth with abnormal size, shape, and organization
D. Replacement of one cell type with another
ANSWER: C
RATIONALE: Dysplasia is characterized by disordered cellular growth with
abnormal cell size, shape, and tissue organization. It is often associated
with chronic irritation and is considered a preneoplastic condition. Unlike
hyperplasia or metaplasia, dysplasia involves cellular atypia.
3
, QUESTION 7:
Reperfusion injury occurs when:
A. Blood flow to tissue is permanently lost
B. Blood flow is restored to ischemic tissue, causing additional damage
C. Tissue adapts to chronic hypoxia
D. Cells undergo apoptosis
ANSWER: B
RATIONALE: Reperfusion injury occurs when blood flow is restored to ischemic
tissue. The reintroduction of oxygen leads to the generation of reactive
oxygen species (ROS) and inflammation, causing additional cellular damage
beyond that caused by the initial ischemic event.
QUESTION 8:
What is the most common cause of cellular injury leading to necrosis?
A. Hypoxia
B. Genetic mutations
C. Immune reactions
D. Nutritional imbalances
ANSWER: A
RATIONALE: Hypoxia (oxygen deprivation) is the most common cause of cellular
injury. It results from ischemia, anemia, pulmonary disease, or carbon
monoxide poisoning. Hypoxia impairs ATP production, leading to cellular
dysfunction and eventually necrosis.
QUESTION 9:
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