Page 1 of 40
NSG 530 EXAM 1 – 2026 WILKES ADVANCED
PATHOPHYSIOLOGY COMPLETE (110) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
NSG
Prepare for the NSG 530 Exam 1 – Wilkes Advanced Pathophysiology with this
comprehensive practice resource designed to strengthen your advanced nursing
knowledge and exam readiness. It features exam-style questions covering disease
processes, cellular adaptations, genetic influences, immune responses,
inflammation, fluid and electrolyte balance, and advanced pathophysiological
concepts. Use it to reinforce essential concepts, assess your understanding, and build
confidence before test day. An excellent study aid for Wilkes University nursing
students preparing for the NSG 530 Advanced Pathophysiology Exam 1.
MULTIPLE CHOICE.
CELLULAR ADAPTATIONS & INJURY (Questions 1–25)
Question 1: A cell is exposed to a toxin that damages mitochondrial DNA.
Which cellular function will be most immediately impaired?
A) Protein synthesis
B) ATP production
C) Lipid synthesis
D) DNA replication
Correct answer: B) ATP production
Rationale: Mitochondria are the primary site of oxidative phosphorylation and
ATP production. Damage to mitochondrial DNA impairs the electron transport
chain, reducing ATP synthesis. Cells with high energy demands (neurons,
cardiac muscle) are most vulnerable .
Question 2: Which type of cellular adaptation involves an increase in the
number of cells in a tissue?
A) Hypertrophy
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B) Hyperplasia
C) Atrophy
D) Metaplasia
Correct answer: B) Hyperplasia
Rationale: Hyperplasia is an increase in cell number due to increased mitotic
division. It occurs in tissues capable of mitosis (e.g., endometrium during the
menstrual cycle, liver regeneration). Hypertrophy is an increase in cell size .
Question 3: A patient with chronic hypoxia develops increased red blood cell
production. This is an example of:
A) Physiologic hypertrophy
B) Pathologic hyperplasia
C) Physiologic hyperplasia
D) Metaplasia
Correct answer: C) Physiologic hyperplasia
Rationale: Increased erythropoietin production in response to hypoxia
stimulates bone marrow hyperplasia, increasing RBC production. This is a
compensatory, physiologic response .
Question 4: Which cellular change is considered a reversible response to
injury?
A) Necrosis
B) Apoptosis
C) Cellular swelling
D) Karyolysis
Correct answer: C) Cellular swelling
Rationale: Cellular swelling (hydropic change) is the earliest and most
reversible manifestation of cell injury. It results from failure of the Na+/K+
pump, leading to intracellular water accumulation .
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Question 5: When a cast is removed from a patient's left calf, the calf is
smaller than the right calf. This is an example of:
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Dysplasia
Correct answer: C) Atrophy
Rationale: Atrophy is a decrease in cell size. Disuse atrophy occurs when a
muscle is immobilized and not used, leading to decreased muscle mass .
Question 6: The lining of the uterus thickens after ovulation because of
increased amounts of estrogen. This is an example of:
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Dysplasia
Correct answer: B) Hyperplasia
Rationale: The endometrial lining thickens due to an increase in the number
of cells (hyperplasia) in response to hormonal stimulation .
Question 7: Columnar epithelium in the bronchi of a cigarette smoker is
replaced by stratified squamous epithelium after smoking cessation. This is
an example of:
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Dysplasia
Correct answer: C) Metaplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type
by another, less mature cell type or change in cell phenotype .
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Question 8: Cells of the cervix can be classified on PAP as high grade or low
grade depending on how abnormal the cells have become in size and shape.
This is an example of:
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Dysplasia
Correct answer: D) Dysplasia
Rationale: Dysplasia is deranged cellular growth characterized by abnormal
cell size, shape, and organization. It is not considered a true cellular
adaptation but rather atypical hyperplasia .
Question 9: A patient with chronic gastroesophageal reflux disease (GERD)
develops Barrett esophagus. This is an example of which cellular adaptation?
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Correct answer: D) Metaplasia
Rationale: Barrett esophagus is metaplasia of normal squamous epithelium
to columnar epithelium in response to chronic acid exposure .
Question 10: Which type of necrosis is most commonly seen in cardiac
muscle following a myocardial infarction?
A) Liquefactive necrosis
B) Coagulative necrosis
C) Caseous necrosis
D) Fat necrosis
Correct answer: B) Coagulative necrosis
Rationale: Coagulative necrosis is characteristic of ischemic injury in solid
organs (heart, kidney, liver) except the brain. It preserves tissue architecture
for several days .
NSG 530 EXAM 1 – 2026 WILKES ADVANCED
PATHOPHYSIOLOGY COMPLETE (110) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
NSG
Prepare for the NSG 530 Exam 1 – Wilkes Advanced Pathophysiology with this
comprehensive practice resource designed to strengthen your advanced nursing
knowledge and exam readiness. It features exam-style questions covering disease
processes, cellular adaptations, genetic influences, immune responses,
inflammation, fluid and electrolyte balance, and advanced pathophysiological
concepts. Use it to reinforce essential concepts, assess your understanding, and build
confidence before test day. An excellent study aid for Wilkes University nursing
students preparing for the NSG 530 Advanced Pathophysiology Exam 1.
MULTIPLE CHOICE.
CELLULAR ADAPTATIONS & INJURY (Questions 1–25)
Question 1: A cell is exposed to a toxin that damages mitochondrial DNA.
Which cellular function will be most immediately impaired?
A) Protein synthesis
B) ATP production
C) Lipid synthesis
D) DNA replication
Correct answer: B) ATP production
Rationale: Mitochondria are the primary site of oxidative phosphorylation and
ATP production. Damage to mitochondrial DNA impairs the electron transport
chain, reducing ATP synthesis. Cells with high energy demands (neurons,
cardiac muscle) are most vulnerable .
Question 2: Which type of cellular adaptation involves an increase in the
number of cells in a tissue?
A) Hypertrophy
, Page 2 of 40
B) Hyperplasia
C) Atrophy
D) Metaplasia
Correct answer: B) Hyperplasia
Rationale: Hyperplasia is an increase in cell number due to increased mitotic
division. It occurs in tissues capable of mitosis (e.g., endometrium during the
menstrual cycle, liver regeneration). Hypertrophy is an increase in cell size .
Question 3: A patient with chronic hypoxia develops increased red blood cell
production. This is an example of:
A) Physiologic hypertrophy
B) Pathologic hyperplasia
C) Physiologic hyperplasia
D) Metaplasia
Correct answer: C) Physiologic hyperplasia
Rationale: Increased erythropoietin production in response to hypoxia
stimulates bone marrow hyperplasia, increasing RBC production. This is a
compensatory, physiologic response .
Question 4: Which cellular change is considered a reversible response to
injury?
A) Necrosis
B) Apoptosis
C) Cellular swelling
D) Karyolysis
Correct answer: C) Cellular swelling
Rationale: Cellular swelling (hydropic change) is the earliest and most
reversible manifestation of cell injury. It results from failure of the Na+/K+
pump, leading to intracellular water accumulation .
, Page 3 of 40
Question 5: When a cast is removed from a patient's left calf, the calf is
smaller than the right calf. This is an example of:
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Dysplasia
Correct answer: C) Atrophy
Rationale: Atrophy is a decrease in cell size. Disuse atrophy occurs when a
muscle is immobilized and not used, leading to decreased muscle mass .
Question 6: The lining of the uterus thickens after ovulation because of
increased amounts of estrogen. This is an example of:
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Dysplasia
Correct answer: B) Hyperplasia
Rationale: The endometrial lining thickens due to an increase in the number
of cells (hyperplasia) in response to hormonal stimulation .
Question 7: Columnar epithelium in the bronchi of a cigarette smoker is
replaced by stratified squamous epithelium after smoking cessation. This is
an example of:
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Dysplasia
Correct answer: C) Metaplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type
by another, less mature cell type or change in cell phenotype .
, Page 4 of 40
Question 8: Cells of the cervix can be classified on PAP as high grade or low
grade depending on how abnormal the cells have become in size and shape.
This is an example of:
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Dysplasia
Correct answer: D) Dysplasia
Rationale: Dysplasia is deranged cellular growth characterized by abnormal
cell size, shape, and organization. It is not considered a true cellular
adaptation but rather atypical hyperplasia .
Question 9: A patient with chronic gastroesophageal reflux disease (GERD)
develops Barrett esophagus. This is an example of which cellular adaptation?
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Correct answer: D) Metaplasia
Rationale: Barrett esophagus is metaplasia of normal squamous epithelium
to columnar epithelium in response to chronic acid exposure .
Question 10: Which type of necrosis is most commonly seen in cardiac
muscle following a myocardial infarction?
A) Liquefactive necrosis
B) Coagulative necrosis
C) Caseous necrosis
D) Fat necrosis
Correct answer: B) Coagulative necrosis
Rationale: Coagulative necrosis is characteristic of ischemic injury in solid
organs (heart, kidney, liver) except the brain. It preserves tissue architecture
for several days .
