NR-283 Verified Comprehensive High-Yield
Exam Review — Pathophysiology |
Chamberlain College of Nursing | Q & A |
2026/2027 Edition
1. A patient has had a leg cast for 6 weeks. Upon removal, the muscles appear smaller. This is an
example of:
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Correct Answer: Atrophy
Rationale: Atrophy is a decrease in cell size due to disuse, denervation, or reduced blood supply.
The cast caused immobilization → reduced workload → muscle cells shrink. Atrophy is
reversible if the stimulus is removed (muscle regrowth after cast removal). Hyperplasia is an
increase in cell number, hypertrophy is an increase in cell size, and metaplasia is the
replacement of one mature cell type by another .
,2. A patient with long-standing, untreated hypertension undergoes an echocardiogram. The
results reveal significant thickening of the left ventricular wall. Which cellular adaptation has
occurred?
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Dysplasia
Correct Answer: Hypertrophy
Rationale: Hypertrophy is an increase in the size of individual cells, often caused by an increased
mechanical workload or stress, such as the heart pumping against high systemic vascular
resistance. Hyperplasia is an increase in cell number, metaplasia is a reversible change from one
mature cell type to another, and dysplasia is disordered cell growth .
3. A tissue biopsy of a chronic smoker's bronchi reveals that normal ciliated columnar epithelial
cells have been replaced by stratified squamous epithelial cells. This is an example of which
process?
A) Anaplasia
B) Metaplasia
C) Dysplasia
D) Atrophy
Correct Answer: Metaplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type by another mature
cell type, usually as an adaptive response to chronic irritation or injury. Ciliated columnar
,epithelium is replaced by stratified squamous epithelium in chronic smokers. Anaplasia is a lack
of differentiation, dysplasia is disordered growth, and atrophy is decreased cell size .
4. During an ischemic event, a lack of oxygen leads to a decrease in cellular ATP production.
Which immediate consequence occurs within the cell?
A) Shrinkage of the nucleus
B) Failure of the sodium-potassium pump, leading to cellular swelling
C) Decreased intracellular calcium levels
D) Increased intracellular pH
Correct Answer: Failure of the sodium-potassium pump, leading to cellular swelling
Rationale: Decreased ATP causes the Na⁺/K⁺ ATPase pump to fail. Sodium accumulates inside
the cell, pulling water in by osmosis, which results in acute cellular swelling. This is one of the
earliest signs of reversible cell injury .
5. Which of the following is the most common cause of cellular injury?
A) Chemical injury from drugs
B) Free radical-induced injury
C) Hypoxia
D) Chemical injury from pollutants
Correct Answer: Hypoxia
, Rationale: Hypoxia is the most common cause of cellular injury. Cells require oxygen for aerobic
metabolism and ATP production. When oxygen supply is inadequate, cells switch to anaerobic
metabolism, leading to decreased ATP production, lactic acidosis, and eventual cell death .
6. A patient experiences myocardial infarction due to arterial occlusion. Which type of cellular
necrosis occurs in the myocardial tissue?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
Correct Answer: Coagulative necrosis
Rationale: Coagulative necrosis typically occurs in solid organs like the heart, kidneys, and
adrenal glands following severe ischemia, preserving the basic structural outline of the tissue
for several days. Liquefactive necrosis occurs in the brain, caseous necrosis in tuberculosis, and
fat necrosis in pancreatitis or breast tissue trauma .
7. A pathology report shows that a patient's tissue sample contains cellular injury characterized
by the activation of digestive lipases, which break down intracellular triglycerides into free fatty
acids that combine with calcium to form chalky white deposits. The nurse knows this describes:
A) Coagulative necrosis
B) Caseous necrosis
C) Liquefactive necrosis
D) Fat necrosis
Correct Answer: Fat necrosis
Exam Review — Pathophysiology |
Chamberlain College of Nursing | Q & A |
2026/2027 Edition
1. A patient has had a leg cast for 6 weeks. Upon removal, the muscles appear smaller. This is an
example of:
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Correct Answer: Atrophy
Rationale: Atrophy is a decrease in cell size due to disuse, denervation, or reduced blood supply.
The cast caused immobilization → reduced workload → muscle cells shrink. Atrophy is
reversible if the stimulus is removed (muscle regrowth after cast removal). Hyperplasia is an
increase in cell number, hypertrophy is an increase in cell size, and metaplasia is the
replacement of one mature cell type by another .
,2. A patient with long-standing, untreated hypertension undergoes an echocardiogram. The
results reveal significant thickening of the left ventricular wall. Which cellular adaptation has
occurred?
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Dysplasia
Correct Answer: Hypertrophy
Rationale: Hypertrophy is an increase in the size of individual cells, often caused by an increased
mechanical workload or stress, such as the heart pumping against high systemic vascular
resistance. Hyperplasia is an increase in cell number, metaplasia is a reversible change from one
mature cell type to another, and dysplasia is disordered cell growth .
3. A tissue biopsy of a chronic smoker's bronchi reveals that normal ciliated columnar epithelial
cells have been replaced by stratified squamous epithelial cells. This is an example of which
process?
A) Anaplasia
B) Metaplasia
C) Dysplasia
D) Atrophy
Correct Answer: Metaplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type by another mature
cell type, usually as an adaptive response to chronic irritation or injury. Ciliated columnar
,epithelium is replaced by stratified squamous epithelium in chronic smokers. Anaplasia is a lack
of differentiation, dysplasia is disordered growth, and atrophy is decreased cell size .
4. During an ischemic event, a lack of oxygen leads to a decrease in cellular ATP production.
Which immediate consequence occurs within the cell?
A) Shrinkage of the nucleus
B) Failure of the sodium-potassium pump, leading to cellular swelling
C) Decreased intracellular calcium levels
D) Increased intracellular pH
Correct Answer: Failure of the sodium-potassium pump, leading to cellular swelling
Rationale: Decreased ATP causes the Na⁺/K⁺ ATPase pump to fail. Sodium accumulates inside
the cell, pulling water in by osmosis, which results in acute cellular swelling. This is one of the
earliest signs of reversible cell injury .
5. Which of the following is the most common cause of cellular injury?
A) Chemical injury from drugs
B) Free radical-induced injury
C) Hypoxia
D) Chemical injury from pollutants
Correct Answer: Hypoxia
, Rationale: Hypoxia is the most common cause of cellular injury. Cells require oxygen for aerobic
metabolism and ATP production. When oxygen supply is inadequate, cells switch to anaerobic
metabolism, leading to decreased ATP production, lactic acidosis, and eventual cell death .
6. A patient experiences myocardial infarction due to arterial occlusion. Which type of cellular
necrosis occurs in the myocardial tissue?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
Correct Answer: Coagulative necrosis
Rationale: Coagulative necrosis typically occurs in solid organs like the heart, kidneys, and
adrenal glands following severe ischemia, preserving the basic structural outline of the tissue
for several days. Liquefactive necrosis occurs in the brain, caseous necrosis in tuberculosis, and
fat necrosis in pancreatitis or breast tissue trauma .
7. A pathology report shows that a patient's tissue sample contains cellular injury characterized
by the activation of digestive lipases, which break down intracellular triglycerides into free fatty
acids that combine with calcium to form chalky white deposits. The nurse knows this describes:
A) Coagulative necrosis
B) Caseous necrosis
C) Liquefactive necrosis
D) Fat necrosis
Correct Answer: Fat necrosis
