TEST BANK PATHOPHYSIOLOGY A PRACTICAL
APPROACH 4TH EDITION BY LACHEL STORY
CHAPTERS 1 - 14 UPDATED 2026 PRACTICAL
REVISON QUESTIONS FOR EXAM GRADED A+
,List of Chapters
1. Chapter 1: Cellular Function
2. Chapter 2: Immunity
3. Chapter 3: Hematopoietic Function
4. Chapter 4: Cardiovascular Function
5. Chapter 5: Respiratory Function
6. Chapter 6: Fluid, Electrolyte, and Acid-Base Homeostasis
7. Chapter 7: Urinary Function
8. Chapter 8: Reproductive Function
9. Chapter 9: Gastrointestinal Function
10.Chapter 10: Endocrine Function
11.Chapter 11: Neural Function
12.Chapter 12: Musculoskeletal Function
13.Chapter 13: Integumentary Function
14.Chapter 14: Sensory Function
,Chapter 1 Summary: Cellular Function
This foundational chapter explores the pathophysiology of disease at the cellular
level. It reviews normal cellular structure and function before detailing the
processes of cellular injury, adaptation (atrophy, hypertrophy, hyperplasia,
metaplasia, dysplasia), and death (necrosis, apoptosis). Key concepts include
the role of free radicals, hypoxia, and the inflammatory response to injury.
Chapter 1 Test Bank: 50 NCLEX-Style Questions
Question 1
A patient with chronic hypertension has an enlarged left ventricular wall on
echocardiogram. This cardiac change is an example of which cellular
adaptation?
A) Atrophy
B) Hypertrophy
C) Hyperplasia
D) Metaplasia
Answer: B
Rationale: Hypertrophy is the increase in the size of cells in response to
increased workload. The left ventricular muscle cells enlarge to pump against
elevated systemic pressure, leading to a thicker heart wall.
Question 2
Which of the following is the most common cause of cellular injury?
A) Chemical toxins
B) Physical trauma
C) Hypoxia
D) Infectious agents
Answer: C
Rationale: Hypoxia, or inadequate oxygen delivery to cells, is the most
common cause of cellular injury. It impairs aerobic metabolism, leading to a
cascade of dysfunction, often due to ischemia (loss of blood flow).
Question 3
A patient with chronic gastroesophageal reflux disease (GERD) has a biopsy
showing that the normal squamous epithelium in the lower esophagus has been
replaced by columnar epithelium. This change is termed:
A) Dysplasia
B) Hyperplasia
C) Metaplasia
, D) Anaplasia
Answer: C
Rationale: Metaplasia is the reversible replacement of one mature cell type by
another, often in response to chronic irritation. In GERD, the acid-resistant
columnar cells replace squamous cells as an adaptive, though abnormal,
response.
Question 4
The irreversible loss of function that occurs when cells are unable to maintain
homeostasis, characterized by nuclear changes like pyknosis and karyorrhexis,
is defined as:
A) Adaptation
B) Apoptosis
C) Necrosis
D) Ischemia
Answer: C
Rationale: Necrosis is the pathologic death of cells and living tissue,
characterized by cell swelling, rupture, and nuclear disintegration (pyknosis,
karyorrhexis, karyolysis). It triggers inflammation.
Question 5
Which type of cellular adaptation is characterized by an increase in
the number of cells in an organ or tissue?
A) Hypertrophy
B) Atrophy
C) Hyperplasia
D) Metaplasia
Answer: C
Rationale: Hyperplasia is an increase in the number of cells. This can be
physiologic (e.g., breast tissue during pregnancy) or pathologic (e.g.,
endometrial hyperplasia).
Question 6
Free radicals cause cellular injury primarily by:
A) Depleting cellular glycogen stores
B) Damaging cell membranes via lipid peroxidation
C) Blocking protein synthesis
D) Increasing intracellular pH
Answer: B
Rationale: Free radicals are unstable molecules with an unpaired electron. They
cause injury by stealing electrons from stable molecules, particularly lipids in
APPROACH 4TH EDITION BY LACHEL STORY
CHAPTERS 1 - 14 UPDATED 2026 PRACTICAL
REVISON QUESTIONS FOR EXAM GRADED A+
,List of Chapters
1. Chapter 1: Cellular Function
2. Chapter 2: Immunity
3. Chapter 3: Hematopoietic Function
4. Chapter 4: Cardiovascular Function
5. Chapter 5: Respiratory Function
6. Chapter 6: Fluid, Electrolyte, and Acid-Base Homeostasis
7. Chapter 7: Urinary Function
8. Chapter 8: Reproductive Function
9. Chapter 9: Gastrointestinal Function
10.Chapter 10: Endocrine Function
11.Chapter 11: Neural Function
12.Chapter 12: Musculoskeletal Function
13.Chapter 13: Integumentary Function
14.Chapter 14: Sensory Function
,Chapter 1 Summary: Cellular Function
This foundational chapter explores the pathophysiology of disease at the cellular
level. It reviews normal cellular structure and function before detailing the
processes of cellular injury, adaptation (atrophy, hypertrophy, hyperplasia,
metaplasia, dysplasia), and death (necrosis, apoptosis). Key concepts include
the role of free radicals, hypoxia, and the inflammatory response to injury.
Chapter 1 Test Bank: 50 NCLEX-Style Questions
Question 1
A patient with chronic hypertension has an enlarged left ventricular wall on
echocardiogram. This cardiac change is an example of which cellular
adaptation?
A) Atrophy
B) Hypertrophy
C) Hyperplasia
D) Metaplasia
Answer: B
Rationale: Hypertrophy is the increase in the size of cells in response to
increased workload. The left ventricular muscle cells enlarge to pump against
elevated systemic pressure, leading to a thicker heart wall.
Question 2
Which of the following is the most common cause of cellular injury?
A) Chemical toxins
B) Physical trauma
C) Hypoxia
D) Infectious agents
Answer: C
Rationale: Hypoxia, or inadequate oxygen delivery to cells, is the most
common cause of cellular injury. It impairs aerobic metabolism, leading to a
cascade of dysfunction, often due to ischemia (loss of blood flow).
Question 3
A patient with chronic gastroesophageal reflux disease (GERD) has a biopsy
showing that the normal squamous epithelium in the lower esophagus has been
replaced by columnar epithelium. This change is termed:
A) Dysplasia
B) Hyperplasia
C) Metaplasia
, D) Anaplasia
Answer: C
Rationale: Metaplasia is the reversible replacement of one mature cell type by
another, often in response to chronic irritation. In GERD, the acid-resistant
columnar cells replace squamous cells as an adaptive, though abnormal,
response.
Question 4
The irreversible loss of function that occurs when cells are unable to maintain
homeostasis, characterized by nuclear changes like pyknosis and karyorrhexis,
is defined as:
A) Adaptation
B) Apoptosis
C) Necrosis
D) Ischemia
Answer: C
Rationale: Necrosis is the pathologic death of cells and living tissue,
characterized by cell swelling, rupture, and nuclear disintegration (pyknosis,
karyorrhexis, karyolysis). It triggers inflammation.
Question 5
Which type of cellular adaptation is characterized by an increase in
the number of cells in an organ or tissue?
A) Hypertrophy
B) Atrophy
C) Hyperplasia
D) Metaplasia
Answer: C
Rationale: Hyperplasia is an increase in the number of cells. This can be
physiologic (e.g., breast tissue during pregnancy) or pathologic (e.g.,
endometrial hyperplasia).
Question 6
Free radicals cause cellular injury primarily by:
A) Depleting cellular glycogen stores
B) Damaging cell membranes via lipid peroxidation
C) Blocking protein synthesis
D) Increasing intracellular pH
Answer: B
Rationale: Free radicals are unstable molecules with an unpaired electron. They
cause injury by stealing electrons from stable molecules, particularly lipids in
