NR 283 PATHO EXAM 1 TEST QUESTIONS AND ANSWERS
2026/2027 | Complete Solution | Chamberlain College of
Nursing | Aligned with Curriculum Standards | Pass
Guaranteed - A+ Graded
Unit 1: Cellular Function & Adaptation (Questions 1-20)
Q1
Scenario: A 65-year-old male with a 40-pack-year smoking history presents with a
chronic cough and dyspnea. A lung biopsy reveals enlarged cells with increased
nuclear-to-cytoplasmic ratio, hyperchromatic nuclei, and evidence of increased protein
synthesis. These cellular changes represent which adaptive response?
A. Atrophy due to chronic hypoxia
B. Hypertrophy in response to increased workload
C. Hyperplasia secondary to chronic irritation
D. Metaplasia with dysplastic changes [CORRECT]
Correct Answer: D
,Rationale: This scenario describes metaplasia with dysplastic changes, which
represents an adaptive cellular response to chronic irritation (cigarette smoke) that has
progressed toward neoplasia.
Pathophysiological Mechanism:
● Metaplasia: Reversible change where one differentiated cell type is replaced by
another cell type better suited to withstand stress. In smokers, normal ciliated
pseudostratified columnar epithelium transforms to stratified squamous
epithelium (squamous metaplasia) to better withstand chemical irritation.
● Dysplasia: Disordered, dysfunctional growth with cellular atypia (enlarged cells,
increased nuclear-to-cytoplasmic ratio, hyperchromatic nuclei). This represents a
preneoplastic change that may progress to carcinoma.
Why other options are incorrect:
● A (Atrophy): Incorrect because atrophy involves decreased cell size and function,
not enlarged cells with increased protein synthesis. Atrophy would present with
smaller cells, not cellular enlargement.
● B (Hypertrophy): While hypertrophy involves increased cell size, it maintains
normal cellular architecture and nuclear-to-cytoplasmic ratio. Hypertrophy is a
response to increased functional demand (e.g., cardiac muscle in hypertension),
not chronic chemical irritation with atypia.
● C (Hyperplasia): Hyperplasia involves increased cell numbers, not necessarily
cellular enlargement with atypia. While smoking can cause basal cell hyperplasia,
the described cellular changes (enlarged cells, hyperchromatic nuclei)
specifically indicate dysplasia, not simple hyperplasia.
Q2
,Scenario: A 45-year-old female undergoes bilateral mastectomy with immediate breast
reconstruction using tissue expanders. Six months post-surgery, histological
examination of the expanded breast tissue reveals individual cells with increased size,
increased organelle numbers, and preserved normal architecture. Which cellular
adaptation is demonstrated?
A. Hyperplasia of adipose tissue
B. Hypertrophy of skin and underlying tissue [CORRECT]
C. Atrophy of mammary glandular tissue
D. Metaplasia of epithelial cells
Correct Answer: B
Rationale: This scenario demonstrates hypertrophy of skin and underlying tissue in
response to mechanical stretch from tissue expanders.
Pathophysiological Mechanism:
● Hypertrophy: Increase in cell size (not cell number) resulting in increased tissue
mass. Individual cells synthesize more proteins and increase organelle numbers
to meet increased functional demands.
● Mechanical stretch is a potent stimulus for cellular hypertrophy. Skin and
connective tissue cells respond to sustained tension by increasing their size and
extracellular matrix production.
● Preserved architecture distinguishes hypertrophy from dysplasia or neoplasia.
, Why other options are incorrect:
● A (Hyperplasia): Incorrect because hyperplasia involves increased cell numbers
through mitosis. While some hyperplasia may occur, the primary adaptive
response to mechanical stretch is cellular enlargement (hypertrophy), not
proliferation.
● C (Atrophy): Opposite of what is described. Atrophy involves decreased cell size
and function due to decreased workload or disuse. The tissue is expanding, not
shrinking.
● D (Metaplasia): Incorrect because there is no change from one differentiated cell
type to another. The cells maintain their original phenotype while increasing in
size.
Q3
Scenario: A 28-year-old athlete discontinues training for 3 months due to injury. Muscle
biopsy of the quadriceps reveals decreased cell size, increased autophagic vacuoles,
and reduced organelle numbers. These findings represent which cellular process?
A. Apoptosis programmed cell death
B. Atrophy due to disuse [CORRECT]
C. Necrosis from ischemic injury
D. Metaplasia of muscle fibers
Correct Answer: B
2026/2027 | Complete Solution | Chamberlain College of
Nursing | Aligned with Curriculum Standards | Pass
Guaranteed - A+ Graded
Unit 1: Cellular Function & Adaptation (Questions 1-20)
Q1
Scenario: A 65-year-old male with a 40-pack-year smoking history presents with a
chronic cough and dyspnea. A lung biopsy reveals enlarged cells with increased
nuclear-to-cytoplasmic ratio, hyperchromatic nuclei, and evidence of increased protein
synthesis. These cellular changes represent which adaptive response?
A. Atrophy due to chronic hypoxia
B. Hypertrophy in response to increased workload
C. Hyperplasia secondary to chronic irritation
D. Metaplasia with dysplastic changes [CORRECT]
Correct Answer: D
,Rationale: This scenario describes metaplasia with dysplastic changes, which
represents an adaptive cellular response to chronic irritation (cigarette smoke) that has
progressed toward neoplasia.
Pathophysiological Mechanism:
● Metaplasia: Reversible change where one differentiated cell type is replaced by
another cell type better suited to withstand stress. In smokers, normal ciliated
pseudostratified columnar epithelium transforms to stratified squamous
epithelium (squamous metaplasia) to better withstand chemical irritation.
● Dysplasia: Disordered, dysfunctional growth with cellular atypia (enlarged cells,
increased nuclear-to-cytoplasmic ratio, hyperchromatic nuclei). This represents a
preneoplastic change that may progress to carcinoma.
Why other options are incorrect:
● A (Atrophy): Incorrect because atrophy involves decreased cell size and function,
not enlarged cells with increased protein synthesis. Atrophy would present with
smaller cells, not cellular enlargement.
● B (Hypertrophy): While hypertrophy involves increased cell size, it maintains
normal cellular architecture and nuclear-to-cytoplasmic ratio. Hypertrophy is a
response to increased functional demand (e.g., cardiac muscle in hypertension),
not chronic chemical irritation with atypia.
● C (Hyperplasia): Hyperplasia involves increased cell numbers, not necessarily
cellular enlargement with atypia. While smoking can cause basal cell hyperplasia,
the described cellular changes (enlarged cells, hyperchromatic nuclei)
specifically indicate dysplasia, not simple hyperplasia.
Q2
,Scenario: A 45-year-old female undergoes bilateral mastectomy with immediate breast
reconstruction using tissue expanders. Six months post-surgery, histological
examination of the expanded breast tissue reveals individual cells with increased size,
increased organelle numbers, and preserved normal architecture. Which cellular
adaptation is demonstrated?
A. Hyperplasia of adipose tissue
B. Hypertrophy of skin and underlying tissue [CORRECT]
C. Atrophy of mammary glandular tissue
D. Metaplasia of epithelial cells
Correct Answer: B
Rationale: This scenario demonstrates hypertrophy of skin and underlying tissue in
response to mechanical stretch from tissue expanders.
Pathophysiological Mechanism:
● Hypertrophy: Increase in cell size (not cell number) resulting in increased tissue
mass. Individual cells synthesize more proteins and increase organelle numbers
to meet increased functional demands.
● Mechanical stretch is a potent stimulus for cellular hypertrophy. Skin and
connective tissue cells respond to sustained tension by increasing their size and
extracellular matrix production.
● Preserved architecture distinguishes hypertrophy from dysplasia or neoplasia.
, Why other options are incorrect:
● A (Hyperplasia): Incorrect because hyperplasia involves increased cell numbers
through mitosis. While some hyperplasia may occur, the primary adaptive
response to mechanical stretch is cellular enlargement (hypertrophy), not
proliferation.
● C (Atrophy): Opposite of what is described. Atrophy involves decreased cell size
and function due to decreased workload or disuse. The tissue is expanding, not
shrinking.
● D (Metaplasia): Incorrect because there is no change from one differentiated cell
type to another. The cells maintain their original phenotype while increasing in
size.
Q3
Scenario: A 28-year-old athlete discontinues training for 3 months due to injury. Muscle
biopsy of the quadriceps reveals decreased cell size, increased autophagic vacuoles,
and reduced organelle numbers. These findings represent which cellular process?
A. Apoptosis programmed cell death
B. Atrophy due to disuse [CORRECT]
C. Necrosis from ischemic injury
D. Metaplasia of muscle fibers
Correct Answer: B
