NUR 631 Exam Test Bank – Midterm and Final (350 Q&A) | Advanced Physiology and Pathophysiology | Grand Canyon University | Complete Study Guide with Rationales | Already Graded A

NUR 631 Exam Test Bank – Midterm and Final
(350 Q&A) | Advanced Physiology and
Pathophysiology | Grand Canyon University |
Complete Study Guide with Rationales | Already
Graded A

Cellular Adaptation, Injury, & Death (Q1–20)

Q1. A patient with a chronic kidney stone causing unilateral hydronephrosis shows
kidney shrinkage. This is best described as:

 A) Hyperplasia
 B) Hypertrophy
 C) Atrophy ✅
 D) Metaplasia

Explanation: Atrophy is a decrease in cell size due to reduced workload or blood supply.
Prolonged obstruction causes pressure atrophy.

Q2. Which type of necrosis is most commonly seen in the heart after a myocardial
infarction?

 A) Coagulative necrosis ✅
 B) Liquefactive necrosis
 C) Caseous necrosis
 D) Fat necrosis

Explanation: Coagulative necrosis preserves tissue architecture for days and occurs in solid
organs (heart, kidney, liver) after ischemia.

, Q3. A patient with tuberculosis has a lung lesion with "cheese-like" appearance. This is:

 A) Coagulative necrosis
 B) Liquefactive necrosis
 C) Caseous necrosis ✅
 D) Gangrenous necrosis

Explanation: Caseous necrosis is a combination of coagulative and liquefactive necrosis
with a granular, friable appearance, typical of TB.

Q4. Which cellular change is irreversible?

 A) Swelling of mitochondria
 B) Detachment of ribosomes
 C) Nuclear pyknosis ✅
 D) Loss of microvilli

Explanation: Nuclear changes (pyknosis, karyorrhexis, karyolysis) indicate irreversible
injury and cell death.

Q5. Apoptosis is characterized by:

 A) Inflammation
 B) Cell swelling
 C) Caspase activation ✅
 D) Random DNA fragmentation

Explanation: Apoptosis is programmed cell death mediated by caspases, without
inflammation. DNA fragments in a "ladder" pattern.

Q6. Reperfusion injury after ischemia is primarily caused by:

 A) Hypoxia
 B) ATP depletion

, C) Reactive oxygen species ✅
 D) Lactic acidosis

Explanation: ROS (free radicals) form upon reoxygenation, damaging cell membranes,
proteins, and DNA.

Q7. A patient with pancreatitis has chalky white deposits in the abdomen. This is:

 A) Coagulative necrosis
 B) Fat necrosis ✅
 C) Fibrinoid necrosis
 D) Gangrenous necrosis

Explanation: Pancreatic enzymes (lipase) digest fat into fatty acids, which bind calcium →
saponification (chalky white).

Q8. Which organ is most susceptible to liquefactive necrosis?

 A) Heart
 B) Kidney
 C) Brain ✅
 D) Liver

Explanation: Brain has high lipid content and few connective tissue → enzymatic digestion
forms a cystic cavity.

Q9. A patient with malignant hypertension shows vascular wall necrosis with
eosinophilic deposits. This is:

 A) Coagulative necrosis
 B) Fat necrosis
 C) Fibrinoid necrosis ✅
 D) Gangrene

, Explanation: Fibrinoid necrosis occurs in blood vessels from immune complexes or severe
hypertension, with fibrin deposition in the vessel wall.

Q10. Cellular swelling and fatty change are examples of:

 A) Irreversible injury
 B) Reversible injury ✅
 C) Necrosis
 D) Apoptosis

Explanation: Reversible injury shows cellular swelling, fatty change, and ribosome
detachment; these reverse with restored blood flow.

Q11. Which finding is not seen in reversible cell injury?

 A) Blebbing of plasma membrane
 B) Clumping of chromatin
 C) Lysosomal rupture ✅
 D) Decreased ATP

Explanation: Lysosomal rupture indicates irreversible injury, leading to enzymatic digestion
of cellular components.

Q12. In atrophy, the intracellular degradation system primarily involved is:

 A) Proteasome
 B) Autophagy ✅
 C) Caspase cascade
 D) Complement system

Explanation: Autophagy is the process by which cells digest their own components during
atrophy, forming autophagic vacuoles.