NUR 631 ADVANCED PHYSIOLOGY AND PATHOPHYSIOLOGY
Midterm & Final Exam Prep Test Bank
*100+ Practice Questions with Verified Answers and Rationales
(2025/2026 Update)*
SECTION 1: CELLULAR ADAPTATION, INJURY, AND DEATH
Question 1:
A patient with chronic hepatitis B develops hepatocellular carcinoma. Which cellular
adaptation is most likely preceding this malignancy?
A. Atrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
Correct Answer: D. Dysplasia
Rationale: Dysplasia is disordered cellular growth often preceding cancer. Chronic
hepatitis leads to dysplastic changes in hepatocytes, increasing carcinoma risk. While
hyperplasia (increased cell number) and metaplasia (replacement of one cell type with
another) are reversible adaptations, dysplasia represents disordered maturation and
organization that can progress to malignancy if the stimulus persists .
,Question 2:
Which type of necrosis is most commonly seen in the myocardium after an acute
infarction?
A. Caseous necrosis
B. Coagulative necrosis
C. Liquefactive necrosis
D. Fat necrosis
Correct Answer: B. Coagulative necrosis
Rationale: Coagulative necrosis results from ischemia in all tissues except the brain.
Myocardial infarction leads to coagulative necrosis due to protein denaturation that
preserves tissue architecture for several days. The heart muscle becomes pale, firm, and
retains cell outlines despite nuclear loss .
Question 3:
A patient's cardiac biopsy shows myocyte hypertrophy. Which stimulus most likely
caused this finding?
A. Decreased workload
B. Chronic hypertension
C. Acute blood loss
D. Denervation
Correct Answer: B. Chronic hypertension
Rationale: Increased afterload from chronic hypertension causes myocyte hypertrophy
(increase in cell size) as an adaptive response. The left ventricle must generate higher
,pressures to eject blood, leading to increased synthesis of contractile proteins and
enlargement of individual myocytes without increased cell number .
Question 4:
What is the hallmark of irreversible cell injury?
A. ATP depletion
B. Cellular swelling
C. Loss of plasma membrane integrity
D. Fatty change
Correct Answer: C. Loss of plasma membrane integrity
Rationale: Irreversible injury is characterized by the inability to restore membrane
function, leading to lysosomal enzyme leakage and nuclear changes (pyknosis,
karyorrhexis, karyolysis). Once membrane integrity is lost, cell death is inevitable and
cannot be reversed even if the injurious stimulus is removed .
Question 5:
Which finding is characteristic of apoptotic cell death?
A. Inflammation
B. Cell swelling
C. Nuclear fragmentation without inflammation
D. Random cell lysis
Correct Answer: C. Nuclear fragmentation without inflammation
, Rationale: Apoptosis is programmed cell death characterized by membrane blebbing,
formation of apoptotic bodies, and phagocytosis without an inflammatory response.
Unlike necrosis, apoptosis does not trigger inflammation because cellular contents are
not released into the extracellular space .
Question 6:
A patient with chronic alcohol abuse has a liver biopsy showing enlarged, pale
hepatocytes with lipid vacuoles. This represents:
A. Hydropic change
B. Fatty change (steatosis)
C. Hyaline change
D. Glycogen accumulation
Correct Answer: B. Fatty change (steatosis)
Rationale: Alcohol impairs fatty acid oxidation and increases triglyceride synthesis,
leading to accumulation of lipid vacuoles within hepatocytes. This reversible change
appears as pale, vacuolated cells on microscopy and may progress to alcoholic hepatitis
or cirrhosis with continued alcohol use .
Question 7:
Removal of part of the liver leads to the remaining liver cells undergoing which process?
A. Compensatory hypertrophy
B. Compensatory hyperplasia
C. Metaplasia
D. Dysplasia
Midterm & Final Exam Prep Test Bank
*100+ Practice Questions with Verified Answers and Rationales
(2025/2026 Update)*
SECTION 1: CELLULAR ADAPTATION, INJURY, AND DEATH
Question 1:
A patient with chronic hepatitis B develops hepatocellular carcinoma. Which cellular
adaptation is most likely preceding this malignancy?
A. Atrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
Correct Answer: D. Dysplasia
Rationale: Dysplasia is disordered cellular growth often preceding cancer. Chronic
hepatitis leads to dysplastic changes in hepatocytes, increasing carcinoma risk. While
hyperplasia (increased cell number) and metaplasia (replacement of one cell type with
another) are reversible adaptations, dysplasia represents disordered maturation and
organization that can progress to malignancy if the stimulus persists .
,Question 2:
Which type of necrosis is most commonly seen in the myocardium after an acute
infarction?
A. Caseous necrosis
B. Coagulative necrosis
C. Liquefactive necrosis
D. Fat necrosis
Correct Answer: B. Coagulative necrosis
Rationale: Coagulative necrosis results from ischemia in all tissues except the brain.
Myocardial infarction leads to coagulative necrosis due to protein denaturation that
preserves tissue architecture for several days. The heart muscle becomes pale, firm, and
retains cell outlines despite nuclear loss .
Question 3:
A patient's cardiac biopsy shows myocyte hypertrophy. Which stimulus most likely
caused this finding?
A. Decreased workload
B. Chronic hypertension
C. Acute blood loss
D. Denervation
Correct Answer: B. Chronic hypertension
Rationale: Increased afterload from chronic hypertension causes myocyte hypertrophy
(increase in cell size) as an adaptive response. The left ventricle must generate higher
,pressures to eject blood, leading to increased synthesis of contractile proteins and
enlargement of individual myocytes without increased cell number .
Question 4:
What is the hallmark of irreversible cell injury?
A. ATP depletion
B. Cellular swelling
C. Loss of plasma membrane integrity
D. Fatty change
Correct Answer: C. Loss of plasma membrane integrity
Rationale: Irreversible injury is characterized by the inability to restore membrane
function, leading to lysosomal enzyme leakage and nuclear changes (pyknosis,
karyorrhexis, karyolysis). Once membrane integrity is lost, cell death is inevitable and
cannot be reversed even if the injurious stimulus is removed .
Question 5:
Which finding is characteristic of apoptotic cell death?
A. Inflammation
B. Cell swelling
C. Nuclear fragmentation without inflammation
D. Random cell lysis
Correct Answer: C. Nuclear fragmentation without inflammation
, Rationale: Apoptosis is programmed cell death characterized by membrane blebbing,
formation of apoptotic bodies, and phagocytosis without an inflammatory response.
Unlike necrosis, apoptosis does not trigger inflammation because cellular contents are
not released into the extracellular space .
Question 6:
A patient with chronic alcohol abuse has a liver biopsy showing enlarged, pale
hepatocytes with lipid vacuoles. This represents:
A. Hydropic change
B. Fatty change (steatosis)
C. Hyaline change
D. Glycogen accumulation
Correct Answer: B. Fatty change (steatosis)
Rationale: Alcohol impairs fatty acid oxidation and increases triglyceride synthesis,
leading to accumulation of lipid vacuoles within hepatocytes. This reversible change
appears as pale, vacuolated cells on microscopy and may progress to alcoholic hepatitis
or cirrhosis with continued alcohol use .
Question 7:
Removal of part of the liver leads to the remaining liver cells undergoing which process?
A. Compensatory hypertrophy
B. Compensatory hyperplasia
C. Metaplasia
D. Dysplasia
