NSG 3280 Pathophysiology for
Nurses I Exam 2 Actual Exam
2026/2027 Galen College of
Nursing Complete Questions &
Detailed Rationales - Pass
Guaranteed - A+ Graded
Cellular Adaptation, Injury & Death
Q1: A patient has been immobilized in a cast for 6 weeks following a leg fracture. When
the cast is removed, the nurse notices the affected leg is significantly smaller in muscle
mass compared to the uninjured leg. Which cellular adaptation is responsible for this
change?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia [CORRECT]
Correct Answer: C
Rationale: The best answer is C because atrophy is defined as a decrease in cell size,
which in this case is caused by the disuse of the muscle during the period of
immobilization.
Q2: A patient with a history of chronic smoking presents with chronic bronchitis. A
biopsy of the bronchial lining reveals that the normal ciliated columnar epithelium has
been replaced by stratified squamous epithelium. Which type of cellular adaptation has
occurred?
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Anaplasia [CORRECT]
,Correct Answer: B
Rationale: This choice is correct because metaplasia is a reversible change where one
adult cell type is replaced by another, often in response to chronic irritation like cigarette
smoke.
Q3: During a physiology lecture, the instructor explains that hypoxia is the most
common cause of cellular injury. Why is hypoxia so detrimental to the cell?
A. It causes the cell to produce excessive free radicals.
B. It deprives the cell of oxygen needed for aerobic metabolism, leading to a failure of
ATP production.
C. It directly destroys the nucleus of the cell.
D. It causes the cell to swell with water. [CORRECT]
Correct Answer: B
Rationale: This choice is correct because oxygen is essential for oxidative
phosphorylation; without it, the cell cannot generate ATP, which is required to power the
sodium-potassium pump and other vital life-sustaining processes.
Q4: A pathologist is examining a tissue sample and notes that the nucleus of the cell is
shrinking and condensing (pyknosis), the DNA is fragmenting (karyorrhexis), and the
cell eventually dissolves into fragments (karyolysis). Which process is describing?
A. Apoptosis
B. Coagulative necrosis
C. Liquefactive necrosis
D. Fatty change [CORRECT]
Correct Answer: B
Rationale: This choice is correct because the sequence of nuclear changes described
(pyknosis, karyorrhexis, karyolysis) is classic for coagulative necrosis, a pattern of cell
death often caused by hypoxia.
Q5: The heart of a patient with long-standing hypertension shows an increase in the
size of the myocardial fibers without an increase in the number of cells. This is an
example of:
A. Hyperplasia
B. Atrophy
C. Hypertrophy
D. Dysplasia [CORRECT]
Correct Answer: C
Rationale: Hypertrophy is an increase in the size of individual cells, which occurs in the
heart muscle in response to the increased workload caused by hypertension.
, Q6: A Papanicolaou (Pap) smear result shows abnormal changes in cervical cells
where the cells vary in size and shape and exhibit disorganized growth. However, the
cells have not invaded the basement membrane. What is this condition called?
A. Metaplasia
B. Anaplasia
C. Dysplasia
D. Hyperplasia [CORRECT]
Correct Answer: C
Rationale: This choice is correct because dysplasia refers to deranged cell growth of a
specific tissue; it is characterized by changes in cell size, shape, and organization, and
is often a precursor to cancer, though not cancer itself in this context.
Q7: Which of the following best describes the difference between necrosis and
apoptosis?
A. Necrosis is programmed cell death, while apoptosis is pathologic.
B. Necrosis causes inflammation, while apoptosis does not cause inflammation.
C. Apoptosis occurs only in viruses, while necrosis occurs in bacteria.
D. Necrosis is reversible, while apoptosis is irreversible. [CORRECT]
Correct Answer: B
Rationale: The best answer is B because necrosis is uncontrolled cell death that
ruptures the cell membrane, releasing contents that trigger inflammation, whereas
apoptosis is programmed, orderly cell death that packages contents for phagocytosis
without inflammation.
Q8: A patient presents with a brain abscess. The nurse knows that necrosis in the brain
tissue typically takes on a specific, creamy consistency. Which type of necrosis is most
likely occurring?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis [CORRECT]
Correct Answer: B
Rationale: This choice is correct because brain tissue is rich in lysosomal enzymes and
lipid; upon cell death, these factors cause rapid autolysis, resulting in liquefactive
necrosis where tissue turns into a liquid or creamy pus.
Inflammation & Tissue Repair
Nurses I Exam 2 Actual Exam
2026/2027 Galen College of
Nursing Complete Questions &
Detailed Rationales - Pass
Guaranteed - A+ Graded
Cellular Adaptation, Injury & Death
Q1: A patient has been immobilized in a cast for 6 weeks following a leg fracture. When
the cast is removed, the nurse notices the affected leg is significantly smaller in muscle
mass compared to the uninjured leg. Which cellular adaptation is responsible for this
change?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia [CORRECT]
Correct Answer: C
Rationale: The best answer is C because atrophy is defined as a decrease in cell size,
which in this case is caused by the disuse of the muscle during the period of
immobilization.
Q2: A patient with a history of chronic smoking presents with chronic bronchitis. A
biopsy of the bronchial lining reveals that the normal ciliated columnar epithelium has
been replaced by stratified squamous epithelium. Which type of cellular adaptation has
occurred?
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Anaplasia [CORRECT]
,Correct Answer: B
Rationale: This choice is correct because metaplasia is a reversible change where one
adult cell type is replaced by another, often in response to chronic irritation like cigarette
smoke.
Q3: During a physiology lecture, the instructor explains that hypoxia is the most
common cause of cellular injury. Why is hypoxia so detrimental to the cell?
A. It causes the cell to produce excessive free radicals.
B. It deprives the cell of oxygen needed for aerobic metabolism, leading to a failure of
ATP production.
C. It directly destroys the nucleus of the cell.
D. It causes the cell to swell with water. [CORRECT]
Correct Answer: B
Rationale: This choice is correct because oxygen is essential for oxidative
phosphorylation; without it, the cell cannot generate ATP, which is required to power the
sodium-potassium pump and other vital life-sustaining processes.
Q4: A pathologist is examining a tissue sample and notes that the nucleus of the cell is
shrinking and condensing (pyknosis), the DNA is fragmenting (karyorrhexis), and the
cell eventually dissolves into fragments (karyolysis). Which process is describing?
A. Apoptosis
B. Coagulative necrosis
C. Liquefactive necrosis
D. Fatty change [CORRECT]
Correct Answer: B
Rationale: This choice is correct because the sequence of nuclear changes described
(pyknosis, karyorrhexis, karyolysis) is classic for coagulative necrosis, a pattern of cell
death often caused by hypoxia.
Q5: The heart of a patient with long-standing hypertension shows an increase in the
size of the myocardial fibers without an increase in the number of cells. This is an
example of:
A. Hyperplasia
B. Atrophy
C. Hypertrophy
D. Dysplasia [CORRECT]
Correct Answer: C
Rationale: Hypertrophy is an increase in the size of individual cells, which occurs in the
heart muscle in response to the increased workload caused by hypertension.
, Q6: A Papanicolaou (Pap) smear result shows abnormal changes in cervical cells
where the cells vary in size and shape and exhibit disorganized growth. However, the
cells have not invaded the basement membrane. What is this condition called?
A. Metaplasia
B. Anaplasia
C. Dysplasia
D. Hyperplasia [CORRECT]
Correct Answer: C
Rationale: This choice is correct because dysplasia refers to deranged cell growth of a
specific tissue; it is characterized by changes in cell size, shape, and organization, and
is often a precursor to cancer, though not cancer itself in this context.
Q7: Which of the following best describes the difference between necrosis and
apoptosis?
A. Necrosis is programmed cell death, while apoptosis is pathologic.
B. Necrosis causes inflammation, while apoptosis does not cause inflammation.
C. Apoptosis occurs only in viruses, while necrosis occurs in bacteria.
D. Necrosis is reversible, while apoptosis is irreversible. [CORRECT]
Correct Answer: B
Rationale: The best answer is B because necrosis is uncontrolled cell death that
ruptures the cell membrane, releasing contents that trigger inflammation, whereas
apoptosis is programmed, orderly cell death that packages contents for phagocytosis
without inflammation.
Q8: A patient presents with a brain abscess. The nurse knows that necrosis in the brain
tissue typically takes on a specific, creamy consistency. Which type of necrosis is most
likely occurring?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis [CORRECT]
Correct Answer: B
Rationale: This choice is correct because brain tissue is rich in lysosomal enzymes and
lipid; upon cell death, these factors cause rapid autolysis, resulting in liquefactive
necrosis where tissue turns into a liquid or creamy pus.
Inflammation & Tissue Repair
