NSG 3280 Pathophysiology for Nurses I
ACTUAL EXAM [2025/2026] | 100
Questions | Updated Blueprint | Pass
Guaranteed - A+ Graded
SECTION 1: Cellular Adaptation & Injury (12 Questions)
Q1: A patient's cardiac biopsy shows myocardial cells with swollen mitochondria,
dilated endoplasmic reticulum, and plasma membrane blebbing. Which type of cellular
injury is BEST represented by these findings?
A. Necrosis with karyolysis
B. Apoptosis with chromatin condensation
C. Reversible cellular injury
D. Irreversible injury with pyknosis
Correct Answer: C
Rationale: Swollen organelles and membrane blebbing without nuclear changes indicate
reversible cellular injury. Irreversible injury requires nuclear changes such as pyknosis,
karyorrhexis, or karyolysis. The absence of these nuclear findings distinguishes
reversible from irreversible damage.
,Q2: Following a cerebrovascular accident, a patient's brain tissue exhibits tissue
swelling, nuclear pyknosis, and inflammatory cell infiltration. This pattern MOST clearly
describes:
A. Apoptosis
B. Coagulative necrosis
C. Caseous necrosis
D. Fat necrosis
Correct Answer: B
Rationale: Coagulative necrosis preserves tissue architecture initially while
demonstrating nuclear changes and inflammation. It is characteristic of ischemic injury
in solid organs including the heart, kidney, and brain. The preservation of cellular
outlines with loss of nuclei distinguishes it from liquefactive necrosis.
Q3: A pathologist notes caseous necrosis within a lung granuloma. The MOST likely
underlying etiology is:
A. Acute bacterial pneumonia
B. Tuberculosis infection
C. Ischemic infarction
D. Pancreatic enzyme leakage
Correct Answer: B
,Rationale: Caseous necrosis combined with granulomatous inflammation is the
hallmark of tuberculosis. While certain fungal infections may produce similar necrosis,
tuberculosis remains the most common cause of caseous necrosis in lung tissue.
Q4: A 58-year-old male with chronic hypertension presents with left ventricular wall
thickening on echocardiogram. The myocardial cells demonstrate enlarged nuclei and
increased cell size. This cellular adaptation is BEST described as:
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Correct Answer: B
Rationale: Hypertrophy refers to an increase in cell size resulting in enlarged organ size.
In chronic hypertension, the left ventricle undergoes compensatory hypertrophy due to
increased workload. The enlarged nuclei and increased cell size are classic histologic
findings, distinguishing hypertrophy from hyperplasia which involves increased cell
number.
Q5: A patient with chronic gastroesophageal reflux disease develops columnar
epithelium in the distal esophagus, replacing the normal squamous epithelium. This
adaptation is termed:
A. Dysplasia
B. Hyperplasia
, C. Metaplasia
D. Anaplasia
Correct Answer: C
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with
another. In Barrett esophagus, chronic acid exposure causes squamous epithelium to
convert to columnar epithelium. This represents an adaptive response to chronic
irritation, though it increases cancer risk.
Q6: During apoptosis, a cell demonstrates chromatin condensation, cytoplasmic
shrinkage, and formation of membrane-bound apoptotic bodies. Which enzyme family
is primarily responsible for executing these changes?
A. Phospholipases
B. Caspases
C. Cyclooxygenases
D. Proteasomes
Correct Answer: B
Rationale: Caspases are cysteine proteases that serve as the primary executioners of
apoptosis. They cleave structural proteins and activate endonucleases, producing the
characteristic chromatin condensation, cytoplasmic shrinkage, and apoptotic body
formation without triggering inflammation.
ACTUAL EXAM [2025/2026] | 100
Questions | Updated Blueprint | Pass
Guaranteed - A+ Graded
SECTION 1: Cellular Adaptation & Injury (12 Questions)
Q1: A patient's cardiac biopsy shows myocardial cells with swollen mitochondria,
dilated endoplasmic reticulum, and plasma membrane blebbing. Which type of cellular
injury is BEST represented by these findings?
A. Necrosis with karyolysis
B. Apoptosis with chromatin condensation
C. Reversible cellular injury
D. Irreversible injury with pyknosis
Correct Answer: C
Rationale: Swollen organelles and membrane blebbing without nuclear changes indicate
reversible cellular injury. Irreversible injury requires nuclear changes such as pyknosis,
karyorrhexis, or karyolysis. The absence of these nuclear findings distinguishes
reversible from irreversible damage.
,Q2: Following a cerebrovascular accident, a patient's brain tissue exhibits tissue
swelling, nuclear pyknosis, and inflammatory cell infiltration. This pattern MOST clearly
describes:
A. Apoptosis
B. Coagulative necrosis
C. Caseous necrosis
D. Fat necrosis
Correct Answer: B
Rationale: Coagulative necrosis preserves tissue architecture initially while
demonstrating nuclear changes and inflammation. It is characteristic of ischemic injury
in solid organs including the heart, kidney, and brain. The preservation of cellular
outlines with loss of nuclei distinguishes it from liquefactive necrosis.
Q3: A pathologist notes caseous necrosis within a lung granuloma. The MOST likely
underlying etiology is:
A. Acute bacterial pneumonia
B. Tuberculosis infection
C. Ischemic infarction
D. Pancreatic enzyme leakage
Correct Answer: B
,Rationale: Caseous necrosis combined with granulomatous inflammation is the
hallmark of tuberculosis. While certain fungal infections may produce similar necrosis,
tuberculosis remains the most common cause of caseous necrosis in lung tissue.
Q4: A 58-year-old male with chronic hypertension presents with left ventricular wall
thickening on echocardiogram. The myocardial cells demonstrate enlarged nuclei and
increased cell size. This cellular adaptation is BEST described as:
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Correct Answer: B
Rationale: Hypertrophy refers to an increase in cell size resulting in enlarged organ size.
In chronic hypertension, the left ventricle undergoes compensatory hypertrophy due to
increased workload. The enlarged nuclei and increased cell size are classic histologic
findings, distinguishing hypertrophy from hyperplasia which involves increased cell
number.
Q5: A patient with chronic gastroesophageal reflux disease develops columnar
epithelium in the distal esophagus, replacing the normal squamous epithelium. This
adaptation is termed:
A. Dysplasia
B. Hyperplasia
, C. Metaplasia
D. Anaplasia
Correct Answer: C
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with
another. In Barrett esophagus, chronic acid exposure causes squamous epithelium to
convert to columnar epithelium. This represents an adaptive response to chronic
irritation, though it increases cancer risk.
Q6: During apoptosis, a cell demonstrates chromatin condensation, cytoplasmic
shrinkage, and formation of membrane-bound apoptotic bodies. Which enzyme family
is primarily responsible for executing these changes?
A. Phospholipases
B. Caspases
C. Cyclooxygenases
D. Proteasomes
Correct Answer: B
Rationale: Caspases are cysteine proteases that serve as the primary executioners of
apoptosis. They cleave structural proteins and activate endonucleases, producing the
characteristic chromatin condensation, cytoplasmic shrinkage, and apoptotic body
formation without triggering inflammation.
