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 nursing student observes that cardiac muscle cells increase in size in response to
chronic hypertension. This cellular adaptation is BEST termed:
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Correct Answer: B
Rationale: Hypertrophy is an increase in cell size resulting in enlarged tissue mass
without an increase in cell number. Cardiac myocytes are permanent cells that cannot
undergo hyperplasia; they respond to increased workload by synthesizing more proteins
and enlarging.
,Q2: A 68-year-old patient with peripheral vascular disease develops a nonhealing wound
on the great toe. Histology shows ghost outlines of cells with loss of nuclei but
preserved tissue architecture. This pattern indicates:
A. Liquefactive necrosis
B. Coagulative necrosis
C. Caseous necrosis
D. Fat necrosis
Correct Answer: B
Rationale: Coagulative necrosis preserves the architectural framework of dead tissue
for several days after cell death. It is characteristic of ischemic injury in solid organs
and extremities, resulting from protein denaturation that maintains cell outlines while
nuclear detail is lost.
Q3: During an acute myocardial infarction, myocardial cells demonstrate cytoplasmic
eosinophilia, nuclear pyknosis, and karyorrhexis. These nuclear changes indicate the
injury has become:
A. Reversible
B. Irreversible
C. Apoptotic
D. Metaplastic
Correct Answer: B
,Rationale: Nuclear changes including pyknosis (nuclear shrinkage), karyorrhexis
(fragmentation), and karyolysis (dissolution) are the histologic hallmarks of irreversible
cell injury and necrosis. Reversible injury does not produce nuclear alterations.
Q4: A patient with chronic gastroesophageal reflux disease undergoes endoscopy
revealing salmon-colored mucosa in the distal esophagus replacing normal squamous
epithelium. This adaptation increases the risk for:
A. Squamous cell carcinoma
B. Adenocarcinoma
C. Sarcoma
D. Lymphoma
Correct Answer: B
Rationale: The described finding is Barrett esophagus, a metaplastic change from
squamous to columnar epithelium. This intestinal metaplasia is a precursor lesion for
esophageal adenocarcinoma, not squamous cell carcinoma which arises from native
squamous epithelium.
Q5: The cellular process characterized by programmed cell death involving cell
shrinkage, chromatin condensation, and formation of apoptotic bodies without
inflammation is:
A. Necrosis
B. Autophagy
C. Apoptosis
, D. Hypertrophy
Correct Answer: C
Rationale: Apoptosis is energy-dependent programmed cell death that maintains
membrane integrity until late stages, produces cell fragments enclosed in membranes,
and does not elicit an inflammatory response. Caspases execute the characteristic
morphologic changes.
Q6: A trauma patient with a crushed thigh muscle develops dark urine and elevated
serum creatine kinase. The dark urine results from:
A. Hematuria from bladder trauma
B. Myoglobin released from necrotic muscle
C. Bilirubin from hemolysis
D. Porphyrins from liver failure
Correct Answer: B
Rationale: Crush injury causes rhabdomyolysis with necrosis of skeletal muscle.
Myoglobin released into circulation filters through glomeruli, producing myoglobinuria
that appears dark or tea-colored. Myoglobin can precipitate in renal tubules causing
acute kidney injury.
Q7: A pathologist examining lung tissue from a smoker notes ciliated pseudostratified
columnar epithelium replaced by stratified squamous epithelium in the bronchi. If the
smoking continues, the NEXT most likely pathologic progression would be:
A. Immediate transformation to invasive carcinoma
ACTUAL EXAM [2025/2026] | 100
Questions | Updated Blueprint | Pass
Guaranteed - A+ Graded
SECTION 1: Cellular Adaptation & Injury (12 Questions)
Q1: A nursing student observes that cardiac muscle cells increase in size in response to
chronic hypertension. This cellular adaptation is BEST termed:
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Correct Answer: B
Rationale: Hypertrophy is an increase in cell size resulting in enlarged tissue mass
without an increase in cell number. Cardiac myocytes are permanent cells that cannot
undergo hyperplasia; they respond to increased workload by synthesizing more proteins
and enlarging.
,Q2: A 68-year-old patient with peripheral vascular disease develops a nonhealing wound
on the great toe. Histology shows ghost outlines of cells with loss of nuclei but
preserved tissue architecture. This pattern indicates:
A. Liquefactive necrosis
B. Coagulative necrosis
C. Caseous necrosis
D. Fat necrosis
Correct Answer: B
Rationale: Coagulative necrosis preserves the architectural framework of dead tissue
for several days after cell death. It is characteristic of ischemic injury in solid organs
and extremities, resulting from protein denaturation that maintains cell outlines while
nuclear detail is lost.
Q3: During an acute myocardial infarction, myocardial cells demonstrate cytoplasmic
eosinophilia, nuclear pyknosis, and karyorrhexis. These nuclear changes indicate the
injury has become:
A. Reversible
B. Irreversible
C. Apoptotic
D. Metaplastic
Correct Answer: B
,Rationale: Nuclear changes including pyknosis (nuclear shrinkage), karyorrhexis
(fragmentation), and karyolysis (dissolution) are the histologic hallmarks of irreversible
cell injury and necrosis. Reversible injury does not produce nuclear alterations.
Q4: A patient with chronic gastroesophageal reflux disease undergoes endoscopy
revealing salmon-colored mucosa in the distal esophagus replacing normal squamous
epithelium. This adaptation increases the risk for:
A. Squamous cell carcinoma
B. Adenocarcinoma
C. Sarcoma
D. Lymphoma
Correct Answer: B
Rationale: The described finding is Barrett esophagus, a metaplastic change from
squamous to columnar epithelium. This intestinal metaplasia is a precursor lesion for
esophageal adenocarcinoma, not squamous cell carcinoma which arises from native
squamous epithelium.
Q5: The cellular process characterized by programmed cell death involving cell
shrinkage, chromatin condensation, and formation of apoptotic bodies without
inflammation is:
A. Necrosis
B. Autophagy
C. Apoptosis
, D. Hypertrophy
Correct Answer: C
Rationale: Apoptosis is energy-dependent programmed cell death that maintains
membrane integrity until late stages, produces cell fragments enclosed in membranes,
and does not elicit an inflammatory response. Caspases execute the characteristic
morphologic changes.
Q6: A trauma patient with a crushed thigh muscle develops dark urine and elevated
serum creatine kinase. The dark urine results from:
A. Hematuria from bladder trauma
B. Myoglobin released from necrotic muscle
C. Bilirubin from hemolysis
D. Porphyrins from liver failure
Correct Answer: B
Rationale: Crush injury causes rhabdomyolysis with necrosis of skeletal muscle.
Myoglobin released into circulation filters through glomeruli, producing myoglobinuria
that appears dark or tea-colored. Myoglobin can precipitate in renal tubules causing
acute kidney injury.
Q7: A pathologist examining lung tissue from a smoker notes ciliated pseudostratified
columnar epithelium replaced by stratified squamous epithelium in the bronchi. If the
smoking continues, the NEXT most likely pathologic progression would be:
A. Immediate transformation to invasive carcinoma
