NR283 Exam 1 Actual Exam Style V3 | NR
283 Pathophysiology | Chamberlain
1. A patient who has smoked two packs of cigarettes a day for 30 years shows a change in the
cellular structure of the bronchial lining on a biopsy. The columnar ciliated epithelial cells
have been replaced by stratified squamous epithelial cells. Which cellular adaptation is this?
A. Hypertrophy
B. Atrophy
C. Metaplasia
D. Dysplasia
Correct Answer: C
Expert Explanation: Metaplasia is the reversible replacement of one mature cell type by
another less mature cell type. This typically occurs in response to chronic irritation or
inflammation, such as cigarette smoke in the lungs. While the new cells may survive better,
they often lose specialized functions like mucus secretion and ciliary movement.
2. An elderly patient has been bedridden for several weeks following a hip fracture. The nurse
notes that the muscles in the patient’s legs have decreased in size. What is the most likely
cause of this cellular change?
A. Hyperplasia
B. Atrophy
C. Metaplasia
,D. Dysplasia
Correct Answer: B
Expert Explanation: Atrophy is a decrease in cellular size caused by aging, disuse, or
reduced blood supply. In this case, the lack of mechanical loading and muscle contraction
leads to disuse atrophy. It is a physiological response where the body reduces the
metabolic demand of underused tissues.
3. A 50-year-old male with chronic high blood pressure exhibits an enlarged left ventricle on
an echocardiogram. This change in the heart muscle is best described as:
A. Pathological Hypertrophy
B. Compensatory Hyperplasia
C. Physiological Hypertrophy
D. Metaplasia
Correct Answer: A
Expert Explanation: Hypertrophy is an increase in the size of cells in response to
increased mechanical load or stress. Because this change is due to a disease state
(hypertension), it is considered pathological rather than physiological. Over time, this
enlargement can lead to heart failure because the thickened muscle becomes less efficient.
4. During a Pap smear, a clinician finds cells that are abnormal in size, shape, and
organization. The lab report describes these changes as:
A. Metaplasia
, B. Apoptosis
C. Hyperplasia
D. Dysplasia
Correct Answer: D
Expert Explanation: Dysplasia refers to abnormal changes in the size, shape, and
organization of mature cells. It is often considered a precursor to cancer, although it is not
cancer itself. Regular monitoring is required because dysplastic cells can progress to
neoplasia if the inciting stimulus is not removed.
5. Which process is considered a programmed, distinct type of cell death that does not
typically trigger an inflammatory response?
A. Liquefactive necrosis
B. Coagulative necrosis
C. Apoptosis
D. Caseous necrosis
Correct Answer: C
Expert Explanation: Apoptosis is an active process of cellular self-destruction, often called
programmed cell death. Unlike necrosis, it does not involve the leaking of intracellular
contents into the interstitial space. Therefore, it does not typically cause inflammation in
the surrounding tissues.
283 Pathophysiology | Chamberlain
1. A patient who has smoked two packs of cigarettes a day for 30 years shows a change in the
cellular structure of the bronchial lining on a biopsy. The columnar ciliated epithelial cells
have been replaced by stratified squamous epithelial cells. Which cellular adaptation is this?
A. Hypertrophy
B. Atrophy
C. Metaplasia
D. Dysplasia
Correct Answer: C
Expert Explanation: Metaplasia is the reversible replacement of one mature cell type by
another less mature cell type. This typically occurs in response to chronic irritation or
inflammation, such as cigarette smoke in the lungs. While the new cells may survive better,
they often lose specialized functions like mucus secretion and ciliary movement.
2. An elderly patient has been bedridden for several weeks following a hip fracture. The nurse
notes that the muscles in the patient’s legs have decreased in size. What is the most likely
cause of this cellular change?
A. Hyperplasia
B. Atrophy
C. Metaplasia
,D. Dysplasia
Correct Answer: B
Expert Explanation: Atrophy is a decrease in cellular size caused by aging, disuse, or
reduced blood supply. In this case, the lack of mechanical loading and muscle contraction
leads to disuse atrophy. It is a physiological response where the body reduces the
metabolic demand of underused tissues.
3. A 50-year-old male with chronic high blood pressure exhibits an enlarged left ventricle on
an echocardiogram. This change in the heart muscle is best described as:
A. Pathological Hypertrophy
B. Compensatory Hyperplasia
C. Physiological Hypertrophy
D. Metaplasia
Correct Answer: A
Expert Explanation: Hypertrophy is an increase in the size of cells in response to
increased mechanical load or stress. Because this change is due to a disease state
(hypertension), it is considered pathological rather than physiological. Over time, this
enlargement can lead to heart failure because the thickened muscle becomes less efficient.
4. During a Pap smear, a clinician finds cells that are abnormal in size, shape, and
organization. The lab report describes these changes as:
A. Metaplasia
, B. Apoptosis
C. Hyperplasia
D. Dysplasia
Correct Answer: D
Expert Explanation: Dysplasia refers to abnormal changes in the size, shape, and
organization of mature cells. It is often considered a precursor to cancer, although it is not
cancer itself. Regular monitoring is required because dysplastic cells can progress to
neoplasia if the inciting stimulus is not removed.
5. Which process is considered a programmed, distinct type of cell death that does not
typically trigger an inflammatory response?
A. Liquefactive necrosis
B. Coagulative necrosis
C. Apoptosis
D. Caseous necrosis
Correct Answer: C
Expert Explanation: Apoptosis is an active process of cellular self-destruction, often called
programmed cell death. Unlike necrosis, it does not involve the leaking of intracellular
contents into the interstitial space. Therefore, it does not typically cause inflammation in
the surrounding tissues.
