Pathophysiology Midterm Exam Nightingale
College Utah 2026/2027 – Verified Questions
with Answers and Detailed Rationales |
Comprehensive Study Guide.
Cellular Adaptation & Injury
1. A nurse is caring for a client with chronic hypertension. The increased workload
on the left ventricle has likely led to an increase in the size of myocardial cells.
Which cellular adaptation is the nurse observing?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Answer: B
Explanation: Hypertrophy is an increase in the size of individual cells in response to
increased mechanical load or stress. This is common in cardiac muscle cells under
pressure, such as in hypertension, where the left ventricle must work harder to pump blood
against higher resistance .
2. A client with chronic acid reflux is diagnosed with Barrett's esophagus. The
pathology report shows normal stratified squamous epithelium replaced by
columnar epithelium. This is an example of:
A) Dysplasia
B) Neoplasia
,C) Metaplasia
D) Anaplasia
Answer: C
Explanation: Metaplasia is the reversible replacement of one mature cell type by another
mature cell type better suited to handle a harsh environment. In Barrett's esophagus, the
esophageal squamous epithelium transforms into columnar epithelium to better withstand
chronic acid exposure .
3. A patient has liquefactive necrosis. Which organ should the nurse assess first?
A) Kidney
B) Heart
C) Brain
D) Liver
Answer: C
Explanation: Hypoxic injury to the brain results in liquefactive necrosis because the central
nervous system contains little connective tissue. The brain tissue essentially liquefies,
forming a cystic space, whereas other organs typically undergo coagulative necrosis .
4. What is the process by which cells program themselves to die?
A) Necrosis
B) Autolysis
C) Apoptosis
D) Phagocytosis
Answer: C
Explanation: Apoptosis is programmed, highly regulated cell death that does not trigger
inflammation. It allows the body to remove old or damaged cells without harming
neighboring healthy cells, unlike necrosis which is accidental and inflammatory .
5. Which adaptive cellular mechanism is characterized by a decrease in cell size?
A) Hypertrophy
,B) Hyperplasia
C) Atrophy
D) Metaplasia
Answer: C
Explanation: Atrophy is the decrease in cell size. This occurs when cells are exposed to
decreased workload, reduced blood supply, inadequate nutrition, loss of nerve stimulation,
or aging .
Genetics & Genetic Disorders
6. A nurse is describing a genetic disease that leads to progressive dementia in
middle to late adulthood. Which disease is the nurse most likely referring to?
A) Alzheimer's disease
B) Parkinson's disease
C) Huntington disease
D) Multiple sclerosis
Answer: C
*Explanation: Huntington disease is an autosomal dominant disorder characterized by
progressive dementia and choreiform movements. Its hallmark is delayed age of onset,
with symptoms typically appearing between ages 30-50, making it unique among
genetic dementias .*
7. A couple has two offspring: one child has an autosomal recessive disease trait
and one is normal. What most likely conclusion can the nurse make about the
parents?
A) One parent has the disease
B) Both parents could be carriers
, C) Both parents have the disease
D) Neither parent carries the gene
Answer: B
Explanation: For an autosomal recessive disorder to manifest in a child, the child must
inherit two copies of the mutated gene. When two carrier parents (each heterozygous for
the trait) have children, each pregnancy has a 25% chance of an affected child and 50%
chance of a carrier child .
8. A baby is born with Down syndrome. The nurse explains this syndrome is a
result of trisomy with which chromosome?
A) Chromosome 13
B) Chromosome 18
C) Chromosome 21
D) Chromosome 23
Answer: C
Explanation: Down syndrome (Trisomy 21) results from an extra full or partial copy of
chromosome 21. The most common cause is nondisjunction during meiosis, where
chromosomes fail to separate properly, resulting in a gamete with an extra chromosome .
9. What is the genetic mechanism of Turner syndrome?
A) Presence of an extra X chromosome (XXY)
B) Presence of a single X chromosome (45,X)
C) Trisomy of chromosome 21
D) Deletion of chromosome 5
Answer: B
Explanation: Turner syndrome results from the presence of a single X chromosome with no
homologous X or Y chromosome, giving a total of 45 chromosomes (45,X karyotype).
Clinical features include short stature, webbed neck, and lack of secondary sexual
characteristics .
College Utah 2026/2027 – Verified Questions
with Answers and Detailed Rationales |
Comprehensive Study Guide.
Cellular Adaptation & Injury
1. A nurse is caring for a client with chronic hypertension. The increased workload
on the left ventricle has likely led to an increase in the size of myocardial cells.
Which cellular adaptation is the nurse observing?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Answer: B
Explanation: Hypertrophy is an increase in the size of individual cells in response to
increased mechanical load or stress. This is common in cardiac muscle cells under
pressure, such as in hypertension, where the left ventricle must work harder to pump blood
against higher resistance .
2. A client with chronic acid reflux is diagnosed with Barrett's esophagus. The
pathology report shows normal stratified squamous epithelium replaced by
columnar epithelium. This is an example of:
A) Dysplasia
B) Neoplasia
,C) Metaplasia
D) Anaplasia
Answer: C
Explanation: Metaplasia is the reversible replacement of one mature cell type by another
mature cell type better suited to handle a harsh environment. In Barrett's esophagus, the
esophageal squamous epithelium transforms into columnar epithelium to better withstand
chronic acid exposure .
3. A patient has liquefactive necrosis. Which organ should the nurse assess first?
A) Kidney
B) Heart
C) Brain
D) Liver
Answer: C
Explanation: Hypoxic injury to the brain results in liquefactive necrosis because the central
nervous system contains little connective tissue. The brain tissue essentially liquefies,
forming a cystic space, whereas other organs typically undergo coagulative necrosis .
4. What is the process by which cells program themselves to die?
A) Necrosis
B) Autolysis
C) Apoptosis
D) Phagocytosis
Answer: C
Explanation: Apoptosis is programmed, highly regulated cell death that does not trigger
inflammation. It allows the body to remove old or damaged cells without harming
neighboring healthy cells, unlike necrosis which is accidental and inflammatory .
5. Which adaptive cellular mechanism is characterized by a decrease in cell size?
A) Hypertrophy
,B) Hyperplasia
C) Atrophy
D) Metaplasia
Answer: C
Explanation: Atrophy is the decrease in cell size. This occurs when cells are exposed to
decreased workload, reduced blood supply, inadequate nutrition, loss of nerve stimulation,
or aging .
Genetics & Genetic Disorders
6. A nurse is describing a genetic disease that leads to progressive dementia in
middle to late adulthood. Which disease is the nurse most likely referring to?
A) Alzheimer's disease
B) Parkinson's disease
C) Huntington disease
D) Multiple sclerosis
Answer: C
*Explanation: Huntington disease is an autosomal dominant disorder characterized by
progressive dementia and choreiform movements. Its hallmark is delayed age of onset,
with symptoms typically appearing between ages 30-50, making it unique among
genetic dementias .*
7. A couple has two offspring: one child has an autosomal recessive disease trait
and one is normal. What most likely conclusion can the nurse make about the
parents?
A) One parent has the disease
B) Both parents could be carriers
, C) Both parents have the disease
D) Neither parent carries the gene
Answer: B
Explanation: For an autosomal recessive disorder to manifest in a child, the child must
inherit two copies of the mutated gene. When two carrier parents (each heterozygous for
the trait) have children, each pregnancy has a 25% chance of an affected child and 50%
chance of a carrier child .
8. A baby is born with Down syndrome. The nurse explains this syndrome is a
result of trisomy with which chromosome?
A) Chromosome 13
B) Chromosome 18
C) Chromosome 21
D) Chromosome 23
Answer: C
Explanation: Down syndrome (Trisomy 21) results from an extra full or partial copy of
chromosome 21. The most common cause is nondisjunction during meiosis, where
chromosomes fail to separate properly, resulting in a gamete with an extra chromosome .
9. What is the genetic mechanism of Turner syndrome?
A) Presence of an extra X chromosome (XXY)
B) Presence of a single X chromosome (45,X)
C) Trisomy of chromosome 21
D) Deletion of chromosome 5
Answer: B
Explanation: Turner syndrome results from the presence of a single X chromosome with no
homologous X or Y chromosome, giving a total of 45 chromosomes (45,X karyotype).
Clinical features include short stature, webbed neck, and lack of secondary sexual
characteristics .
