NUR631 ADVANCED PHYSIOLOGY &
PATHOPHYSIOLOGY MIDTERM EXAM PREP 2026
UPDATED | Verified Questions, Correct Answers &
Detailed Rationales | GCU | INSTANT PDF
DOWNLOAD
• 200 exam-style questions covering all core NUR631 Advanced Physiology &
Pathophysiology topics tested at midterm — use these to drill concepts, self-test,
and identify weak areas before your exam.
• Each question includes five options (A–E), a clearly marked correct answer with
bold highlighting, and a EXPERT RATIONALE directly below to reinforce
understanding.
NUR631 ADVANCED PHYSIOLOGY & PATHOPHYSIOLOGY MIDTERM EXAM PREP
2026 Grand Canyon University (GCU)
SECTION 1: CELL BIOLOGY & CELLULAR ADAPTATION
1. Which cellular adaptation occurs when cardiac muscle cells increase in size
in response to increased workload?
A. Hyperplasia
B. Metaplasia
C. Atrophy
D. Dysplasia
E. Hypertrophy
Correct Answer: E. Hypertrophy
EXPERT RATIONALE: Hypertrophy is an increase in cell size without an increase
in cell number. Cardiac muscle cells are terminally differentiated and cannot divide,
so they respond to increased demand (e.g., hypertension) by enlarging — this is
hypertrophy.
,2. A cell that changes from one mature cell type to another in response to
chronic irritation is undergoing which process?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
E. Neoplasia
Correct Answer: D. Metaplasia
EXPERT RATIONALE: Metaplasia is the reversible replacement of one
differentiated cell type with another. A classic example is the replacement of
columnar epithelium with squamous epithelium in the bronchi of smokers.
3. Which of the following best describes apoptosis?
A. Cell death caused by external trauma leading to inflammation
B. Unregulated cell proliferation resulting in tumor formation
C. Swelling and lysis of cells due to hypoxic injury
D. Programmed cell death that is energy-dependent and non-inflammatory
E. Accumulation of intracellular fluid causing cellular dysfunction
Correct Answer: D. Programmed cell death that is energy-dependent and
non-inflammatory
EXPERT RATIONALE: Apoptosis is an orderly, genetically programmed process
of cell death. It is ATP-dependent, does not trigger inflammation, and involves
caspase activation. It eliminates damaged or unnecessary cells without harming
surrounding tissue.
,4. Cellular swelling, the earliest sign of cellular injury, is primarily caused by:
A. Excessive calcium influx into the nucleus
B. Mitochondrial DNA mutations
C. Activation of caspase-3 and caspase-9
D. Failure of the sodium-potassium ATPase pump due to ATP depletion
E. Lysosomal membrane rupture releasing digestive enzymes
Correct Answer: D. Failure of the sodium-potassium ATPase pump due to
ATP depletion
EXPERT RATIONALE: When ATP is depleted (e.g., due to ischemia), the Na⁺/K⁺-
ATPase pump fails. Sodium accumulates intracellularly, drawing water in by
osmosis, leading to cellular swelling — the earliest and most reversible sign of cell
injury.
5. Which of the following intracellular organelles is primarily responsible for
ATP production through oxidative phosphorylation?
A. Golgi apparatus
B. Endoplasmic reticulum
C. Lysosome
D. Mitochondria
E. Ribosome
Correct Answer: D. Mitochondria
EXPERT RATIONALE: Mitochondria are the powerhouses of the cell, generating
ATP via the electron transport chain and oxidative phosphorylation. Mitochondrial
dysfunction is central to ischemic and toxic cell injury.
, 6. Which type of necrosis is most commonly associated with myocardial
infarction?
A. Caseous necrosis
B. Liquefactive necrosis
C. Fat necrosis
D. Coagulative necrosis
E. Gangrenous necrosis
Correct Answer: D. Coagulative necrosis
EXPERT RATIONALE: Coagulative necrosis preserves the cell architecture while
the cell contents are denatured. It is the hallmark of ischemic infarction in solid
organs, particularly the heart and kidneys.
7. Liquefactive necrosis is characteristically seen in which of the following
conditions?
A. Myocardial infarction
B. Tuberculosis
C. Brain infarction
D. Pancreatic fat necrosis
E. Gangrene of the lower limb
Correct Answer: C. Brain infarction
EXPERT RATIONALE: The brain's high lipid content and enzymatic activity lead
to liquefactive necrosis following ischemia. Neutrophils and macrophages digest
the dead tissue, resulting in a fluid-filled cavity.
8. Free radical injury to cells is primarily neutralized by which of the
following?
PATHOPHYSIOLOGY MIDTERM EXAM PREP 2026
UPDATED | Verified Questions, Correct Answers &
Detailed Rationales | GCU | INSTANT PDF
DOWNLOAD
• 200 exam-style questions covering all core NUR631 Advanced Physiology &
Pathophysiology topics tested at midterm — use these to drill concepts, self-test,
and identify weak areas before your exam.
• Each question includes five options (A–E), a clearly marked correct answer with
bold highlighting, and a EXPERT RATIONALE directly below to reinforce
understanding.
NUR631 ADVANCED PHYSIOLOGY & PATHOPHYSIOLOGY MIDTERM EXAM PREP
2026 Grand Canyon University (GCU)
SECTION 1: CELL BIOLOGY & CELLULAR ADAPTATION
1. Which cellular adaptation occurs when cardiac muscle cells increase in size
in response to increased workload?
A. Hyperplasia
B. Metaplasia
C. Atrophy
D. Dysplasia
E. Hypertrophy
Correct Answer: E. Hypertrophy
EXPERT RATIONALE: Hypertrophy is an increase in cell size without an increase
in cell number. Cardiac muscle cells are terminally differentiated and cannot divide,
so they respond to increased demand (e.g., hypertension) by enlarging — this is
hypertrophy.
,2. A cell that changes from one mature cell type to another in response to
chronic irritation is undergoing which process?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
E. Neoplasia
Correct Answer: D. Metaplasia
EXPERT RATIONALE: Metaplasia is the reversible replacement of one
differentiated cell type with another. A classic example is the replacement of
columnar epithelium with squamous epithelium in the bronchi of smokers.
3. Which of the following best describes apoptosis?
A. Cell death caused by external trauma leading to inflammation
B. Unregulated cell proliferation resulting in tumor formation
C. Swelling and lysis of cells due to hypoxic injury
D. Programmed cell death that is energy-dependent and non-inflammatory
E. Accumulation of intracellular fluid causing cellular dysfunction
Correct Answer: D. Programmed cell death that is energy-dependent and
non-inflammatory
EXPERT RATIONALE: Apoptosis is an orderly, genetically programmed process
of cell death. It is ATP-dependent, does not trigger inflammation, and involves
caspase activation. It eliminates damaged or unnecessary cells without harming
surrounding tissue.
,4. Cellular swelling, the earliest sign of cellular injury, is primarily caused by:
A. Excessive calcium influx into the nucleus
B. Mitochondrial DNA mutations
C. Activation of caspase-3 and caspase-9
D. Failure of the sodium-potassium ATPase pump due to ATP depletion
E. Lysosomal membrane rupture releasing digestive enzymes
Correct Answer: D. Failure of the sodium-potassium ATPase pump due to
ATP depletion
EXPERT RATIONALE: When ATP is depleted (e.g., due to ischemia), the Na⁺/K⁺-
ATPase pump fails. Sodium accumulates intracellularly, drawing water in by
osmosis, leading to cellular swelling — the earliest and most reversible sign of cell
injury.
5. Which of the following intracellular organelles is primarily responsible for
ATP production through oxidative phosphorylation?
A. Golgi apparatus
B. Endoplasmic reticulum
C. Lysosome
D. Mitochondria
E. Ribosome
Correct Answer: D. Mitochondria
EXPERT RATIONALE: Mitochondria are the powerhouses of the cell, generating
ATP via the electron transport chain and oxidative phosphorylation. Mitochondrial
dysfunction is central to ischemic and toxic cell injury.
, 6. Which type of necrosis is most commonly associated with myocardial
infarction?
A. Caseous necrosis
B. Liquefactive necrosis
C. Fat necrosis
D. Coagulative necrosis
E. Gangrenous necrosis
Correct Answer: D. Coagulative necrosis
EXPERT RATIONALE: Coagulative necrosis preserves the cell architecture while
the cell contents are denatured. It is the hallmark of ischemic infarction in solid
organs, particularly the heart and kidneys.
7. Liquefactive necrosis is characteristically seen in which of the following
conditions?
A. Myocardial infarction
B. Tuberculosis
C. Brain infarction
D. Pancreatic fat necrosis
E. Gangrene of the lower limb
Correct Answer: C. Brain infarction
EXPERT RATIONALE: The brain's high lipid content and enzymatic activity lead
to liquefactive necrosis following ischemia. Neutrophils and macrophages digest
the dead tissue, resulting in a fluid-filled cavity.
8. Free radical injury to cells is primarily neutralized by which of the
following?
