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NR 283 Pathophysiology Test Question Bank
2026/2027 | Chamberlain NR283 Exam 1, Exam 2,
Exam 3 & Final Exam | Comprehensive Practice
Questions & Verified Answers
NR283 Exam 1 — Pathophysiology Practice Exam
# Section 1: Cell Injury & Adaptatio
**Question 1**
A patient's biopsy reveals cells that have increased in size in response to
increased workload. This cellular adaptation is called:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
- ✅ Answer & Rationale
**Answer: B — Hypertrophy**
Hypertrophy is an increase in cell *size* in response to increased
demand (e.g., cardiac muscle hypertrophy from hypertension).
Hyperplasia is an increase in cell *number*. Atrophy is a decrease in
cell size. Metaplasia is replacement of one cell type with another.
pg. 1
,2|Page
**Question 2**
Which of the following is the EARLIEST reversible sign of cell injury?
A) Nuclear pyknosis
B) Cellular swelling (hydropic change)
C) Membrane rupture
D) Karyolysis
- ✅ Answer & Rationale
**Answer: B — Cellular swelling (hydropic change)**
Cellular swelling (also called cloudy swelling or hydropic
degeneration) is the earliest and most common response to cell injury.
It results from failure of the Na⁺/K⁺-ATPase pump, causing sodium and
water to accumulate intracellularly. It is reversible. Nuclear pyknosis,
karyolysis, and membrane rupture are signs of irreversible (lethal)
injury.
**Question 3**
A nurse is caring for a patient with prolonged ischemia to the
myocardium. Which finding would indicate the injury has become
IRREVERSIBLE?
A) Cellular swelling
pg. 2
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B) Decreased ATP production
C) Ribosomal detachment from the ER
D) Massive calcium influx into the cell
- ✅ Answer & Rationale
**Answer: D — Massive calcium influx into the cell**
Massive influx of calcium into the cell is the hallmark of irreversible
cell injury. Calcium activates destructive enzymes (phospholipases,
proteases, endonucleases) that lead to cell death. Cellular swelling,
decreased ATP, and ribosomal detachment are early, potentially
reversible signs.
**Question 4**
Apoptosis differs from necrosis in that apoptosis:
A) Always results from pathological injury
B) Triggers a significant inflammatory response
C) Is a programmed, orderly process that does not cause inflammation
D) Causes cellular swelling and membrane rupture
- ✅ Answer & Rationale
pg. 3
, 4|Page
**Answer: C — Is a programmed, orderly process that does not cause
inflammation**
Apoptosis is a controlled, energy-dependent process of
programmed cell death. The cell shrinks, chromatin condenses, and
membrane-bound apoptotic bodies are phagocytosed without
triggering inflammation. Necrosis, by contrast, is uncontrolled, causes
membrane rupture, and provokes a strong inflammatory response.
**Question 5**
A 55-year-old smoker's bronchial epithelium has changed from ciliated
columnar cells to squamous cells. This is an example of:
A) Dysplasia
B) Hyperplasia
C) Metaplasia
D) Anaplasia
- ✅ Answer & Rationale
**Answer: C — Metaplasia**
Metaplasia is the reversible replacement of one mature cell type
with another. In chronic smokers, bronchial ciliated columnar
epithelium is replaced by squamous epithelium as an adaptive
response to irritation. While initially reversible, persistent metaplasia
can progress to dysplasia and malignancy.
pg. 4
NR 283 Pathophysiology Test Question Bank
2026/2027 | Chamberlain NR283 Exam 1, Exam 2,
Exam 3 & Final Exam | Comprehensive Practice
Questions & Verified Answers
NR283 Exam 1 — Pathophysiology Practice Exam
# Section 1: Cell Injury & Adaptatio
**Question 1**
A patient's biopsy reveals cells that have increased in size in response to
increased workload. This cellular adaptation is called:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
- ✅ Answer & Rationale
**Answer: B — Hypertrophy**
Hypertrophy is an increase in cell *size* in response to increased
demand (e.g., cardiac muscle hypertrophy from hypertension).
Hyperplasia is an increase in cell *number*. Atrophy is a decrease in
cell size. Metaplasia is replacement of one cell type with another.
pg. 1
,2|Page
**Question 2**
Which of the following is the EARLIEST reversible sign of cell injury?
A) Nuclear pyknosis
B) Cellular swelling (hydropic change)
C) Membrane rupture
D) Karyolysis
- ✅ Answer & Rationale
**Answer: B — Cellular swelling (hydropic change)**
Cellular swelling (also called cloudy swelling or hydropic
degeneration) is the earliest and most common response to cell injury.
It results from failure of the Na⁺/K⁺-ATPase pump, causing sodium and
water to accumulate intracellularly. It is reversible. Nuclear pyknosis,
karyolysis, and membrane rupture are signs of irreversible (lethal)
injury.
**Question 3**
A nurse is caring for a patient with prolonged ischemia to the
myocardium. Which finding would indicate the injury has become
IRREVERSIBLE?
A) Cellular swelling
pg. 2
,3|Page
B) Decreased ATP production
C) Ribosomal detachment from the ER
D) Massive calcium influx into the cell
- ✅ Answer & Rationale
**Answer: D — Massive calcium influx into the cell**
Massive influx of calcium into the cell is the hallmark of irreversible
cell injury. Calcium activates destructive enzymes (phospholipases,
proteases, endonucleases) that lead to cell death. Cellular swelling,
decreased ATP, and ribosomal detachment are early, potentially
reversible signs.
**Question 4**
Apoptosis differs from necrosis in that apoptosis:
A) Always results from pathological injury
B) Triggers a significant inflammatory response
C) Is a programmed, orderly process that does not cause inflammation
D) Causes cellular swelling and membrane rupture
- ✅ Answer & Rationale
pg. 3
, 4|Page
**Answer: C — Is a programmed, orderly process that does not cause
inflammation**
Apoptosis is a controlled, energy-dependent process of
programmed cell death. The cell shrinks, chromatin condenses, and
membrane-bound apoptotic bodies are phagocytosed without
triggering inflammation. Necrosis, by contrast, is uncontrolled, causes
membrane rupture, and provokes a strong inflammatory response.
**Question 5**
A 55-year-old smoker's bronchial epithelium has changed from ciliated
columnar cells to squamous cells. This is an example of:
A) Dysplasia
B) Hyperplasia
C) Metaplasia
D) Anaplasia
- ✅ Answer & Rationale
**Answer: C — Metaplasia**
Metaplasia is the reversible replacement of one mature cell type
with another. In chronic smokers, bronchial ciliated columnar
epithelium is replaced by squamous epithelium as an adaptive
response to irritation. While initially reversible, persistent metaplasia
can progress to dysplasia and malignancy.
pg. 4
