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NUR 631 Advanced Physiology and
Pathophysiology: Cumulative Final Exam
Practice Bank – 150 Verified Questions
with Detailed Rationales (Academic Year
2026/2027)
SECTION 1: CELLULAR ADAPTATION & INJURY (Questions 1-20)
Question 1
A patient with chronic anemia presents with an enlarged heart on chest X-ray.
Which cellular adaptation most likely explains this finding?
A) Atrophy
B) Hyperplasia
C) Hypertrophy
D) Metaplasia
☑ CORRECTANSWER: C (Hypertrophy)
Rationale: Increased workload due to chronic anemia (decreased oxygen-carrying
capacity) causes cardiac myocytes to increase in size (hypertrophy) to generate
more contractile force. This is a compensatory mechanism.
Question 2
A 65-year-old smoker has columnar cells replacing the normal squamous
epithelium in his bronchi. This change is known as:
, 2
A) Dysplasia
B) Anaplasia
C) Hyperplasia
D) Metaplasia
☑ CORRECTANSWER: D (Metaplasia)
Rationale: Metaplasia is the reversible replacement of one differentiated cell type
with another. Chronic irritation from smoking causes squamous-to-columnar
metaplasia in airways as a protective response, though it is abnormal.
Question 3 (SATA)
Which processes are REVERSIBLE cellular adaptations? (Select all that apply)
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Necrosis
E) Apoptosis
☑ CORRECTANSWER: A, B, C
Rationale: Hypertrophy, hyperplasia, and metaplasia are reversible adaptations.
Necrosis and apoptosis are forms of cell death and are irreversible.
Question 4
Removal of part of the liver leads to the remaining liver cells undergoing:
, 3
A) Atrophy
B) Compensatory hyperplasia
C) Metaplasia
D) Dysplasia
☑ CORRECTANSWER: B (Compensatory hyperplasia)
Rationale: Compensatory hyperplasia is an adaptive mechanism that enables
certain organs to regenerate. Removal of part of the liver leads to hyperplasia of
the remaining hepatocytes to compensate for the loss.
Question 5
A pathologist notes "coagulative necrosis" in a kidney specimen. This most likely
resulted from:
A) Tuberculosis infection
B) Ischemia from arterial blockage
C) Pancreatic enzyme leakage
D) Hypocalcemia
☑ CORRECTANSWER: B (Ischemia from arterial blockage)
Rationale: Coagulative necrosis (preserved tissue outline, no lysosomal enzymes)
is typical of ischemia in solid organs (heart, kidney, liver) except the brain.
Question 6
Which intracellular substance is released into the bloodstream and is a highly
, 4
sensitive indicator of acute myocardial infarction?
A) AST
B) Creatinine kinase-MM
C) Troponin I
D) LDH-1
☑ CORRECTANSWER: C (Troponin I)
Rationale: Troponin I and T are cardiac-specific proteins released within 3-4 hours
of MI. They are more sensitive and specific than CK-MB.
Question 7
A patient with chronic alcoholism develops liver fibrosis. The cell injury
mechanism most involved is:
A) Direct membrane damage by ethanol
B) Accumulation of fat (steatosis)
C) Acetaldehyde-induced free radical formation
D) Inhibition of protein synthesis
☑ CORRECTANSWER: C (Acetaldehyde-induced free radical formation)
Rationale: Alcohol is metabolized to acetaldehyde, which generates free radicals,
leading to lipid peroxidation, inflammation, and eventual fibrosis/cirrhosis.
Question 8
Which type of necrosis is associated with brain infarction?
NUR 631 Advanced Physiology and
Pathophysiology: Cumulative Final Exam
Practice Bank – 150 Verified Questions
with Detailed Rationales (Academic Year
2026/2027)
SECTION 1: CELLULAR ADAPTATION & INJURY (Questions 1-20)
Question 1
A patient with chronic anemia presents with an enlarged heart on chest X-ray.
Which cellular adaptation most likely explains this finding?
A) Atrophy
B) Hyperplasia
C) Hypertrophy
D) Metaplasia
☑ CORRECTANSWER: C (Hypertrophy)
Rationale: Increased workload due to chronic anemia (decreased oxygen-carrying
capacity) causes cardiac myocytes to increase in size (hypertrophy) to generate
more contractile force. This is a compensatory mechanism.
Question 2
A 65-year-old smoker has columnar cells replacing the normal squamous
epithelium in his bronchi. This change is known as:
, 2
A) Dysplasia
B) Anaplasia
C) Hyperplasia
D) Metaplasia
☑ CORRECTANSWER: D (Metaplasia)
Rationale: Metaplasia is the reversible replacement of one differentiated cell type
with another. Chronic irritation from smoking causes squamous-to-columnar
metaplasia in airways as a protective response, though it is abnormal.
Question 3 (SATA)
Which processes are REVERSIBLE cellular adaptations? (Select all that apply)
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Necrosis
E) Apoptosis
☑ CORRECTANSWER: A, B, C
Rationale: Hypertrophy, hyperplasia, and metaplasia are reversible adaptations.
Necrosis and apoptosis are forms of cell death and are irreversible.
Question 4
Removal of part of the liver leads to the remaining liver cells undergoing:
, 3
A) Atrophy
B) Compensatory hyperplasia
C) Metaplasia
D) Dysplasia
☑ CORRECTANSWER: B (Compensatory hyperplasia)
Rationale: Compensatory hyperplasia is an adaptive mechanism that enables
certain organs to regenerate. Removal of part of the liver leads to hyperplasia of
the remaining hepatocytes to compensate for the loss.
Question 5
A pathologist notes "coagulative necrosis" in a kidney specimen. This most likely
resulted from:
A) Tuberculosis infection
B) Ischemia from arterial blockage
C) Pancreatic enzyme leakage
D) Hypocalcemia
☑ CORRECTANSWER: B (Ischemia from arterial blockage)
Rationale: Coagulative necrosis (preserved tissue outline, no lysosomal enzymes)
is typical of ischemia in solid organs (heart, kidney, liver) except the brain.
Question 6
Which intracellular substance is released into the bloodstream and is a highly
, 4
sensitive indicator of acute myocardial infarction?
A) AST
B) Creatinine kinase-MM
C) Troponin I
D) LDH-1
☑ CORRECTANSWER: C (Troponin I)
Rationale: Troponin I and T are cardiac-specific proteins released within 3-4 hours
of MI. They are more sensitive and specific than CK-MB.
Question 7
A patient with chronic alcoholism develops liver fibrosis. The cell injury
mechanism most involved is:
A) Direct membrane damage by ethanol
B) Accumulation of fat (steatosis)
C) Acetaldehyde-induced free radical formation
D) Inhibition of protein synthesis
☑ CORRECTANSWER: C (Acetaldehyde-induced free radical formation)
Rationale: Alcohol is metabolized to acetaldehyde, which generates free radicals,
leading to lipid peroxidation, inflammation, and eventual fibrosis/cirrhosis.
Question 8
Which type of necrosis is associated with brain infarction?
