1
PORTAGE LEARNING NURS 231 PATHOPHYSIOLOGY
MODULES 1-10 2026/2027 | Complete Exam Compilation |
Latest Update | Verified Answers | Pass Guaranteed - A+
Graded
MODULE 1 EXAM: Cellular Adaptation, Injury & Neoplasia (Q1-15)
Q1. A 68-year-old male with a history of emphysema presents with chronic
hypoxemia. Which cellular adaptation best describes the increase in number of his
alveolar type II cells?
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
B. Hyperplasia [CORRECT]
Rationale: Hyperplasia is an increase in cell number. Hypertrophy is increased cell
size, metaplasia is reversible change of one cell type to another, and dysplasia
represents disordered growth—not pure numerical increase.
Correct Answer: B
Q2. A 45-year-old female develops cervical intraepithelial neoplasia (CIN III) following
persistent HPV infection. This represents which type of cellular adaptation?
A. Hyperplasia
B. Metaplasia
C. Dysplasia
D. Anaplasia
C. Dysplasia [CORRECT]
Rationale: Dysplasia is disordered epithelial growth with nuclear pleomorphism and
loss of polarity, representing a pre-neoplastic change. Anaplasia implies complete
loss of differentiation (malignancy), which is more advanced than CIN III.
Correct Answer: C
,2
Q3. During myocardial infarction, the affected cardiac tissue demonstrates preserved
tissue architecture with loss of nuclei and increased eosinophilia. This pattern
describes:
A. Liquefactive necrosis
B. Coagulative necrosis
C. Caseous necrosis
D. Fat necrosis
B. Coagulative necrosis [CORRECT]
Rationale: Coagulative necrosis preserves tissue architecture for days due to
denaturation of structural proteins, characteristic of ischemic injury in solid organs
except brain. Liquefactive necrosis occurs in brain abscesses; caseous necrosis in
tuberculosis; fat necrosis in pancreatic injury.
Correct Answer: B
Q4. A patient with acute pancreatitis develops chalky white deposits in peripancreatic
fat. The pathophysiology involves saponification by:
A. Lipase
B. Amylase
C. Trypsin
D. Elastase
A. Lipase [CORRECT]
Rationale: Pancreatic lipase hydrolyzes triglycerides into fatty acids, which combine
with calcium to form soaps (saponification), producing chalky white fat necrosis.
Trypsin and elastase cause vascular damage and hemorrhage.
Correct Answer: A
Q5. Which mechanism is the primary driver of cellular injury in carbon monoxide
poisoning?
A. Lipid peroxidation by free radicals
B. Inhibition of cytochrome oxidase
C. Decreased oxygen-carrying capacity of hemoglobin
D. Depletion of cellular ATP via uncoupling
C. Decreased oxygen-carrying capacity of hemoglobin [CORRECT]
Rationale: CO binds hemoglobin with 240× greater affinity than oxygen, forming
,3
carboxyhemoglobin and impairing oxygen transport. Cyanide inhibits cytochrome
oxidase; free radical injury is more characteristic of reperfusion.
Correct Answer: C
Q6. Which finding distinguishes coagulative necrosis from liquefactive necrosis?
A. Coagulative necrosis occurs only in neural tissue
B. Liquefactive necrosis preserves tissue architecture initially
C. Coagulative necrosis maintains tissue outlines early after cell death
D. Liquefactive necrosis requires fungal infection to occur
C. Coagulative necrosis maintains tissue outlines early after cell death [CORRECT]
Rationale: Coagulative necrosis denatures structural proteins, preserving tissue
outlines for days, whereas liquefactive necrosis involves enzymatic digestion
producing liquid debris (brain infarcts, abscesses).
Correct Answer: C
Q7. A 55-year-old smoker presents with squamous cell carcinoma of the lung. The
precursor lesion demonstrating conversion from ciliated pseudostratified columnar
to squamous epithelium represents:
A. Hyperplasia
B. Metaplasia
C. Dysplasia
D. Hypertrophy
B. Metaplasia [CORRECT]
Rationale: Metaplasia is the reversible replacement of one differentiated cell type by
another, often an adaptive response to chronic irritation. Persistent metaplasia can
progress to dysplasia and carcinoma.
Correct Answer: B
Q8. In apoptosis, which cellular event characterizes the execution phase?
A. Mitochondrial swelling and plasma membrane rupture
B. Chromatin condensation and cell fragmentation into apoptotic bodies
C. Karyolysis and inflammatory infiltrate formation
D. Cytoplasmic vacuolization and hydropic swelling
B. Chromatin condensation and cell fragmentation into apoptotic bodies [CORRECT]
Rationale: Apoptosis features chromatin condensation, nuclear fragmentation, and
, 4
formation of membrane-bound apoptotic bodies without inflammation. Necrosis
involves mitochondrial swelling, membrane rupture, and inflammation.
Correct Answer: B
Q9. Which feature best differentiates a benign neoplasm from a malignant
neoplasm?
A. Rate of cell proliferation
B. Presence of a fibrous capsule
C. Metastatic potential
D. Tissue of origin
C. Metastatic potential [CORRECT]
Rationale: Metastasis is the definitive hallmark of malignancy. Benign and malignant
tumors may both proliferate rapidly; encapsulation is common but not universal in
benign lesions; tissue of origin does not determine behavior.
Correct Answer: C
Q10. A tumor marker elevated in ovarian epithelial cancers and useful for monitoring
treatment response is:
A. Alpha-fetoprotein (AFP)
B. Cancer antigen 125 (CA-125)
C. Prostate-specific antigen (PSA)
D. Carcinoembryonic antigen (CEA)
B. Cancer antigen 125 (CA-125) [CORRECT]
Rationale: CA-125 is a glycoprotein tumor marker elevated in epithelial ovarian
cancers and used for diagnosis and monitoring. AFP marks hepatocellular carcinoma;
PSA marks prostate cancer; CEA marks colorectal cancer.
Correct Answer: B
Q11. A 62-year-old male with cirrhosis develops hepatocellular carcinoma. The tumor
demonstrates abnormal blood vessel formation to support growth. This process is
termed:
A. Invasion
B. Angiogenesis
C. Metastasis
D. Differentiation
PORTAGE LEARNING NURS 231 PATHOPHYSIOLOGY
MODULES 1-10 2026/2027 | Complete Exam Compilation |
Latest Update | Verified Answers | Pass Guaranteed - A+
Graded
MODULE 1 EXAM: Cellular Adaptation, Injury & Neoplasia (Q1-15)
Q1. A 68-year-old male with a history of emphysema presents with chronic
hypoxemia. Which cellular adaptation best describes the increase in number of his
alveolar type II cells?
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
B. Hyperplasia [CORRECT]
Rationale: Hyperplasia is an increase in cell number. Hypertrophy is increased cell
size, metaplasia is reversible change of one cell type to another, and dysplasia
represents disordered growth—not pure numerical increase.
Correct Answer: B
Q2. A 45-year-old female develops cervical intraepithelial neoplasia (CIN III) following
persistent HPV infection. This represents which type of cellular adaptation?
A. Hyperplasia
B. Metaplasia
C. Dysplasia
D. Anaplasia
C. Dysplasia [CORRECT]
Rationale: Dysplasia is disordered epithelial growth with nuclear pleomorphism and
loss of polarity, representing a pre-neoplastic change. Anaplasia implies complete
loss of differentiation (malignancy), which is more advanced than CIN III.
Correct Answer: C
,2
Q3. During myocardial infarction, the affected cardiac tissue demonstrates preserved
tissue architecture with loss of nuclei and increased eosinophilia. This pattern
describes:
A. Liquefactive necrosis
B. Coagulative necrosis
C. Caseous necrosis
D. Fat necrosis
B. Coagulative necrosis [CORRECT]
Rationale: Coagulative necrosis preserves tissue architecture for days due to
denaturation of structural proteins, characteristic of ischemic injury in solid organs
except brain. Liquefactive necrosis occurs in brain abscesses; caseous necrosis in
tuberculosis; fat necrosis in pancreatic injury.
Correct Answer: B
Q4. A patient with acute pancreatitis develops chalky white deposits in peripancreatic
fat. The pathophysiology involves saponification by:
A. Lipase
B. Amylase
C. Trypsin
D. Elastase
A. Lipase [CORRECT]
Rationale: Pancreatic lipase hydrolyzes triglycerides into fatty acids, which combine
with calcium to form soaps (saponification), producing chalky white fat necrosis.
Trypsin and elastase cause vascular damage and hemorrhage.
Correct Answer: A
Q5. Which mechanism is the primary driver of cellular injury in carbon monoxide
poisoning?
A. Lipid peroxidation by free radicals
B. Inhibition of cytochrome oxidase
C. Decreased oxygen-carrying capacity of hemoglobin
D. Depletion of cellular ATP via uncoupling
C. Decreased oxygen-carrying capacity of hemoglobin [CORRECT]
Rationale: CO binds hemoglobin with 240× greater affinity than oxygen, forming
,3
carboxyhemoglobin and impairing oxygen transport. Cyanide inhibits cytochrome
oxidase; free radical injury is more characteristic of reperfusion.
Correct Answer: C
Q6. Which finding distinguishes coagulative necrosis from liquefactive necrosis?
A. Coagulative necrosis occurs only in neural tissue
B. Liquefactive necrosis preserves tissue architecture initially
C. Coagulative necrosis maintains tissue outlines early after cell death
D. Liquefactive necrosis requires fungal infection to occur
C. Coagulative necrosis maintains tissue outlines early after cell death [CORRECT]
Rationale: Coagulative necrosis denatures structural proteins, preserving tissue
outlines for days, whereas liquefactive necrosis involves enzymatic digestion
producing liquid debris (brain infarcts, abscesses).
Correct Answer: C
Q7. A 55-year-old smoker presents with squamous cell carcinoma of the lung. The
precursor lesion demonstrating conversion from ciliated pseudostratified columnar
to squamous epithelium represents:
A. Hyperplasia
B. Metaplasia
C. Dysplasia
D. Hypertrophy
B. Metaplasia [CORRECT]
Rationale: Metaplasia is the reversible replacement of one differentiated cell type by
another, often an adaptive response to chronic irritation. Persistent metaplasia can
progress to dysplasia and carcinoma.
Correct Answer: B
Q8. In apoptosis, which cellular event characterizes the execution phase?
A. Mitochondrial swelling and plasma membrane rupture
B. Chromatin condensation and cell fragmentation into apoptotic bodies
C. Karyolysis and inflammatory infiltrate formation
D. Cytoplasmic vacuolization and hydropic swelling
B. Chromatin condensation and cell fragmentation into apoptotic bodies [CORRECT]
Rationale: Apoptosis features chromatin condensation, nuclear fragmentation, and
, 4
formation of membrane-bound apoptotic bodies without inflammation. Necrosis
involves mitochondrial swelling, membrane rupture, and inflammation.
Correct Answer: B
Q9. Which feature best differentiates a benign neoplasm from a malignant
neoplasm?
A. Rate of cell proliferation
B. Presence of a fibrous capsule
C. Metastatic potential
D. Tissue of origin
C. Metastatic potential [CORRECT]
Rationale: Metastasis is the definitive hallmark of malignancy. Benign and malignant
tumors may both proliferate rapidly; encapsulation is common but not universal in
benign lesions; tissue of origin does not determine behavior.
Correct Answer: C
Q10. A tumor marker elevated in ovarian epithelial cancers and useful for monitoring
treatment response is:
A. Alpha-fetoprotein (AFP)
B. Cancer antigen 125 (CA-125)
C. Prostate-specific antigen (PSA)
D. Carcinoembryonic antigen (CEA)
B. Cancer antigen 125 (CA-125) [CORRECT]
Rationale: CA-125 is a glycoprotein tumor marker elevated in epithelial ovarian
cancers and used for diagnosis and monitoring. AFP marks hepatocellular carcinoma;
PSA marks prostate cancer; CEA marks colorectal cancer.
Correct Answer: B
Q11. A 62-year-old male with cirrhosis develops hepatocellular carcinoma. The tumor
demonstrates abnormal blood vessel formation to support growth. This process is
termed:
A. Invasion
B. Angiogenesis
C. Metastasis
D. Differentiation
