NSG 5140 Advanced Pathophysiology
Midterm & Final Exam Review | South
College | 2026 Exam Questions and
Answers | 100% Pass Guaranteed |
Graded A+ | Graduate-Level Rationales
Section 1: Cellular Adaptation, Injury & Death (Q1–Q20)
Q1. A cell adapts to increased workload by increasing in size. This
process is called:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct ,,,answer,,,,: B
Rationale: Hypertrophy is an increase in cell size leading to
tissue/organ enlargement. It occurs in response to increased
workload (e.g., cardiac myocytes in hypertension). Hyperplasia is
increased cell number .
Q2. Chronic exposure to gastric acid in the lower esophagus causes
normal squamous epithelium to change to columnar epithelium.
This change is called:
A) Dysplasia
B) Metaplasia
,C) Anaplasia
D) Neoplasia
Correct ,,,answer,,,,: B
Rationale: Metaplasia is the reversible replacement of one
differentiated cell type with another (e.g., Barrett esophagus —
squamous to columnar). Dysplasia is disordered growth; anaplasia
is loss of differentiation in cancer .
Q3. A pathologist examining a myocardial infarction notes
preserved tissue architecture with loss of nuclei and eosinophilic
cytoplasm. This type of necrosis is:
A) Liquefactive necrosis
B) Coagulative necrosis
C) Caseous necrosis
D) Fat necrosis
Correct ,,,answer,,,,: B
Rationale: Coagulative necrosis (typical of ischemic injury in heart,
kidney, liver) preserves tissue outline but shows nuclear loss and
increased cytoplasmic eosinophilia. Liquefactive necrosis occurs in
the brain .
Q4. Which type of necrosis is classically associated with tuberculosis
and appears as "cheesy" on gross examination?
A) Coagulative necrosis
B) Fat necrosis
C) Caseous necrosis
D) Fibrinoid necrosis
Correct ,,,answer,,,,: C
Rationale: Caseous necrosis (e.g., TB, fungal infections) has a friable,
granular, cheese-like appearance due to a combination of
,coagulative and liquefactive necrosis with extensive tissue
destruction .
Q5. The nurse understands that ischemic injury becomes
irreversible when there is:
A) ATP depletion
B) Cellular swelling
C) Severe mitochondrial dysfunction and membrane damage
D) Lactic acid accumulation
Correct ,,,answer,,,,: C
Rationale: Irreversibility of ischemic injury is marked by severe
mitochondrial damage (inability to regenerate ATP) and disruption
of plasma membrane integrity (loss of phospholipids, influx of
calcium, leakage of enzymes) .
Q6. Which of the following is a characteristic of apoptosis?
A) Inflammation is always present
B) Cell swelling and rupture
C) Programmed cell death without inflammation
D) Occurs only in disease states
Correct ,,,answer,,,,: C
Rationale: Apoptosis is programmed cell death that does NOT
trigger inflammation because cellular contents are packaged into
apoptotic bodies and phagocytosed without releasing intracellular
contents. It is essential for development and tissue homeostasis .
Q7. The cellular organelle most vulnerable to hypoxic injury is the:
A) Nucleus
B) Mitochondria
C) Ribosome
D) Golgi apparatus
, Correct ,,,answer,,,,: B
Rationale: Mitochondria are most vulnerable to hypoxia because
they require oxygen for oxidative phosphorylation. ATP depletion
from mitochondrial dysfunction leads to failure of all energy-
dependent cellular processes, including ion pumps .
Q8. A patient with chronic hepatitis C develops liver enlargement
from an increase in the number of hepatocytes. This adaptation is:
A) Physiologic hypertrophy
B) Pathologic hyperplasia
C) Physiologic hyperplasia
D) Pathologic atrophy
Correct ,,,answer,,,,: B
Rationale: Pathologic hyperplasia is an abnormal increase in cell
number in response to chronic irritation (e.g., viral hepatitis,
hormonal stimulation). It can increase cancer risk. Physiologic
hyperplasia occurs in response to normal stimuli (e.g., endometrial
proliferation) .
Q9. Free calcium (Ca²⁺) in the cytoplasm of an injured cell causes:
A) Activation of ATP production
B) Activation of proteases, phospholipases, and endonucleases (cell
damage)
C) Inhibition of apoptosis
D) Restoration of membrane integrity
Correct ,,,answer,,,,: B
Rationale: Intracellular calcium overload activates destructive
enzymes: proteases (break proteins), phospholipases (damage
membranes), and endonucleases (damage DNA), leading to
Midterm & Final Exam Review | South
College | 2026 Exam Questions and
Answers | 100% Pass Guaranteed |
Graded A+ | Graduate-Level Rationales
Section 1: Cellular Adaptation, Injury & Death (Q1–Q20)
Q1. A cell adapts to increased workload by increasing in size. This
process is called:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct ,,,answer,,,,: B
Rationale: Hypertrophy is an increase in cell size leading to
tissue/organ enlargement. It occurs in response to increased
workload (e.g., cardiac myocytes in hypertension). Hyperplasia is
increased cell number .
Q2. Chronic exposure to gastric acid in the lower esophagus causes
normal squamous epithelium to change to columnar epithelium.
This change is called:
A) Dysplasia
B) Metaplasia
,C) Anaplasia
D) Neoplasia
Correct ,,,answer,,,,: B
Rationale: Metaplasia is the reversible replacement of one
differentiated cell type with another (e.g., Barrett esophagus —
squamous to columnar). Dysplasia is disordered growth; anaplasia
is loss of differentiation in cancer .
Q3. A pathologist examining a myocardial infarction notes
preserved tissue architecture with loss of nuclei and eosinophilic
cytoplasm. This type of necrosis is:
A) Liquefactive necrosis
B) Coagulative necrosis
C) Caseous necrosis
D) Fat necrosis
Correct ,,,answer,,,,: B
Rationale: Coagulative necrosis (typical of ischemic injury in heart,
kidney, liver) preserves tissue outline but shows nuclear loss and
increased cytoplasmic eosinophilia. Liquefactive necrosis occurs in
the brain .
Q4. Which type of necrosis is classically associated with tuberculosis
and appears as "cheesy" on gross examination?
A) Coagulative necrosis
B) Fat necrosis
C) Caseous necrosis
D) Fibrinoid necrosis
Correct ,,,answer,,,,: C
Rationale: Caseous necrosis (e.g., TB, fungal infections) has a friable,
granular, cheese-like appearance due to a combination of
,coagulative and liquefactive necrosis with extensive tissue
destruction .
Q5. The nurse understands that ischemic injury becomes
irreversible when there is:
A) ATP depletion
B) Cellular swelling
C) Severe mitochondrial dysfunction and membrane damage
D) Lactic acid accumulation
Correct ,,,answer,,,,: C
Rationale: Irreversibility of ischemic injury is marked by severe
mitochondrial damage (inability to regenerate ATP) and disruption
of plasma membrane integrity (loss of phospholipids, influx of
calcium, leakage of enzymes) .
Q6. Which of the following is a characteristic of apoptosis?
A) Inflammation is always present
B) Cell swelling and rupture
C) Programmed cell death without inflammation
D) Occurs only in disease states
Correct ,,,answer,,,,: C
Rationale: Apoptosis is programmed cell death that does NOT
trigger inflammation because cellular contents are packaged into
apoptotic bodies and phagocytosed without releasing intracellular
contents. It is essential for development and tissue homeostasis .
Q7. The cellular organelle most vulnerable to hypoxic injury is the:
A) Nucleus
B) Mitochondria
C) Ribosome
D) Golgi apparatus
, Correct ,,,answer,,,,: B
Rationale: Mitochondria are most vulnerable to hypoxia because
they require oxygen for oxidative phosphorylation. ATP depletion
from mitochondrial dysfunction leads to failure of all energy-
dependent cellular processes, including ion pumps .
Q8. A patient with chronic hepatitis C develops liver enlargement
from an increase in the number of hepatocytes. This adaptation is:
A) Physiologic hypertrophy
B) Pathologic hyperplasia
C) Physiologic hyperplasia
D) Pathologic atrophy
Correct ,,,answer,,,,: B
Rationale: Pathologic hyperplasia is an abnormal increase in cell
number in response to chronic irritation (e.g., viral hepatitis,
hormonal stimulation). It can increase cancer risk. Physiologic
hyperplasia occurs in response to normal stimuli (e.g., endometrial
proliferation) .
Q9. Free calcium (Ca²⁺) in the cytoplasm of an injured cell causes:
A) Activation of ATP production
B) Activation of proteases, phospholipases, and endonucleases (cell
damage)
C) Inhibition of apoptosis
D) Restoration of membrane integrity
Correct ,,,answer,,,,: B
Rationale: Intracellular calcium overload activates destructive
enzymes: proteases (break proteins), phospholipases (damage
membranes), and endonucleases (damage DNA), leading to
