NSG 5140 – NSG5140 Advanced Pathophysiology
(Final Exam Review) Questions And Correct
Answers (Verified Answers) Plus Rationales 2026
Q&A | Instant Download PDF South College based
on standard advanced pathophysiology topics
taught at South College,
Q1. A cell adapts to a decreased workload by decreasing in size. This
process is called:
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Correct ,,,answer,,,,: C
Rationale: Atrophy is a decrease in cell size due to reduced workload,
denervation, decreased blood supply, or inadequate nutrition. It is a
reversible adaptation if the stimulus is removed .
Q2. Chronic exposure to gastric acid in the lower esophagus causes the
normal stratified 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 under the
microscope 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 solid organs
like 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. It is a form of coagulative necrosis with
extensive destruction of tissue architecture .
,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 (with inability to regenerate ATP) and disruption of
plasma membrane integrity (loss of phospholipids, influx of calcium) .
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 .
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 .
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 .
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 irreversible cell injury .
Q10. A patient with pancreatitis develops chalky white deposits in the
peritoneum. This represents:
A) Coagulative necrosis
B) Fat necrosis
C) Liquefactive necrosis
D) Fibrinoid necrosis
(Final Exam Review) Questions And Correct
Answers (Verified Answers) Plus Rationales 2026
Q&A | Instant Download PDF South College based
on standard advanced pathophysiology topics
taught at South College,
Q1. A cell adapts to a decreased workload by decreasing in size. This
process is called:
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Correct ,,,answer,,,,: C
Rationale: Atrophy is a decrease in cell size due to reduced workload,
denervation, decreased blood supply, or inadequate nutrition. It is a
reversible adaptation if the stimulus is removed .
Q2. Chronic exposure to gastric acid in the lower esophagus causes the
normal stratified 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 under the
microscope 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 solid organs
like 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. It is a form of coagulative necrosis with
extensive destruction of tissue architecture .
,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 (with inability to regenerate ATP) and disruption of
plasma membrane integrity (loss of phospholipids, influx of calcium) .
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 .
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 .
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 .
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 irreversible cell injury .
Q10. A patient with pancreatitis develops chalky white deposits in the
peritoneum. This represents:
A) Coagulative necrosis
B) Fat necrosis
C) Liquefactive necrosis
D) Fibrinoid necrosis
