NUR 5461 COMPLETE COURSE Q&A BANK (200
QUESTIONS) Modules 1-7 & Final Exam | William
Paterson University | 2026 Curriculum
MODULE 1: CELLULAR ADAPTATION, INJURY & GENETICS
Q1. A patient with hypertension develops left ventricular hypertrophy. This is an
example of which type of cellular adaptation?
A. Atrophy
B. Hyperplasia
C. Hypertrophy
D. Metaplasia
Rationale: Hypertrophy is an increase in cell size. In hypertension, the left ventricle works
against increased pressure, causing heart muscle cells (myocytes) to enlarge.
Q2. The hallmark of apoptosis is:
A. Cell swelling and lysis
B. Inflammation
C. Cell shrinkage, nuclear fragmentation, and formation of apoptotic bodies
(no inflammation)
D. Caseous necrosis
Rationale: Apoptosis is programmed cell death characterized by cell shrinkage, chromatin
condensation, nuclear fragmentation, and formation of apoptotic bodies that are
phagocytosed without causing inflammation.
Q3. A patient who smokes has chronic bronchial irritation. Normal ciliated columnar
epithelium is replaced by stratified squamous epithelium. This is an example of:
A. Hypertrophy
B. Hyperplasia
, C. Metaplasia
D. Dysplasia
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with
another as an adaptive response to chronic irritation. In smokers, this change is protective
but can predispose to cancer.
Q4. A patient with chronic kidney disease has small, shrunken kidneys due to loss of
cells. This is an example of:
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Rationale: Atrophy is a decrease in cell size and organ size. In chronic kidney disease,
prolonged ischemia and loss of nephrons lead to atrophy of remaining nephrons and overall
kidney shrinkage.
Q5. A patient experiences a myocardial infarction. The type of cell death that occurs
is:
A. Apoptosis
B. Necrosis (coagulative necrosis)
C. Pyroptosis
D. Autophagy
Rationale: Myocardial infarction causes ischemic cell death (necrosis), specifically
coagulative necrosis. Necrosis is unprogrammed cell death due to injury, whereas apoptosis
is programmed.
Q6. Which statement is true regarding basal cell carcinoma (BCC)?
A. BCC is most commonly found on the trunk and lower limbs
B. BCC is most commonly found on the head and neck
C. BCC rarely occurs on sun-exposed areas
D. BCC primarily arises on mucous membranes
,Rationale: Basal cell carcinoma is strongly linked to chronic sun exposure and therefore
most often appears on sun-exposed areas such as the face, scalp, and neck.
Q7. Which statement is true regarding unmatched packed red blood cell
transfusions?
A. People with type O blood have both A and B antigens
B. People with type O blood have neither A nor B antigens
C. People with type O blood have no antibodies in their plasma
D. Type AB blood cells lack A and B antigens
Rationale: Type O RBCs lack A and B antigens, making them "universal donor" red cells
when plasma is removed. Their plasma, however, contains anti-A and anti-B antibodies.
Q8. Which pathways activate the complement system?
A. Classical, lectin, and alternative
B. Intrinsic, extrinsic, and common
C. Primary, secondary, and tertiary
D. IgG-dependent and IgM-dependent
*Rationale: Complement can be activated via the antibody-dependent classical pathway,
the lectin pathway (mannose-binding), or the antibody-independent alternative pathway. All
converge on C3 activation.*
Q9. What is the term for cancer originating in connective tissues?
A. Carcinoma
B. Sarcoma
C. Lymphoma
D. Adenoma
Rationale: Sarcomas are malignant tumors arising from mesenchymal tissues such as
bone, muscle, fat, and connective tissue, distinct from carcinomas which arise from
epithelial tissues.
Q10. A substance that is recognized as foreign or nonself is:
A. An antibody
, B. A hapten
C. An antigen
D. A complement
Rationale: Antigens are molecules capable of being recognized by immune receptors as
foreign, thereby eliciting an immune response. Antibodies are the immune proteins
produced against antigens.
Q11. The most common cause of cellular injury is:
A. Genetic defects
B. Hypoxia (lack of oxygen)
C. Nutritional imbalances
D. Physical agents
Rationale: Hypoxia is the most common cause of cellular injury. It can result from ischemia
(reduced blood flow), anemia, CO poisoning, or respiratory failure. Hypoxia leads to ATP
depletion, sodium-potassium pump failure, and cell swelling.
Q12. Reperfusion injury refers to:
A. Injury that occurs during hypoxia
B. Additional injury that occurs when blood flow is restored to ischemic tissue
(due to oxygen free radicals and inflammation)
C. Injury that occurs during anesthesia
D. Injury that occurs during exercise
Rationale: Reperfusion injury is the paradoxical exacerbation of cellular injury when blood
flow is restored to ischemic tissue. Oxygen free radicals and inflammatory mediators cause
additional damage beyond that caused by ischemia alone.
Q13. A patient with carbon monoxide poisoning has hypoxia. The mechanism of
injury is:
A. Impaired oxygen-carrying capacity of hemoglobin
B. Reduced blood flow
C. Inability to use oxygen at the cellular level
QUESTIONS) Modules 1-7 & Final Exam | William
Paterson University | 2026 Curriculum
MODULE 1: CELLULAR ADAPTATION, INJURY & GENETICS
Q1. A patient with hypertension develops left ventricular hypertrophy. This is an
example of which type of cellular adaptation?
A. Atrophy
B. Hyperplasia
C. Hypertrophy
D. Metaplasia
Rationale: Hypertrophy is an increase in cell size. In hypertension, the left ventricle works
against increased pressure, causing heart muscle cells (myocytes) to enlarge.
Q2. The hallmark of apoptosis is:
A. Cell swelling and lysis
B. Inflammation
C. Cell shrinkage, nuclear fragmentation, and formation of apoptotic bodies
(no inflammation)
D. Caseous necrosis
Rationale: Apoptosis is programmed cell death characterized by cell shrinkage, chromatin
condensation, nuclear fragmentation, and formation of apoptotic bodies that are
phagocytosed without causing inflammation.
Q3. A patient who smokes has chronic bronchial irritation. Normal ciliated columnar
epithelium is replaced by stratified squamous epithelium. This is an example of:
A. Hypertrophy
B. Hyperplasia
, C. Metaplasia
D. Dysplasia
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with
another as an adaptive response to chronic irritation. In smokers, this change is protective
but can predispose to cancer.
Q4. A patient with chronic kidney disease has small, shrunken kidneys due to loss of
cells. This is an example of:
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Rationale: Atrophy is a decrease in cell size and organ size. In chronic kidney disease,
prolonged ischemia and loss of nephrons lead to atrophy of remaining nephrons and overall
kidney shrinkage.
Q5. A patient experiences a myocardial infarction. The type of cell death that occurs
is:
A. Apoptosis
B. Necrosis (coagulative necrosis)
C. Pyroptosis
D. Autophagy
Rationale: Myocardial infarction causes ischemic cell death (necrosis), specifically
coagulative necrosis. Necrosis is unprogrammed cell death due to injury, whereas apoptosis
is programmed.
Q6. Which statement is true regarding basal cell carcinoma (BCC)?
A. BCC is most commonly found on the trunk and lower limbs
B. BCC is most commonly found on the head and neck
C. BCC rarely occurs on sun-exposed areas
D. BCC primarily arises on mucous membranes
,Rationale: Basal cell carcinoma is strongly linked to chronic sun exposure and therefore
most often appears on sun-exposed areas such as the face, scalp, and neck.
Q7. Which statement is true regarding unmatched packed red blood cell
transfusions?
A. People with type O blood have both A and B antigens
B. People with type O blood have neither A nor B antigens
C. People with type O blood have no antibodies in their plasma
D. Type AB blood cells lack A and B antigens
Rationale: Type O RBCs lack A and B antigens, making them "universal donor" red cells
when plasma is removed. Their plasma, however, contains anti-A and anti-B antibodies.
Q8. Which pathways activate the complement system?
A. Classical, lectin, and alternative
B. Intrinsic, extrinsic, and common
C. Primary, secondary, and tertiary
D. IgG-dependent and IgM-dependent
*Rationale: Complement can be activated via the antibody-dependent classical pathway,
the lectin pathway (mannose-binding), or the antibody-independent alternative pathway. All
converge on C3 activation.*
Q9. What is the term for cancer originating in connective tissues?
A. Carcinoma
B. Sarcoma
C. Lymphoma
D. Adenoma
Rationale: Sarcomas are malignant tumors arising from mesenchymal tissues such as
bone, muscle, fat, and connective tissue, distinct from carcinomas which arise from
epithelial tissues.
Q10. A substance that is recognized as foreign or nonself is:
A. An antibody
, B. A hapten
C. An antigen
D. A complement
Rationale: Antigens are molecules capable of being recognized by immune receptors as
foreign, thereby eliciting an immune response. Antibodies are the immune proteins
produced against antigens.
Q11. The most common cause of cellular injury is:
A. Genetic defects
B. Hypoxia (lack of oxygen)
C. Nutritional imbalances
D. Physical agents
Rationale: Hypoxia is the most common cause of cellular injury. It can result from ischemia
(reduced blood flow), anemia, CO poisoning, or respiratory failure. Hypoxia leads to ATP
depletion, sodium-potassium pump failure, and cell swelling.
Q12. Reperfusion injury refers to:
A. Injury that occurs during hypoxia
B. Additional injury that occurs when blood flow is restored to ischemic tissue
(due to oxygen free radicals and inflammation)
C. Injury that occurs during anesthesia
D. Injury that occurs during exercise
Rationale: Reperfusion injury is the paradoxical exacerbation of cellular injury when blood
flow is restored to ischemic tissue. Oxygen free radicals and inflammatory mediators cause
additional damage beyond that caused by ischemia alone.
Q13. A patient with carbon monoxide poisoning has hypoxia. The mechanism of
injury is:
A. Impaired oxygen-carrying capacity of hemoglobin
B. Reduced blood flow
C. Inability to use oxygen at the cellular level
