NURS 611 Exam 1 V2 | NURS 611
Advanced Pathophysiology | Maryville
University of St. Louis | 2026 Q&A with
Rationale (Maryville NURS611 Exam 1
2026)
1. A patient with a history of smoking presents with a change in the cellular structure of the
bronchial lining, where ciliated columnar epithelium is replaced by stratified squamous
epithelium. What is this cellular adaptation called?
A. Metaplasia
B. Hyperplasia
C. Dysplasia
D. Anaplasia
Correct Answer: A
Rationale: Metaplasia is the reversible replacement of one mature cell type by another
mature cell type. In smokers, the chronic irritation from smoke causes the delicate ciliated
columnar cells to be replaced by tougher stratified squamous cells. While these new cells
are more resistant to smoke, they lose the protective function of mucus secretion and cilia.
2. Which of the following processes is characterized by programmed cell death and does not
typically trigger an inflammatory response?
A. Coagulative necrosis
,B. Liquefactive necrosis
C. Autophagy
D. Apoptosis
Correct Answer: D
Rationale: Apoptosis is a distinct type of cell death that is genetically programmed and
occurs in both physiological and pathological conditions. Unlike necrosis, which involves
cell swelling and membrane rupture leading to inflammation, apoptosis results in the
fragmentation of the cell into membrane-bound bodies. These apoptotic bodies are quickly
phagocytosed by neighboring cells without releasing cellular contents into the
environment.
3. A 45-year-old male is diagnosed with left ventricular hypertrophy due to chronic
hypertension. This increase in heart size is primarily caused by:
A. An increase in the number of cardiac myocytes
B. Accumulation of fluid in the pericardial sac
C. An increase in the size of individual cardiac myocytes
D. Replacement of muscle with fibrous connective tissue
Correct Answer: C
Rationale: Hypertrophy is an increase in the size of cells, which consequently increases the
size of the organ. In the heart, cardiac myocytes are unable to divide (undergo hyperplasia),
, so the heart compensates for an increased workload by increasing the size of existing cells.
This adaptation is a response to mechanical stretch and trophic signals like growth factors.
4. During a hypoxic injury, the failure of the sodium-potassium pump leads to which of the
following intracellular changes?
A. Intracellular dehydration
B. Increased intracellular pH
C. Decreased intracellular sodium
D. Increased intracellular calcium
Correct Answer: D
Rationale: When ATP levels drop during hypoxia, the Na+/K+ pump and the calcium pump
fail. This leads to an accumulation of sodium inside the cell, which draws water in
(swelling), and a significant rise in intracellular calcium. The high calcium levels activate
enzymes that damage the cell membrane and DNA.
5. A patient is found to have a chromosomal abnormality where they have only one X
chromosome (45, X). This condition is known as:
A. Klinefelter syndrome
B. Down syndrome
C. Turner syndrome
D. Cri du chat syndrome
Advanced Pathophysiology | Maryville
University of St. Louis | 2026 Q&A with
Rationale (Maryville NURS611 Exam 1
2026)
1. A patient with a history of smoking presents with a change in the cellular structure of the
bronchial lining, where ciliated columnar epithelium is replaced by stratified squamous
epithelium. What is this cellular adaptation called?
A. Metaplasia
B. Hyperplasia
C. Dysplasia
D. Anaplasia
Correct Answer: A
Rationale: Metaplasia is the reversible replacement of one mature cell type by another
mature cell type. In smokers, the chronic irritation from smoke causes the delicate ciliated
columnar cells to be replaced by tougher stratified squamous cells. While these new cells
are more resistant to smoke, they lose the protective function of mucus secretion and cilia.
2. Which of the following processes is characterized by programmed cell death and does not
typically trigger an inflammatory response?
A. Coagulative necrosis
,B. Liquefactive necrosis
C. Autophagy
D. Apoptosis
Correct Answer: D
Rationale: Apoptosis is a distinct type of cell death that is genetically programmed and
occurs in both physiological and pathological conditions. Unlike necrosis, which involves
cell swelling and membrane rupture leading to inflammation, apoptosis results in the
fragmentation of the cell into membrane-bound bodies. These apoptotic bodies are quickly
phagocytosed by neighboring cells without releasing cellular contents into the
environment.
3. A 45-year-old male is diagnosed with left ventricular hypertrophy due to chronic
hypertension. This increase in heart size is primarily caused by:
A. An increase in the number of cardiac myocytes
B. Accumulation of fluid in the pericardial sac
C. An increase in the size of individual cardiac myocytes
D. Replacement of muscle with fibrous connective tissue
Correct Answer: C
Rationale: Hypertrophy is an increase in the size of cells, which consequently increases the
size of the organ. In the heart, cardiac myocytes are unable to divide (undergo hyperplasia),
, so the heart compensates for an increased workload by increasing the size of existing cells.
This adaptation is a response to mechanical stretch and trophic signals like growth factors.
4. During a hypoxic injury, the failure of the sodium-potassium pump leads to which of the
following intracellular changes?
A. Intracellular dehydration
B. Increased intracellular pH
C. Decreased intracellular sodium
D. Increased intracellular calcium
Correct Answer: D
Rationale: When ATP levels drop during hypoxia, the Na+/K+ pump and the calcium pump
fail. This leads to an accumulation of sodium inside the cell, which draws water in
(swelling), and a significant rise in intracellular calcium. The high calcium levels activate
enzymes that damage the cell membrane and DNA.
5. A patient is found to have a chromosomal abnormality where they have only one X
chromosome (45, X). This condition is known as:
A. Klinefelter syndrome
B. Down syndrome
C. Turner syndrome
D. Cri du chat syndrome
