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NUR 2063 Essentials of Pathophysiology Exam 1
Rasmussen University Actual Exam 2026/2027 –
Complete Exam-Style Questions with Detailed
Rationales | Pass Guaranteed – A+ Graded
[SECTION 1: Cellular Adaptation, Injury & Death — Questions 1-15]
Q1: A patient diagnosed with chronic obstructive pulmonary disease (COPD) presents with
increased muscle mass in the lower extremities due to the increased work of breathing. This
adaptation is best described as:
A. Atrophy
B. Hyperplasia
C. Metaplasia
D. Hypertrophy
Correct Answer: D
Rationale: Hypertrophy is defined as an increase in the size of individual cells, resulting in an
increase in the size of the organ. In this case, the respiratory muscles undergo hypertrophy in
response to the increased workload caused by COPD. Atrophy is a decrease in size, hyperplasia
is an increase in the number of cells, and metaplasia is a change in cell type.
Q2: A heavy smoker’s bronchial epithelium undergoes a reversible change where ciliated
columnar cells are replaced by stratified squamous epithelium. This cellular adaptation is called:
A. Metaplasia
B. Dysplasia
C. Anaplasia
D. Hyperplasia
Correct Answer: A
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with another,
often in response to chronic irritation or stress. In smokers, the normal ciliated columnar cells
,2
(which clear mucus) are replaced by tougher stratified squamous cells to withstand the smoke,
though this impairs lung function. Dysplasia refers to disordered growth and is a precancerous
change.
Q3: Which of the following is the most common cause of cellular injury?
A. Hypoxia
B. Chemical injury
C. Genetic factors
D. Immunologic injury
Correct Answer: A
Rationale: Hypoxia, or a lack of sufficient oxygen, is the most common cause of cellular injury
because oxygen is essential for aerobic ATP production. Without oxygen, cells cannot generate
energy to maintain membrane pumps, leading to cellular swelling and death. Chemical injury,
infection, and genetic factors are also significant causes but less prevalent than hypoxia.
Q4: A patient presents with a myocardial infarction (heart attack). Microscopic examination of
the affected heart tissue reveals coagulative necrosis. Which of the following best describes the
appearance of the cells in this type of necrosis?
A. liquefied, creamy pus
B. Preserved cellular outlines, loss of nuclei
C. Cheese-like appearance
D. Chalky white, fatty deposits
Correct Answer: B
Rationale: Coagulative necrosis is characteristic of ischemic injury in most organs (except the
brain). The architecture of the tissue is preserved for several days, but the cells lose their nuclei
and eosinophilic cytoplasm, creating a "ghost" outline of the cells. Liquefactive necrosis (Option
A) is seen in the brain or infections, and caseous (Option C) is seen in TB.
,3
Q5: A nurse is caring for a patient with a brain abscess. The nurse understands that the type of
necrosis occurring in the brain tissue is:
A. Coagulative necrosis
B. Liquefactive necrosis
C. Fat necrosis
D. Fibrinoid necrosis
Correct Answer: B
Rationale: Liquefactive necrosis occurs when cells are digested by enzymes, resulting in a liquid,
viscous mass. This is typical of the central nervous system (CNS) because brain tissue is rich in
lipids and lacks a robust stromal support structure, leading to rapid liquefaction after ischemia or
infection. Coagulative is typical of heart/kidney; fat necrosis is typical of the pancreas.
Q6: Which cellular change is considered a preneoplastic (potentially cancerous) alteration
characterized by disordered growth and maturation?
A. Dysplasia
B. Hyperplasia
C. Hypertrophy
D. Metaplasia
Correct Answer: A
Rationale: Dysplasia refers to deranged cell growth of a specific tissue, resulting in cells that
vary in size, shape, and organization. It is often a response to chronic irritation and is considered
a precursor to cancer (preneoplastic), particularly in epithelial tissues like the cervix. Hyperplasia
is an increase in number but maintains order.
Q7: During an ischemic event, the failure of the sodium-potassium (Na+/K+) pump leads to:
A. Increased protein synthesis
B. Shrinkage of the cell
C. Cellular swelling (hydropic degeneration)
, 4
D. Immediate cell death
Correct Answer: C
Rationale: Ischemia leads to ATP depletion. Without ATP, the Na+/K+ pump fails, allowing
sodium (and water) to rush into the cell while potassium leaks out. This influx of water causes
the cell to swell, a reversible injury known as hydropic degeneration. Increased protein synthesis
requires ATP, which is depleted.
Q8: Which of the following initiates the intrinsic pathway of apoptosis?
A. Release of cytochrome c from mitochondria
B. Binding of Fas ligand to its receptor
C. Activation of caspase-8
D. Binding of TNF-alpha to its receptor
Correct Answer: A
Rationale: The intrinsic (mitochondrial) pathway of apoptosis is triggered by internal cellular
stress, such as DNA damage or oxidative stress, leading to mitochondrial permeability and the
release of cytochrome c into the cytosol. Options B, C, and D describe the extrinsic pathway,
which is triggered by external death signals binding to cell surface receptors.
Q9: A patient with uncontrolled diabetes mellitus presents with a white, chalky substance on the
abdominal skin. This is indicative of:
A. Coagulative necrosis
B. Liquefactive necrosis
C. Calcification
D. Gangrene
Correct Answer: C
Rationale: Dystrophic calcification occurs in necrotic or degenerated tissue despite normal serum
calcium levels. In patients with diabetes, necrosis of fat (fat necrosis) can lead to the deposition
NUR 2063 Essentials of Pathophysiology Exam 1
Rasmussen University Actual Exam 2026/2027 –
Complete Exam-Style Questions with Detailed
Rationales | Pass Guaranteed – A+ Graded
[SECTION 1: Cellular Adaptation, Injury & Death — Questions 1-15]
Q1: A patient diagnosed with chronic obstructive pulmonary disease (COPD) presents with
increased muscle mass in the lower extremities due to the increased work of breathing. This
adaptation is best described as:
A. Atrophy
B. Hyperplasia
C. Metaplasia
D. Hypertrophy
Correct Answer: D
Rationale: Hypertrophy is defined as an increase in the size of individual cells, resulting in an
increase in the size of the organ. In this case, the respiratory muscles undergo hypertrophy in
response to the increased workload caused by COPD. Atrophy is a decrease in size, hyperplasia
is an increase in the number of cells, and metaplasia is a change in cell type.
Q2: A heavy smoker’s bronchial epithelium undergoes a reversible change where ciliated
columnar cells are replaced by stratified squamous epithelium. This cellular adaptation is called:
A. Metaplasia
B. Dysplasia
C. Anaplasia
D. Hyperplasia
Correct Answer: A
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with another,
often in response to chronic irritation or stress. In smokers, the normal ciliated columnar cells
,2
(which clear mucus) are replaced by tougher stratified squamous cells to withstand the smoke,
though this impairs lung function. Dysplasia refers to disordered growth and is a precancerous
change.
Q3: Which of the following is the most common cause of cellular injury?
A. Hypoxia
B. Chemical injury
C. Genetic factors
D. Immunologic injury
Correct Answer: A
Rationale: Hypoxia, or a lack of sufficient oxygen, is the most common cause of cellular injury
because oxygen is essential for aerobic ATP production. Without oxygen, cells cannot generate
energy to maintain membrane pumps, leading to cellular swelling and death. Chemical injury,
infection, and genetic factors are also significant causes but less prevalent than hypoxia.
Q4: A patient presents with a myocardial infarction (heart attack). Microscopic examination of
the affected heart tissue reveals coagulative necrosis. Which of the following best describes the
appearance of the cells in this type of necrosis?
A. liquefied, creamy pus
B. Preserved cellular outlines, loss of nuclei
C. Cheese-like appearance
D. Chalky white, fatty deposits
Correct Answer: B
Rationale: Coagulative necrosis is characteristic of ischemic injury in most organs (except the
brain). The architecture of the tissue is preserved for several days, but the cells lose their nuclei
and eosinophilic cytoplasm, creating a "ghost" outline of the cells. Liquefactive necrosis (Option
A) is seen in the brain or infections, and caseous (Option C) is seen in TB.
,3
Q5: A nurse is caring for a patient with a brain abscess. The nurse understands that the type of
necrosis occurring in the brain tissue is:
A. Coagulative necrosis
B. Liquefactive necrosis
C. Fat necrosis
D. Fibrinoid necrosis
Correct Answer: B
Rationale: Liquefactive necrosis occurs when cells are digested by enzymes, resulting in a liquid,
viscous mass. This is typical of the central nervous system (CNS) because brain tissue is rich in
lipids and lacks a robust stromal support structure, leading to rapid liquefaction after ischemia or
infection. Coagulative is typical of heart/kidney; fat necrosis is typical of the pancreas.
Q6: Which cellular change is considered a preneoplastic (potentially cancerous) alteration
characterized by disordered growth and maturation?
A. Dysplasia
B. Hyperplasia
C. Hypertrophy
D. Metaplasia
Correct Answer: A
Rationale: Dysplasia refers to deranged cell growth of a specific tissue, resulting in cells that
vary in size, shape, and organization. It is often a response to chronic irritation and is considered
a precursor to cancer (preneoplastic), particularly in epithelial tissues like the cervix. Hyperplasia
is an increase in number but maintains order.
Q7: During an ischemic event, the failure of the sodium-potassium (Na+/K+) pump leads to:
A. Increased protein synthesis
B. Shrinkage of the cell
C. Cellular swelling (hydropic degeneration)
, 4
D. Immediate cell death
Correct Answer: C
Rationale: Ischemia leads to ATP depletion. Without ATP, the Na+/K+ pump fails, allowing
sodium (and water) to rush into the cell while potassium leaks out. This influx of water causes
the cell to swell, a reversible injury known as hydropic degeneration. Increased protein synthesis
requires ATP, which is depleted.
Q8: Which of the following initiates the intrinsic pathway of apoptosis?
A. Release of cytochrome c from mitochondria
B. Binding of Fas ligand to its receptor
C. Activation of caspase-8
D. Binding of TNF-alpha to its receptor
Correct Answer: A
Rationale: The intrinsic (mitochondrial) pathway of apoptosis is triggered by internal cellular
stress, such as DNA damage or oxidative stress, leading to mitochondrial permeability and the
release of cytochrome c into the cytosol. Options B, C, and D describe the extrinsic pathway,
which is triggered by external death signals binding to cell surface receptors.
Q9: A patient with uncontrolled diabetes mellitus presents with a white, chalky substance on the
abdominal skin. This is indicative of:
A. Coagulative necrosis
B. Liquefactive necrosis
C. Calcification
D. Gangrene
Correct Answer: C
Rationale: Dystrophic calcification occurs in necrotic or degenerated tissue despite normal serum
calcium levels. In patients with diabetes, necrosis of fat (fat necrosis) can lead to the deposition
