Exam 1: NSG3280 / NSG 3280
Pathophysiology for Nurses I
(Latest Update 2026/ 2027 Update) Review Q & A
With Detailed Rationales | Grade A
100% Correct - Galen
Q1: A patient with long-standing hypertension develops left ventricular hypertrophy. Which
cellular adaptation mechanism best explains this change?
A. Hyperplasia of cardiac myocytes
B. Metaplasia of endothelial cells
C. Hypertrophy of cardiac myocytes [CORRECT]
D. Atrophy due to reduced workload
Correct Answer: C
Rationale: Correct because hypertrophy is the increase in cell size, not number, which is the
primary adaptation in cardiac muscle under increased pressure load. This matches the
pathophysiology of hypertension-induced cardiac remodeling.
Q2: During cellular injury, which event occurs first in the progression toward irreversible
damage?
A. Lysosomal enzyme release
B. Mitochondrial membrane permeability transition
C. ATP depletion and failure of Na+/K+ pumps [CORRECT]
D. Nuclear chromatin clumping
Correct Answer: C
,Rationale: Correct because ATP depletion disrupts ion gradients, causing cellular swelling and
initiating the cascade of injury. This matches the sequence of early ischemic cell damage.
Q3: A 45-year-old smoker has bronchial epithelial cells replaced by stratified squamous
epithelium. Which term describes this change?
A. Dysplasia
B. Metaplasia [CORRECT]
C. Anaplasia
D. Hyperplasia
Correct Answer: B
Rationale: Correct because metaplasia is the reversible replacement of one mature cell type
with another, typically in response to chronic irritation. This matches the adaptive response
seen in smokers' airways.
Q4: Which type of necrosis is characterized by the preservation of tissue architecture as a
"ghost outline"?
A. Caseous
B. Coagulative [CORRECT]
C. Liquefactive
D. Fat
Correct Answer: B
Rationale: Correct because coagulative necrosis maintains tissue architecture due to protein
denaturation, common in ischemic organs like the heart. This matches the histologic pattern of
myocardial infarction.
Q5: A patient with severe sepsis develops disseminated intravascular coagulation (DIC). Which
pathophysiologic mechanism is primarily responsible?
, A. Uncontrolled platelet aggregation
B. Systemic activation of clotting and fibrinolytic pathways [CORRECT]
C. Vitamin K deficiency
D. Hepatic failure
Correct Answer: B
Rationale: Correct because DIC involves simultaneous widespread clotting and bleeding due to
systemic protease activation.
Q6: Which cellular change is associated with the accumulation of lipofuscin pigment?
A. Apoptosis
B. Atrophy and aging [CORRECT]
C. Hypertrophy
D. Hyperplasia
Correct Answer: B
Rationale: Correct because lipofuscin is a "wear-and-tear" pigment that accumulates in
lysosomes during atrophy or aging. This matches the histologic finding in older adults' organs.
Q7: A patient with a deep wound develops a red, swollen area with purulent drainage. Which
inflammatory cell is most abundant in this exudate?
A. Lymphocytes
B. Neutrophils [CORRECT]
C. Eosinophils
D. Macrophages
Correct Answer: B
Rationale: Correct because neutrophils are the first responders to bacterial infection,
dominating the acute inflammatory exudate. This matches the cellular profile of purulent
drainage.
Pathophysiology for Nurses I
(Latest Update 2026/ 2027 Update) Review Q & A
With Detailed Rationales | Grade A
100% Correct - Galen
Q1: A patient with long-standing hypertension develops left ventricular hypertrophy. Which
cellular adaptation mechanism best explains this change?
A. Hyperplasia of cardiac myocytes
B. Metaplasia of endothelial cells
C. Hypertrophy of cardiac myocytes [CORRECT]
D. Atrophy due to reduced workload
Correct Answer: C
Rationale: Correct because hypertrophy is the increase in cell size, not number, which is the
primary adaptation in cardiac muscle under increased pressure load. This matches the
pathophysiology of hypertension-induced cardiac remodeling.
Q2: During cellular injury, which event occurs first in the progression toward irreversible
damage?
A. Lysosomal enzyme release
B. Mitochondrial membrane permeability transition
C. ATP depletion and failure of Na+/K+ pumps [CORRECT]
D. Nuclear chromatin clumping
Correct Answer: C
,Rationale: Correct because ATP depletion disrupts ion gradients, causing cellular swelling and
initiating the cascade of injury. This matches the sequence of early ischemic cell damage.
Q3: A 45-year-old smoker has bronchial epithelial cells replaced by stratified squamous
epithelium. Which term describes this change?
A. Dysplasia
B. Metaplasia [CORRECT]
C. Anaplasia
D. Hyperplasia
Correct Answer: B
Rationale: Correct because metaplasia is the reversible replacement of one mature cell type
with another, typically in response to chronic irritation. This matches the adaptive response
seen in smokers' airways.
Q4: Which type of necrosis is characterized by the preservation of tissue architecture as a
"ghost outline"?
A. Caseous
B. Coagulative [CORRECT]
C. Liquefactive
D. Fat
Correct Answer: B
Rationale: Correct because coagulative necrosis maintains tissue architecture due to protein
denaturation, common in ischemic organs like the heart. This matches the histologic pattern of
myocardial infarction.
Q5: A patient with severe sepsis develops disseminated intravascular coagulation (DIC). Which
pathophysiologic mechanism is primarily responsible?
, A. Uncontrolled platelet aggregation
B. Systemic activation of clotting and fibrinolytic pathways [CORRECT]
C. Vitamin K deficiency
D. Hepatic failure
Correct Answer: B
Rationale: Correct because DIC involves simultaneous widespread clotting and bleeding due to
systemic protease activation.
Q6: Which cellular change is associated with the accumulation of lipofuscin pigment?
A. Apoptosis
B. Atrophy and aging [CORRECT]
C. Hypertrophy
D. Hyperplasia
Correct Answer: B
Rationale: Correct because lipofuscin is a "wear-and-tear" pigment that accumulates in
lysosomes during atrophy or aging. This matches the histologic finding in older adults' organs.
Q7: A patient with a deep wound develops a red, swollen area with purulent drainage. Which
inflammatory cell is most abundant in this exudate?
A. Lymphocytes
B. Neutrophils [CORRECT]
C. Eosinophils
D. Macrophages
Correct Answer: B
Rationale: Correct because neutrophils are the first responders to bacterial infection,
dominating the acute inflammatory exudate. This matches the cellular profile of purulent
drainage.
