NURS 370 | PATH370 Exam 1: Pathophysiology -
WCU Updated and Latest Questions and Correct
Answers with Rationale
1. A patient’s biopsy report indicates a decrease in the size of the skeletal muscle cells in the
left leg. How should the nurse document this cellular adaptation?
A. Atrophy
B. Hypertrophy
C. Metaplasia
D. Hyperplasia
Correct Answer: A
Rationale: Atrophy occurs when cells decrease in size due to a reduction in demand or
adverse environmental conditions. This adaptation allows the cell to survive by decreasing
its metabolic requirements. It often occurs in skeletal muscle when a limb is placed in a cast
and remains immobile. Unlike hypertrophy, which involves an increase in size, atrophy is a
downsizing process. Consequently, the affected organ or tissue becomes smaller and less
functional.
2. Which process describes the replacement of one adult cell type by another, often due to
chronic irritation like smoking?
A. Dysplasia
B. Hyperplasia
C. Anaplasia
D. Metaplasia
Correct Answer: D
Rationale: Metaplasia is a reversible change in which one adult cell type is replaced by
another adult cell type. This usually occurs in response to chronic irritation or
inflammation to better withstand the environment. A common example is the replacement
of ciliated columnar epithelium with stratified squamous epithelium in smokers. While this
new cell type is more resilient, it often lacks the specialized functions of the original tissue.
This adaptation remains reversible if the causative stimulus is removed promptly.
3. A patient is diagnosed with an enlarged heart due to chronic high blood pressure. Which
type of cellular adaptation is this?
A. Physiologic Hypertrophy
B. Pathologic Hyperplasia
,C. Pathologic Hypertrophy
D. Atrophy
Correct Answer: C
Rationale: Pathologic hypertrophy is an increase in cell size in response to an abnormal
workload. In the case of hypertension, the heart muscle cells must work harder to pump
blood against increased resistance. This results in the thickening of the ventricular walls to
accommodate the stress. Unlike physiologic hypertrophy seen in athletes, this condition
can eventually lead to heart failure. Therefore, it is categorized as a pathologic adaptation
to disease.
4. What is the primary mechanism of cellular injury caused by hypoxia?
A. Increase in cellular pH
B. Failure of the sodium-potassium pump
C. Decrease in intracellular calcium
D. Increased protein synthesis
Correct Answer: B
Rationale: Hypoxia leads to a decrease in mitochondrial oxygenation and a subsequent
drop in ATP production. Without ATP, the sodium-potassium pump fails, leading to sodium
accumulation inside the cell. Water follows sodium into the cell, resulting in acute cellular
swelling. This process also causes potassium to leak out of the cell. If oxygen is not
restored, the swelling can lead to irreversible damage and cell death.
5. Which type of necrosis is typically associated with tuberculosis infections in the lungs?
A. Liquefactive necrosis
B. Caseous necrosis
C. Fat necrosis
D. Coagulative necrosis
Correct Answer: B
Rationale: Caseous necrosis is a unique form of cell death that results in a cheese-like
appearance of the dead tissue. It is most commonly seen in the center of tuberculous
granulomas in the lungs. The tissue architecture is completely obliterated, leaving a soft,
friable mass. It combines elements of both coagulative and liquefactive necrosis. This
specific pattern helps clinicians identify underlying mycobacterial infections.
6. A patient experiences a myocardial infarction. Which type of necrosis is most likely to occur
in the heart tissue?
A. Gangrenous necrosis
, B. Liquefactive necrosis
C. Caseous necrosis
D. Coagulative necrosis
Correct Answer: D
Rationale: Coagulative necrosis occurs primarily in the heart, kidneys, and adrenal glands
following hypoxia or ischemia. The denaturation of proteins causes the tissue to maintain a
firm, opaque appearance for several days. This allows the basic outline of the cells to
remain visible under a microscope even though they are dead. It is the characteristic
pattern of death for most solid organ infarcts except the brain. Eventually, inflammatory
cells remove the dead tissue to allow for scarring.
7. What is the hallmark of irreversible cellular injury?
A. Cellular swelling
B. Ribosomal detachment
C. Massive calcium influx into the cell
D. Accumulation of lipids
Correct Answer: C
Rationale: Irreversible injury is characterized by severe membrane damage and
mitochondrial dysfunction. When the cell membrane is breached, calcium ions flood into
the cytosol from the extracellular space. This massive influx of calcium activates various
destructive enzymes that degrade proteins, DNA, and lipids. Once these internal structures
are destroyed, the cell can no longer recover. Therefore, calcium regulation loss is a critical
point of no return in cell death.
8. Which of the following describes apoptosis?
A. Uncontrolled cell death causing inflammation
B. Programmed cell death that does not trigger inflammation
C. Cell death caused by physical trauma
D. Death of a large group of cells simultaneously
Correct Answer: B
Rationale: Apoptosis is a highly regulated, programmed cell suicide process that removes
unwanted or damaged cells. Unlike necrosis, it does not cause the cell to burst or release its
contents into the surrounding tissue. Phagocytic cells quickly ingest the apoptotic bodies,
preventing an inflammatory response. This process is essential for normal development
and the elimination of potentially cancerous cells. It can be triggered by both internal and
external cellular signals.
WCU Updated and Latest Questions and Correct
Answers with Rationale
1. A patient’s biopsy report indicates a decrease in the size of the skeletal muscle cells in the
left leg. How should the nurse document this cellular adaptation?
A. Atrophy
B. Hypertrophy
C. Metaplasia
D. Hyperplasia
Correct Answer: A
Rationale: Atrophy occurs when cells decrease in size due to a reduction in demand or
adverse environmental conditions. This adaptation allows the cell to survive by decreasing
its metabolic requirements. It often occurs in skeletal muscle when a limb is placed in a cast
and remains immobile. Unlike hypertrophy, which involves an increase in size, atrophy is a
downsizing process. Consequently, the affected organ or tissue becomes smaller and less
functional.
2. Which process describes the replacement of one adult cell type by another, often due to
chronic irritation like smoking?
A. Dysplasia
B. Hyperplasia
C. Anaplasia
D. Metaplasia
Correct Answer: D
Rationale: Metaplasia is a reversible change in which one adult cell type is replaced by
another adult cell type. This usually occurs in response to chronic irritation or
inflammation to better withstand the environment. A common example is the replacement
of ciliated columnar epithelium with stratified squamous epithelium in smokers. While this
new cell type is more resilient, it often lacks the specialized functions of the original tissue.
This adaptation remains reversible if the causative stimulus is removed promptly.
3. A patient is diagnosed with an enlarged heart due to chronic high blood pressure. Which
type of cellular adaptation is this?
A. Physiologic Hypertrophy
B. Pathologic Hyperplasia
,C. Pathologic Hypertrophy
D. Atrophy
Correct Answer: C
Rationale: Pathologic hypertrophy is an increase in cell size in response to an abnormal
workload. In the case of hypertension, the heart muscle cells must work harder to pump
blood against increased resistance. This results in the thickening of the ventricular walls to
accommodate the stress. Unlike physiologic hypertrophy seen in athletes, this condition
can eventually lead to heart failure. Therefore, it is categorized as a pathologic adaptation
to disease.
4. What is the primary mechanism of cellular injury caused by hypoxia?
A. Increase in cellular pH
B. Failure of the sodium-potassium pump
C. Decrease in intracellular calcium
D. Increased protein synthesis
Correct Answer: B
Rationale: Hypoxia leads to a decrease in mitochondrial oxygenation and a subsequent
drop in ATP production. Without ATP, the sodium-potassium pump fails, leading to sodium
accumulation inside the cell. Water follows sodium into the cell, resulting in acute cellular
swelling. This process also causes potassium to leak out of the cell. If oxygen is not
restored, the swelling can lead to irreversible damage and cell death.
5. Which type of necrosis is typically associated with tuberculosis infections in the lungs?
A. Liquefactive necrosis
B. Caseous necrosis
C. Fat necrosis
D. Coagulative necrosis
Correct Answer: B
Rationale: Caseous necrosis is a unique form of cell death that results in a cheese-like
appearance of the dead tissue. It is most commonly seen in the center of tuberculous
granulomas in the lungs. The tissue architecture is completely obliterated, leaving a soft,
friable mass. It combines elements of both coagulative and liquefactive necrosis. This
specific pattern helps clinicians identify underlying mycobacterial infections.
6. A patient experiences a myocardial infarction. Which type of necrosis is most likely to occur
in the heart tissue?
A. Gangrenous necrosis
, B. Liquefactive necrosis
C. Caseous necrosis
D. Coagulative necrosis
Correct Answer: D
Rationale: Coagulative necrosis occurs primarily in the heart, kidneys, and adrenal glands
following hypoxia or ischemia. The denaturation of proteins causes the tissue to maintain a
firm, opaque appearance for several days. This allows the basic outline of the cells to
remain visible under a microscope even though they are dead. It is the characteristic
pattern of death for most solid organ infarcts except the brain. Eventually, inflammatory
cells remove the dead tissue to allow for scarring.
7. What is the hallmark of irreversible cellular injury?
A. Cellular swelling
B. Ribosomal detachment
C. Massive calcium influx into the cell
D. Accumulation of lipids
Correct Answer: C
Rationale: Irreversible injury is characterized by severe membrane damage and
mitochondrial dysfunction. When the cell membrane is breached, calcium ions flood into
the cytosol from the extracellular space. This massive influx of calcium activates various
destructive enzymes that degrade proteins, DNA, and lipids. Once these internal structures
are destroyed, the cell can no longer recover. Therefore, calcium regulation loss is a critical
point of no return in cell death.
8. Which of the following describes apoptosis?
A. Uncontrolled cell death causing inflammation
B. Programmed cell death that does not trigger inflammation
C. Cell death caused by physical trauma
D. Death of a large group of cells simultaneously
Correct Answer: B
Rationale: Apoptosis is a highly regulated, programmed cell suicide process that removes
unwanted or damaged cells. Unlike necrosis, it does not cause the cell to burst or release its
contents into the surrounding tissue. Phagocytic cells quickly ingest the apoptotic bodies,
preventing an inflammatory response. This process is essential for normal development
and the elimination of potentially cancerous cells. It can be triggered by both internal and
external cellular signals.
