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NR 507 Advanced Pathophysiology Midterm Exam –
Chamberlain University | 75 Actual Exam Questions
& Answers (2026/2027)Verified Q&A with Detailed
Rationales | 100% Correct | A+ Graded
CORE CONCEPTS: CELLULAR ADAPTATION & INJURY
Q1. A patient is diagnosed with an irreversible cell injury
characterized by cell swelling, rupture of the cell membrane, and
inflammation. Which type of cellular death is this?
• A) Apoptosis
• B) Necrosis
• C) Autophagy
• D) Atrophy
: Answer : B) Necrosis
Rationale: Necrosis is a form of irreversible cell injury that results in cell
swelling, membrane rupture, and an inflammatory response. It is
typically caused by external factors like ischemia, toxins, or trauma.
Apoptosis (A) is programmed cell death that is controlled, energy-
dependent, and does not elicit inflammation. Autophagy (C) is a self-
digestive process that recycles cellular components. Atrophy (D) is a
decrease in cell size due to reduced workload or nutrients.
Q2. Which cellular adaptation is most likely to occur in the heart
muscle of a patient with long-standing, uncontrolled hypertension?
pg. 1
,2
• A) Hyperplasia
• B) Metaplasia
• C) Hypertrophy
• D) Dysplasia
: Answer : C) Hypertrophy
Rationale: Hypertrophy is an increase in cell size leading to organ
enlargement. The cardiac myocytes cannot divide significantly (limited
hyperplasia), so they respond to increased afterload from chronic
hypertension by synthesizing more proteins and increasing in size.
Hyperplasia (A) is an increase in cell number, typical in tissues that can
divide. Metaplasia (B) is the replacement of one differentiated cell type
with another. Dysplasia (D) is disordered cellular growth often
associated with neoplasia.
Q3. A nurse recalls that the primary mechanism of cellular injury
during hypoxia is:
• A) ATP depletion leading to failure of sodium-potassium pump
• B) Direct damage to the cell membrane by free radicals
• C) Activation of the complement system
• D) Release of lysosomal enzymes by bacteria
: Answer : A) ATP depletion leading to failure of sodium-potassium
pump
Rationale: Hypoxia reduces oxidative phosphorylation, decreasing ATP
production. The ATP-dependent Na+/K+ pump fails, causing
intracellular sodium and water accumulation (cellular swelling), and
pg. 2
,3
calcium influx, which activates damaging enzymes. While free radicals
(B) may play a role in reperfusion injury, the primary event in hypoxia is
ATP depletion. Complement activation (C) occurs in immune-mediated
injury. Lysosomal enzyme release (D) occurs in some infections but is
not the primary mechanism of hypoxic injury.
Q4. A patient with chronic gastroesophageal reflux disease (GERD) has
squamous epithelial cells in the lower esophagus replaced by
columnar epithelial cells. This change is known as:
• A) Dysplasia
• B) Hyperplasia
• C) Anaplasia
• D) Metaplasia
: Answer : D) Metaplasia
Rationale: Metaplasia is the reversible replacement of one
differentiated cell type with another better suited to withstand an
adverse environment. In GERD, the acidic reflux damages the squamous
epithelium, so the body replaces it with more resilient columnar cells
(Barrett's esophagus). Dysplasia (A) is disordered growth. Hyperplasia
(B) is increased cell number. Anaplasia (C) is loss of differentiation
characteristic of malignant cells.
Q5. Which of the following is an example of physiologic hyperplasia?
• A) Endometrial hyperplasia in a postmenopausal woman
• B) Prostatic hyperplasia in an older man
pg. 3
, 4
• C) Breast and uterine enlargement during pregnancy
• D) Gingival hyperplasia due to phenytoin
: Answer : C) Breast and uterine enlargement during pregnancy
Rationale: Physiologic hyperplasia occurs in response to a normal,
expected stimulus, such as hormonal stimulation (estrogen and
progesterone) during pregnancy leading to enlargement of the breast
and uterus. Options A and B are examples of pathologic hyperplasia
(abnormal proliferation). Option D is drug-induced hyperplasia.
Q6. Free radical injury is implicated in the pathogenesis of all of the
following EXCEPT:
• A) Reperfusion injury after myocardial infarction
• B) Alzheimer's disease
• C) Allergic contact dermatitis
• D) Atherosclerosis
: Answer : C) Allergic contact dermatitis
Rationale: Allergic contact dermatitis is a Type IV (delayed)
hypersensitivity reaction mediated by T-cells, not directly by free
radical injury. Free radicals (reactive oxygen species) contribute to
reperfusion injury (A), Alzheimer's (B) (oxidative stress), and
atherosclerosis (D) (oxidation of LDL).
Q7. The process of cellular aging is associated with progressive
shortening of which chromosomal structure?
• A) Centromere
pg. 4
NR 507 Advanced Pathophysiology Midterm Exam –
Chamberlain University | 75 Actual Exam Questions
& Answers (2026/2027)Verified Q&A with Detailed
Rationales | 100% Correct | A+ Graded
CORE CONCEPTS: CELLULAR ADAPTATION & INJURY
Q1. A patient is diagnosed with an irreversible cell injury
characterized by cell swelling, rupture of the cell membrane, and
inflammation. Which type of cellular death is this?
• A) Apoptosis
• B) Necrosis
• C) Autophagy
• D) Atrophy
: Answer : B) Necrosis
Rationale: Necrosis is a form of irreversible cell injury that results in cell
swelling, membrane rupture, and an inflammatory response. It is
typically caused by external factors like ischemia, toxins, or trauma.
Apoptosis (A) is programmed cell death that is controlled, energy-
dependent, and does not elicit inflammation. Autophagy (C) is a self-
digestive process that recycles cellular components. Atrophy (D) is a
decrease in cell size due to reduced workload or nutrients.
Q2. Which cellular adaptation is most likely to occur in the heart
muscle of a patient with long-standing, uncontrolled hypertension?
pg. 1
,2
• A) Hyperplasia
• B) Metaplasia
• C) Hypertrophy
• D) Dysplasia
: Answer : C) Hypertrophy
Rationale: Hypertrophy is an increase in cell size leading to organ
enlargement. The cardiac myocytes cannot divide significantly (limited
hyperplasia), so they respond to increased afterload from chronic
hypertension by synthesizing more proteins and increasing in size.
Hyperplasia (A) is an increase in cell number, typical in tissues that can
divide. Metaplasia (B) is the replacement of one differentiated cell type
with another. Dysplasia (D) is disordered cellular growth often
associated with neoplasia.
Q3. A nurse recalls that the primary mechanism of cellular injury
during hypoxia is:
• A) ATP depletion leading to failure of sodium-potassium pump
• B) Direct damage to the cell membrane by free radicals
• C) Activation of the complement system
• D) Release of lysosomal enzymes by bacteria
: Answer : A) ATP depletion leading to failure of sodium-potassium
pump
Rationale: Hypoxia reduces oxidative phosphorylation, decreasing ATP
production. The ATP-dependent Na+/K+ pump fails, causing
intracellular sodium and water accumulation (cellular swelling), and
pg. 2
,3
calcium influx, which activates damaging enzymes. While free radicals
(B) may play a role in reperfusion injury, the primary event in hypoxia is
ATP depletion. Complement activation (C) occurs in immune-mediated
injury. Lysosomal enzyme release (D) occurs in some infections but is
not the primary mechanism of hypoxic injury.
Q4. A patient with chronic gastroesophageal reflux disease (GERD) has
squamous epithelial cells in the lower esophagus replaced by
columnar epithelial cells. This change is known as:
• A) Dysplasia
• B) Hyperplasia
• C) Anaplasia
• D) Metaplasia
: Answer : D) Metaplasia
Rationale: Metaplasia is the reversible replacement of one
differentiated cell type with another better suited to withstand an
adverse environment. In GERD, the acidic reflux damages the squamous
epithelium, so the body replaces it with more resilient columnar cells
(Barrett's esophagus). Dysplasia (A) is disordered growth. Hyperplasia
(B) is increased cell number. Anaplasia (C) is loss of differentiation
characteristic of malignant cells.
Q5. Which of the following is an example of physiologic hyperplasia?
• A) Endometrial hyperplasia in a postmenopausal woman
• B) Prostatic hyperplasia in an older man
pg. 3
, 4
• C) Breast and uterine enlargement during pregnancy
• D) Gingival hyperplasia due to phenytoin
: Answer : C) Breast and uterine enlargement during pregnancy
Rationale: Physiologic hyperplasia occurs in response to a normal,
expected stimulus, such as hormonal stimulation (estrogen and
progesterone) during pregnancy leading to enlargement of the breast
and uterus. Options A and B are examples of pathologic hyperplasia
(abnormal proliferation). Option D is drug-induced hyperplasia.
Q6. Free radical injury is implicated in the pathogenesis of all of the
following EXCEPT:
• A) Reperfusion injury after myocardial infarction
• B) Alzheimer's disease
• C) Allergic contact dermatitis
• D) Atherosclerosis
: Answer : C) Allergic contact dermatitis
Rationale: Allergic contact dermatitis is a Type IV (delayed)
hypersensitivity reaction mediated by T-cells, not directly by free
radical injury. Free radicals (reactive oxygen species) contribute to
reperfusion injury (A), Alzheimer's (B) (oxidative stress), and
atherosclerosis (D) (oxidation of LDL).
Q7. The process of cellular aging is associated with progressive
shortening of which chromosomal structure?
• A) Centromere
pg. 4
