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Question 1: Cellular Adaptation and Injury
 Define cellular adaptation and provide examples of reversible and irreversible
cellular injuries. Explain the mechanisms of cellular injury in hypoxia and the
resulting cellular responses.
 Answer 1: Cellular Adaptation and Injury
 Cellular adaptation refers to the ability of cells to respond to environmental
changes to maintain homeostasis. Reversible injuries include cellular swelling, while
irreversible injuries involve necrosis or apoptosis. In hypoxia, decreased oxygen
supply leads to ATP depletion, causing sodium-potassium pump failure, cellular
swelling, and eventual cell death. The resulting cellular responses include activation
of inflammatory mediators and tissue damage.
 Rationale:
 This question assesses students' understanding of cellular adaptation, injury, and
the pathophysiological processes in hypoxic conditions, essential for nursing
assessment and intervention in clinical settings.
Question 2: Inflammation and Immune Response
 Outline the processes of acute and chronic inflammation, including the key cellular
and chemical mediators involved. Discuss the differences in the immune response
between innate and adaptive immunity.
 Answer 2: Inflammation and Immune Response
 Acute inflammation involves vasodilation, increased vascular permeability, and
leukocyte recruitment mediated by histamine, prostaglandins, and leukotrienes.
Chronic inflammation is characterized by tissue destruction, fibrosis, and
mononuclear cell infiltration, with cytokines and growth factors playing prominent
roles. Innate immunity provides immediate, nonspecific defense through physical
barriers and phagocytic cells, while adaptive immunity offers specific, long-term
protection via T and B lymphocytes and memory cells.
 Rationale:
 Evaluating students' grasp of inflammatory processes and immune responses is
crucial for recognizing and managing pathophysiological conditions in nursing
practice, particularly in infection and immune-related disorders.
Question 3: Endocrine Disorders and Hormonal Imbalance
 Describe the pathophysiology of type 1 diabetes mellitus, including the
autoimmune destruction of pancreatic beta cells and the resulting hormonal
imbalances. Discuss the clinical manifestations and potential complications
associated with uncontrolled type 1 diabetes.
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