A 23-year-old woman presents with a productive cough, malaise, difficulty breathing, and wheezing. The nurse practitioner diagnoses her with acute bronchitis and knows that which of the following describes the pathophysiology of this disease process?
A trigger such as viral infection causes inflammation of the bronchial wall. This inflammation leads to mucosal thickening, epithelial cell desquamation, and denudation of the basement membrane.
An irritant causes an inflammatory response that leads to destruction of the alveolar air sacs, causing irreversible obstructive airway physiology.
Airway obstruction occurs due to the combination of inflammatory cell infiltration, mucus hypersecretion with mucus plug formation, and smooth muscle contraction.
The inflammatory response initiated by a viral or bacterial infection causes leakage of the alveolar-capillary membrane at the site of inflammation, causing a decrease in lung compliance and shortness of breath.
The Correct Answer is A
Choice A reason: Acute bronchitis is most commonly caused by viral infections that trigger inflammation of the bronchial walls. This leads to mucosal thickening, epithelial damage, and increased mucus production, resulting in cough and wheezing. The epithelial injury contributes to the symptoms and transient airflow limitation.
Choice B reason: This describes emphysema, a chronic condition involving destruction of alveolar walls and irreversible airflow obstruction. Acute bronchitis does not involve alveolar destruction.
Choice C reason: This describes asthma, which involves chronic inflammation, mucus plugging, and bronchial smooth muscle contraction. While bronchitis may cause wheezing, it does not involve the same pathophysiologic mechanisms.
Choice D reason: This describes acute respiratory distress syndrome (ARDS), which involves alveolar-capillary membrane damage and fluid leakage. It is a severe condition unrelated to the typical presentation of acute bronchitis.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: CCBs are effective in Black patients with hypertension, especially in monotherapy. They work by relaxing vascular smooth muscle and reducing peripheral resistance, which is beneficial in salt-sensitive hypertension.
Choice B reason: ACE inhibitors are less effective as monotherapy in Black patients due to lower plasma renin activity. They may be used in combination therapy but are not preferred as initial treatment unless there are compelling indications such as heart failure or diabetic nephropathy.
Choice C reason: ARBs have similar limitations to ACE inhibitors in Black populations but may be better tolerated due to lower risk of cough. They are more effective when combined with diuretics or CCBs.
Choice D reason: Beta blockers are generally less effective in controlling blood pressure in Black patients unless there are specific indications such as arrhythmias or post-MI management. However, ACE inhibitors are still considered less effective overall in this demographic.
Correct Answer is A
Explanation
Choice A reason: ALL is most common in children, particularly those under 18 years of age, and is more prevalent in White populations. It is relatively rare in individuals over 50, and Black race is associated with slightly lower incidence rates. Therefore, this demographic profile is not typical of ALL.
Choice B reason: This is a common demographic for ALL. The disease predominantly affects children, especially those of White ethnicity, and is the most common pediatric cancer.
Choice C reason: Genetic syndromes such as Down syndrome, neurofibromatosis type 1, Bloom syndrome, and ataxia telangiectasia are known risk factors for developing ALL. These conditions are associated with genomic instability and increased malignancy risk.
Choice D reason: Advances in treatment have significantly improved survival rates for pediatric ALL, with five-year survival exceeding 85% in many cases. This reflects the effectiveness of current chemotherapy protocols and supportive care.
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