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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Carcinomas are typically hard, irregular, immobile, and may be associated with skin changes or nipple retraction. While breast cancer must always be ruled out, the described mass lacks the suspicious features of malignancy.
Choice B reason: A clogged duct is usually painful and associated with lactation. It presents as a tender, localized area of swelling and is not typically rubbery or mobile. This patient is nulligravid and not lactating, making this diagnosis unlikely.
Choice C reason: Fibroadenomas are common benign breast tumors in young women. They are typically smooth, round, rubbery, mobile, and nontender. The location in the upper outer quadrant and the described characteristics strongly suggest a fibroadenoma.
Choice D reason: Duct ectasia involves dilation of the milk ducts and may present with nipple discharge, tenderness, or inflammation. It is more common in older women and does not typically present as a discrete, mobile mass.
Correct Answer is B
Explanation
Choice A reason: Extreme blood loss is characteristic of hypovolemic shock, not septic shock. Hypovolemic shock results from a significant reduction in circulating blood volume due to hemorrhage or fluid loss, but it does not involve the immune-mediated cascade seen in sepsis.
Choice B reason: Septic shock is caused by an overwhelming infection that triggers a dysregulated host response, leading to widespread inflammation, endothelial dysfunction, vasodilation, and impaired tissue perfusion. This cascade is driven by microbial components such as lipopolysaccharides (LPS) binding to toll-like receptors, which activate cytokines like TNF and IL-1, resulting in systemic effects including hypotension and multi-organ dysfunction.
Choice C reason: Acute allergic reactions can lead to anaphylactic shock, which is mediated by IgE and histamine release, not by infectious agents. While both involve vasodilation and hypotension, the underlying mechanisms are distinct.
Choice D reason: Injury to the myocardium is a hallmark of cardiogenic shock, which results from impaired cardiac output due to myocardial infarction or arrhythmias. It does not explain the immune and vascular phenomena seen in septic shock.
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