A 35-year-old man was salvaged from a burning house. Because of marked shortness of breath, he was placed on a ventilator. What is the underlying cause of dyspnea in this patient?
Bronchial Asthma
Diffuse alveolar damage
Hypersensitivity pneumonitis
Pulmonary emphysema
Wegener granulomatosis
The Correct Answer is B
A. Bronchial Asthma: Bronchial asthma involves reversible airway obstruction due to bronchospasm and inflammation, typically triggered by allergens or irritants. Although smoke can provoke bronchospasm, severe respiratory failure requiring ventilation after a burn injury is more consistent with widespread alveolar injury rather than isolated airway hyperreactivity.
B. Diffuse alveolar damage: Inhalation of hot gases and toxic smoke from a fire can cause direct injury to the alveolar-capillary membrane. This leads to increased vascular permeability, interstitial and alveolar edema, and formation of hyaline membranes—hallmarks of diffuse alveolar damage, the pathologic basis of acute respiratory distress syndrome (ARDS), resulting in severe hypoxemia and dyspnea.
C. Hypersensitivity pneumonitis: Hypersensitivity pneumonitis is an immune-mediated inflammatory reaction to inhaled organic antigens, such as mold or bird proteins. It develops after repeated antigen exposure and does not typically present acutely following smoke inhalation from a fire.
D. Pulmonary emphysema: Emphysema is characterized by destruction of alveolar walls and loss of elastic recoil, most commonly due to long-term smoking. It is a chronic condition and would not acutely develop after a single episode of smoke exposure.
E. Wegener granulomatosis: Wegener granulomatosis, now known as granulomatosis with polyangiitis, is a systemic vasculitis affecting small- to medium-sized vessels. It presents with chronic respiratory and renal manifestations, not acute respiratory failure immediately following smoke inhalation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Bronchial asthma:Asthma involves reversible airway obstruction due to bronchospasm and inflammation. While it can cause wheezing and shortness of breath, it does not typically result in sudden hoarseness or loss of voice.
B. Chronic bronchitis:Chronic bronchitis is a long-standing productive cough with mucus hypersecretion. It can cause throat irritation but does not usually produce acute hoarseness or aphonia.
C. Goodpasture syndrome:Goodpasture syndrome is an autoimmune disorder affecting the kidneys and lungs, causing hematuria and pulmonary hemorrhage. It does not involve the larynx or vocal cords and would not produce hoarseness or voice loss.
D. Laryngeal cancer:Laryngeal cancer, particularly in chronic smokers, commonly presents with progressive hoarseness due to involvement of the vocal cords. Tumor growth can eventually obstruct the vocal cords, leading to aphonia. These symptoms align with the patient’s history of hoarseness progressing to inability to speak.
E. Pulmonary thromboembolism:Pulmonary embolism causes sudden dyspnea, chest pain, and hypoxia, but it does not directly affect the larynx or vocal cords and would not account for hoarseness or voice loss.
Correct Answer is A
Explanation
A. Angina:Chest pain precipitated by exertion and relieved by nitroglycerin is characteristic of stable angina pectoris. It results from transient myocardial ischemia due to a mismatch between oxygen supply and demand, typically caused by atherosclerotic narrowing of coronary arteries. Nitroglycerin relieves pain by causing venodilation, reducing preload and myocardial oxygen demand.
B. Dyspnea:Dyspnea refers to the subjective sensation of shortness of breath. Although it may accompany cardiac ischemia, it is not defined as chest pain and does not specifically describe exertional discomfort relieved by nitroglycerin.
C. Dyspepsia:Dyspepsia describes indigestion or epigastric discomfort related to gastrointestinal causes. While it can sometimes mimic cardiac chest pain, it is unrelated to myocardial ischemia and would not consistently improve with nitroglycerin.
D. Dysphagia:Dysphagia refers to difficulty swallowing and is associated with esophageal or neuromuscular disorders. It does not describe exertional chest pain related to cardiac ischemia.
E. Orthopnea:Orthopnea is shortness of breath that occurs when lying flat and improves with sitting upright, often seen in heart failure. It is distinct from exertional chest pain relieved by nitrates and does not describe anginal symptoms.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.