A 41-year-old woman is diagnosed with asthma. Which of the following most closely explains the pathophysiology of airway constriction associated with asthma?
Inflammation of the bronchial wall leads to mucosal thickening, epithelial cell desquamation, and denudation of the basement membrane.
An irritant causes an inflammatory response, which leads to destruction of the alveolar air sacs. This causes 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 C
Choice A reason: While mucosal thickening and epithelial damage are part of asthma’s pathology, this description is incomplete and does not fully explain the mechanism of airway constriction. It omits the critical roles of smooth muscle contraction and mucus plugging, which are central to airflow limitation.
Choice B reason: This describes the pathophysiology of emphysema, a form of chronic obstructive pulmonary disease (COPD), not asthma. Emphysema involves destruction of alveolar walls and irreversible airflow obstruction, which is not characteristic of asthma.
Choice C reason: Asthma is a chronic inflammatory disorder of the airways characterized by variable and reversible airflow obstruction. The key mechanisms include infiltration of inflammatory cells (e.g., eosinophils, mast cells), mucus hypersecretion with plug formation, and bronchial smooth muscle contraction. These processes lead to narrowing of the airways and symptoms such as wheezing, dyspnea, and coughing.
Choice D reason: This describes the pathophysiology of acute respiratory distress syndrome (ARDS), not asthma. ARDS involves alveolar-capillary membrane damage and decreased lung compliance due to fluid leakage, which is unrelated to the bronchial hyperresponsiveness seen in asthma.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Cerebral edema is a rare but serious complication associated more with rapid shifts in osmolality, such as in dialysis disequilibrium syndrome. It is not the most common or significant complication of routine intermittent hemodialysis.
Choice B reason: Arrhythmias can occur due to electrolyte imbalances during dialysis, particularly with potassium shifts. However, they are less frequent and not as consistently observed as hypotension.
Choice C reason: Hypotension is the most frequent and significant complication of intermittent hemodialysis. It results from rapid fluid removal, autonomic dysfunction, or impaired cardiac output. It can lead to dizziness, nausea, cramps, and even syncope, making it a critical concern during dialysis sessions.
Choice D reason: Hypertension is a chronic issue in patients with kidney disease, but it is not a direct complication of the dialysis procedure itself. In fact, dialysis often helps manage fluid overload and blood pressure.
Correct Answer is D
Explanation
Choice A reason: This describes the pathophysiology of chronic bronchitis, a form of chronic obstructive pulmonary disease (COPD), not bacterial pneumonia. It involves inflammation of the bronchial walls and mucosal changes but does not explain the alveolar involvement seen in pneumonia.
Choice B reason: This is characteristic of emphysema, another form of COPD, where alveolar walls are destroyed leading to air trapping and reduced gas exchange. It is not the mechanism of bacterial pneumonia.
Choice C reason: This describes asthma, where airway obstruction results from smooth muscle contraction, mucus production, and inflammation. Pneumonia does not typically involve bronchospasm or reversible airway obstruction.
Choice D reason: This accurately describes bacterial pneumonia. The infection triggers an inflammatory response that increases permeability of the alveolar-capillary membrane, leading to fluid accumulation, impaired gas exchange, and reduced lung compliance. This results in symptoms such as dyspnea, cough, and hypoxia.
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