A nurse is caring for a client admitted with meningitis. The student nurse asks, "I know that the client has a lot of edemas in the brain, but what causes it?" Which of the following responses from the nurse best answers the student's question?
"Cerebral edema is caused by osmotic cerebral edema."
"Cerebral edema is caused by whole body inflammation which affects the brain the most."
"Cerebral edema is caused by the by-products of the pathogen that causes the meningitis."
"Cerebral edema is caused by cerebrospinal fluid flowing from the intraventricular space to the interstitial area of the brain."
The Correct Answer is C
A. Osmotic edema refers to fluid shifts due to changes in osmotic gradients (as seen in conditions like hyponatremia), not the inflammatory process of meningitis.
B. While inflammation is a key part of the body's response in meningitis, the edema is not a result of generalized whole-body inflammation. The edema is more directly linked to local inflammatory reactions in the brain triggered by the pathogen’s by-products.
C. Bacterial cell walls, endotoxins, and other components released by the bacteria directly stimulate inflammation, causing the breakdown of the BBB and allowing fluid and inflammatory cells to leak into the brain tissue.
D. This description is more aligned with the pathophysiology of conditions like hydrocephalus rather than meningitis. In meningitis, cerebral edema is primarily due to the inflammatory response, not abnormal CSF flow.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Decreased mucus production contributes to airway constriction: This statement is incorrect. Bronchospasm does not decrease mucus production; instead, it primarily affects the smooth muscles surrounding the bronchioles, leading to their constriction and narrowing of the airways. Increased mucus production, often accompanied by inflammation, can contribute to airway obstruction in conditions like asthma.
Choice B Reason:
Inflammation is reduced due to airway diameter: This statement is incorrect. Bronchospasm typically occurs in the setting of inflammation in conditions such as asthma. Constriction of the airways during bronchospasm exacerbates the inflammation and can further narrow the airways, leading to symptoms such as wheezing and dyspnea.
Choice C Reason:
Bronchospasm occurs when there is inflammation, edema, and excess mucus: This statement is partially correct. Bronchospasm often occurs in the presence of inflammation, edema, and excess mucus production, as seen in conditions like asthma. These factors contribute to airway hyperresponsiveness, leading to bronchospasm and airway narrowing.
Choice D Reason:
Airway obstruction occurs due to thinning mucus: This statement is incorrect. Airway obstruction in conditions like asthma is primarily due to bronchospasm, inflammation, and excessive mucus production, rather than thinning mucus. Thinning of mucus would not typically contribute to airway obstruction.
Correct Answer is ["B","C","D","E","F"]
Explanation
Choice A Reason:
Easily getting back to sleep after awakening is incorrect. This is not typically a manifestation of obstructive sleep apnea. Instead, individuals with OSA often experience fragmented sleep due to frequent awakenings caused by apnea episodes.
Choice B Reason:
Many episodes of apnea per night is correct. Yes, individuals with obstructive sleep apnea experience many episodes of apnea (complete cessation of breathing) or hypopnea (partial obstruction of airflow) per night. These episodes can occur multiple times throughout the night, disrupting normal sleep patterns.
Choice C Reason:
Loud snort after breathing cessation is correct. This is a characteristic manifestation of obstructive sleep apnea. Individuals with OSA often make choking, snorting, or gasping sounds after a period of breathing cessation as they attempt to resume breathing.
Choice D Reason:
10 seconds or longer of breathing cessation is correct. Yes, breathing cessation episodes in obstructive sleep apnea typically last for 10 seconds or longer. These prolonged episodes of apnea contribute to oxygen desaturation and disrupted sleep.
Choice E Reason:
Daytime sleepiness is correct. Yes, daytime sleepiness is a common symptom of obstructive sleep apnea. Disrupted sleep patterns and frequent awakenings during the night can lead to excessive daytime sleepiness, fatigue, and decreased alertness.
Choice F Reason:
Frequent, loud snoring is correct. Yes, frequent, loud snoring is a hallmark symptom of obstructive sleep apnea. Snoring occurs due to the partial obstruction of airflow in the upper airway during sleep.
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