A nurse working in a burn unit cares for clients with complicated body system responses. Which response describes the body's initial reaction to a severe burn injury?
Anaphylactic.
Noncompensatory.
Inflammatory.
Cholinergic.
The Correct Answer is C
A. Anaphylactic. Anaphylactic reactions are caused by severe allergic responses, leading to histamine release, vasodilation, and bronchoconstriction. While burns trigger an immune response, it is an inflammatory reaction rather than an allergic one.
B. Noncompensatory. The body's response to burns is compensatory, not noncompensatory. The body immediately reacts by activating the inflammatory and stress responses to maintain perfusion and initiate healing.
C. Inflammatory. A severe burn triggers an immediate and massive inflammatory response, causing capillary leakage, fluid shifts (burn shock), and immune activation. This leads to edema, hypovolemia, and increased risk of infection. The inflammatory response also activates cytokines and white blood cells to begin tissue repair.
D. Cholinergic. The cholinergic response is related to the parasympathetic nervous system, which controls rest-and-digest functions. Severe burns primarily activate the sympathetic nervous system (fight-or-flight), leading to vasoconstriction, tachycardia, and increased metabolic demands.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Activation of exocytosis. Exocytosis is a cellular process used for releasing substances such as neurotransmitters or hormones, but it is not the primary response to inflammation. The immune response involves chemical mediators like histamine, prostaglandins, and cytokines, which increase vascular permeability.
B. Vasoconstriction. Vasodilation, not vasoconstriction, is a hallmark of inflammation. Initially, there may be a brief period of vasoconstriction, but the primary response is vasodilation, which increases blood flow to the inflamed area.
C. Decreased histamine production. Histamine production increases during inflammation, leading to vasodilation and increased vascular permeability. This allows immune cells to travel to the site of injury or infection.
D. Increased vascular permeability. The inflammatory response involves increased vascular permeability, allowing immune cells, proteins, and fluid to move from the bloodstream into tissues to fight infection and promote healing. This process leads to swelling (edema), redness, and warmth, which are classic signs of inflammation.
Correct Answer is B
Explanation
A. Developmental stage. While understanding the client’s psychosocial needs is important, the ability to perform daily activities and remain independent is more critical in determining the best living environment.
B. Functional capacity. The ability to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs) is the most important factor in determining the appropriate living environment. Clients with limited mobility, cognitive decline, or difficulty managing self-care may require assisted living or skilled nursing care.
C. Age and gender. Age and gender alone do not determine the need for a particular living environment. Some older adults remain independent well into their later years, while others may require assistance at a younger age due to functional decline.
D. Medical diagnoses. While medical conditions influence care needs, they do not solely determine living arrangements. A client with a chronic illness who maintains functional independence may still live at home, whereas a client with minimal medical issues but significant functional decline may require assisted care.
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