A patient with chronic bronchitis exhibits a productive cough and dyspnea. Which physiological change primarily contributes to these symptoms?
Increased bronchial diameter
Alveolar destruction
Overproduction of surfactant
Decreased ciliary function
The Correct Answer is D
A. Increased bronchial diameter: Chronic bronchitis is characterized by obstructive changes that decrease rather than increase the airway lumen. Chronic inflammation leads to wall thickening and smooth muscle hypertrophy, which increases resistance to airflow. This pathological narrowing contributes significantly to the patient’s expiratory effort and dyspnea.
B. Alveolar destruction: The breakdown of alveolar walls and loss of elastic recoil are the primary pathophysiological hallmarks of emphysema rather than chronic bronchitis. While both conditions often coexist in COPD, bronchitis specifically involves the conducting airways. Alveolar destruction leads to permanent air trapping and impaired gas exchange.
C. Overproduction of surfactant: Surfactant is a lipoprotein that reduces surface tension to prevent alveolar collapse during expiration. In chronic inflammatory lung diseases, surfactant function is often impaired or inhibited by inflammatory exudates rather than being overproduced. Overproduction is not a recognized feature of the bronchitic disease process.
D. Decreased ciliary function: Chronic inhalation of irritants causes squamous metaplasia of the epithelium and direct damage to the mucociliary escalator. This impairment prevents the effective clearance of the excess mucus produced by hypertrophied goblet cells. The resulting stasis of secretions leads to the characteristic persistent productive cough.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Encouraging increased fluid intake:Hydration is a core supportive measure for viral infections to maintain mucosal moisture and facilitate the clearance of debris. It prevents the complications of dehydration associated with fever or reduced oral intake. This is a highly appropriate and standard nursing intervention for viral pharyngitis.
B. Advising on rest and avoiding exertion:Conserving metabolic energy allows the body to prioritize the immunological response required to clear the viral load. Physical exertion can exacerbate fatigue and delay the recovery process. Rest is an essential component of the non-pharmacological management of viral upper respiratory infections.
C. Recommending throat lozenges for discomfort relief:Lozenges provide localized soothing and can temporarily reduce the severity of odynophagia. They act as a topical analgesic to improve the patient's comfort and ability to maintain oral hydration. This is an appropriate symptomatic treatment for the inflammation seen in pharyngitis.
D. Administering prescribed antibiotics:Antibiotics are biologically inert against viruses as they target bacterial structures like cell walls or 70S ribosomes. Administering them for a viral etiology is inappropriate and contributes to the proliferation of multidrug-resistant organisms. They should only be used if a bacterial co-infection is definitively diagnosed.
Correct Answer is D
Explanation
A. Antibiotics form the primary defense: Antibiotics are exogenous pharmacological agents used to treat an established infection by targeting bacterial structures. They are not a part of the body's natural, endogenous defense mechanisms. The body relies on physical barriers and innate immunity as its first line of protection.
B. Skin and mucous membranes function as chemical barriers: While these structures do secrete antimicrobial substances like sebum and lysozyme, their primary classification is as physical or mechanical barriers. They provide a structural wall that prevents pathogens from entering the internal environment. They are the body's initial line of defense.
C. Vaccination boosts chemical barriers: Vaccines work by stimulating the adaptive immune system to produce specific antibodies and memory cells against a particular pathogen. This is a form of acquired, specific immunity rather than a boost to the non-specific chemical barriers. They prepare the body for a secondary immune response.
D. Inflammation is a key component of nonspecific defense: Inflammation is a localized, immediate response to tissue injury or infection designed to contain the pathogen and initiate repair. It involves vasodilation, increased capillary permeability, and the recruitment of leukocytes. It is considered a non-specific defense because it responds similarly to any insult.
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