Alcoholism is the single most common predisposing condition for the development of which of the following pulmonary diseases?
Bronchial asthma
Chronic bronchitis
Diffuse alveolar damage
Emphysema
Pulmonary abscess
The Correct Answer is E
A. Bronchial asthma: Bronchial asthma is primarily an inflammatory airway disorder associated with atopy, allergens, and genetic predisposition. Alcoholism is not a recognized major risk factor for the development of asthma, which involves reversible bronchoconstriction rather than infectious or aspiration-related pathology.
B. Chronic bronchitis: Chronic bronchitis is most strongly associated with long-term cigarette smoking and environmental irritants. While alcohol use may coexist with smoking, alcoholism itself is not the primary predisposing factor for chronic bronchial inflammation and mucus hypersecretion.
C. Diffuse alveolar damage: Diffuse alveolar damage, the histologic basis of ARDS, is typically triggered by severe systemic insults such as sepsis, trauma, or aspiration. Although alcohol abuse may increase susceptibility to infections, it is not the most common direct cause of diffuse alveolar damage.
D. Emphysema: Emphysema results from destruction of alveolar walls, most commonly due to cigarette smoking or alpha-1 antitrypsin deficiency. Alcoholism does not directly cause the protease-antiprotease imbalance responsible for alveolar destruction seen in emphysema.
E. Pulmonary abscess: Alcoholism predisposes individuals to aspiration due to impaired consciousness and depressed cough reflex. Aspiration of oropharyngeal contents introduces anaerobic bacteria into the lungs, leading to localized suppurative infection and cavitation, which characterizes a pulmonary abscess.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is D
Explanation
A. Bacterial endocarditis:Bacterial endocarditis can produce septic emboli, but it usually presents with systemic signs of infection such as fever, positive blood cultures, and a heart murmur. In this patient, the absence of infection and negative blood cultures make endocarditis less likely.
B. Cardiogenic shock:Cardiogenic shock results in global tissue hypoperfusion, affecting multiple organs simultaneously. Isolated gangrene of a single toe without systemic hypotension does not fit this presentation.
C. Congestive heart failure:Heart failure can cause chronic peripheral edema and poor perfusion, but it rarely leads to acute, localized gangrene in a single distal extremity without other systemic signs.
D. Embolism from mural thrombus:After myocardial infarction, areas of akinetic or dyskinetic myocardium can form mural thrombi in the left ventricle. Small thromboemboli can detach and travel to peripheral arteries, causing acute ischemia and necrosis in distal extremities, such as a toe. This mechanism explains isolated gangrene without systemic hypotension or infection.
E. Hypovolemic shock:Hypovolemic shock produces generalized hypoperfusion and hypotension, typically affecting multiple organ systems. Localized gangrene in a single toe without systemic compromise is inconsistent with hypovolemic shock.
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