The characteristic vascular changes at the site of an injury produce: (Select all that apply)
Increased permeability and leakage
Blood vessel constriction after dilation
Pallor and swelling
None of the above
Tightening of the capillary endothelial cell junctions
Correct Answer : A,B,C
Choice A reason: Increased permeability and leakage occur at an injury site due to histamine and cytokine release, causing endothelial gaps. This allows plasma and immune cells to enter tissues, promoting inflammation and edema, making this a correct vascular change.
Choice B reason: Blood vessels initially constrict to limit bleeding, then dilate to increase blood flow, delivering immune cells and nutrients. This biphasic response (constriction followed by dilation) is a hallmark of acute injury, making this a correct vascular change.
Choice C reason: Pallor occurs from initial vasoconstriction, reducing blood flow, followed by swelling from increased permeability and fluid leakage. These are typical injury responses, reflecting vascular and tissue changes, making this a correct observation.
Choice D reason: “None of the above” is incorrect, as increased permeability, biphasic vessel response, and pallor with swelling are well-documented vascular changes at injury sites. These align with the inflammatory process, making this an invalid choice.
Choice E reason: Tightening of capillary endothelial junctions does not occur during acute injury. Junctions loosen due to inflammatory mediators, increasing permeability, not tightening, which would limit leakage, making this an incorrect vascular change.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Acute pancreatitis is likely, given severe abdominal pain, elevated amylase and lipase, fever, hypotension (89/46 mm Hg), tachycardia (116 bpm), and alcohol history. These are classic signs, with C-reactive protein indicating inflammation, making this the first suspected diagnosis for this patient.
Choice B reason: Cholecystitis causes right upper quadrant pain and fever but is less associated with elevated amylase/lipase or severe hypotension. Pancreatitis aligns better with the patient’s alcohol use, vital signs, and lab results, so this is incorrect as the primary suspicion.
Choice C reason: Hepatitis C may cause liver inflammation but not acute abdominal pain or elevated amylase/lipase. The patient’s acute symptoms, alcohol history, and vital signs point to pancreatitis, not a chronic viral infection, making this incorrect for the first diagnosis.
Choice D reason: Liver cirrhosis is chronic, not acute, and doesn’t typically cause sudden pain or elevated amylase/lipase. Acute pancreatitis matches the patient’s acute presentation, alcohol use, and lab findings, so cirrhosis is incorrect as the initial suspected diagnosis.
Correct Answer is B
Explanation
Choice A reason: Hyperperfusion, or excessive renal blood flow, is not a common cause of prerenal AKI. Prerenal AKI results from reduced renal perfusion, like hypovolemia or hypotension, not increased flow, making this an incorrect cause for the condition.
Choice B reason: Ischemia, due to reduced renal perfusion from hypovolemia, hypotension, or shock, is the most common cause of prerenal AKI. It impairs glomerular filtration, leading to acute renal dysfunction, reversible with restored perfusion, making this the correct cause.
Choice C reason: Nephrotoxic drugs cause intrinsic AKI by directly damaging renal tubules, not prerenal AKI, which stems from reduced blood flow. While significant, nephrotoxicity is less common than ischemic causes in prerenal AKI, making this incorrect.
Choice D reason: Urinary tract obstruction causes postrenal AKI by blocking urine outflow, not prerenal AKI, which involves pre-renal hypoperfusion. Obstruction is a distinct mechanism, less frequent than ischemia in prerenal cases, making this an incorrect cause.
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