The nurse cares for a patient who has smoked a pack of cigarettes a day for the past 20 years. The patient's normal ciliated columnar epithelial cells have been replaced with squamous epithelial cells.
Which option best describes this cellular change?
Hyperplasia.
Anaplasia.
Dysplasia.
Metaplasia.
The Correct Answer is D
Choice A rationale
Hyperplasia is defined as an increase in the number of cells in a tissue or organ. For example, the proliferation of glandular cells in the female breast during pregnancy. This differs from the described change where one cell type (ciliated columnar) is replaced by a different, more resilient cell type (squamous), without necessarily increasing cell number.
Choice B rationale
Anaplasia describes the loss of cellular differentiation, a hallmark of malignancy where cells revert to a more primitive, undifferentiated state. The resulting cells exhibit marked pleomorphism (variation in size/shape) and high mitotic activity, which is a far more severe and characteristic change than the adaptive cell substitution seen in the lung's lining.
Choice C rationale
Dysplasia involves deranged cellular growth, resulting in cells that vary in size, shape, and organization, and often signifies a pre-cancerous condition. The change in the smoker's lung (columnar to squamous) is typically a protective response, called metaplasia, which may progress to dysplasia but is not dysplasia itself initially.
Choice D rationale
Metaplasia is an adaptive reversible change where one differentiated adult cell type (in this case, ciliated columnar epithelium) is replaced by another differentiated adult cell type (stratified squamous epithelium). This is a protective response to chronic irritation, such as cigarette smoke, as the squamous cells are more robust, though they sacrifice the important function of mucous clearance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
The five cardinal signs of acute inflammation, stemming from the initial vascular and cellular responses, include redness (rubor), swelling (tumor), heat (calor), pain (dolor), and loss of function (functio laesa). Redness and heat are caused by vasodilation, swelling by increased vascular permeability, and pain by chemical mediators stimulating nerve endings.
Choice B rationale
Pain and edema (swelling) are correct signs, but pulselessness is a sign of arterial occlusion or profound hypoperfusion (ischemia), not a classic or inherent sign of the inflammatory process itself. Inflammation typically involves increased blood flow, not its cessation.
Choice C rationale
Redness is correct. Paresthesias (abnormal sensation like tingling or numbness) are indicative of nerve damage or compression, and coolness is a sign of vasoconstriction or impaired blood flow, which is contrary to the vasodilation that defines the acute inflammatory response.
Choice D rationale
Heat and swelling are correct, but cyanosis (bluish discoloration) is caused by the presence of deoxygenated blood and is a sign of hypoxia or impaired venous return (stasis), not typically a direct feature of the initial acute inflammatory response, which is characterized by increased blood flow (hyperemia).
Correct Answer is D
Explanation
Choice A rationale
Naloxone is an opioid receptor antagonist that competes with and displaces opioid molecules from μ-opioid receptors in the central nervous system. Its pharmacological action directly reverses the life-threatening effects of acute opioid overdose, primarily respiratory depression. It does not pharmacologically influence or immediately eliminate the patient's underlying drug-seeking behavior.
Choice B rationale
Opioid overdose causes respiratory depression and bradycardia (slowed heart rate), often below the normal range of 60-100 beats per minute. Naloxone reverses the respiratory depression, which then leads to improved oxygenation, and subsequent heart rate normalization (reversal of bradycardia). The primary immediate effect is reversing respiratory depression, which secondarily helps normalize the heart rate.
Choice C rationale
The rapid displacement of opioids by naloxone can precipitate an acute opioid withdrawal syndrome, characterized by symptoms like nausea, vomiting, sweating, and agitation. While this is a common consequence of administering the antagonist, the most immediate therapeutic goal in this life-threatening scenario is the reversal of inadequate ventilation to restore oxygenation and prevent hypoxia-related organ damage.
Choice D rationale
The most immediate life-threatening sign of opioid overdose is respiratory depression (patient's rate of 4 breaths per minute is dangerously low; normal is 12-20 breaths per minute), resulting from opioid binding to μ-receptors in the brainstem's respiratory centers. Naloxone rapidly reverses this central nervous system depression, stimulating the patient's drive to breathe, which is critical for restoring adequate oxygenation and ventilation.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.