The nurse is caring for a client suffering from an acute asthma exacerbation. Which pathology occurs with an asthma exacerbation?

Recurring spasms of the airways accompanied by edema and mucus production.

Acute inflammation in which lung airways become blocked with thick exudates.

Chronic inflammation of the bronchi and/or trachea caused by infection.

Reduced surface area of the lungs caused by rupture or other damage to the alveoli.

Answer and Explanation

The Correct Answer is A

Choice A reason: Acute asthma exacerbations involve bronchospasms, airway edema, and excessive mucus production, narrowing airways and causing wheezing and dyspnea. These reversible inflammatory responses are triggered by allergens or irritants, aligning with asthma’s pathophysiology. This accurately describes the acute obstructive process, per respiratory medicine evidence.

Choice B reason: Thick exudates blocking airways are characteristic of conditions like pneumonia, not asthma. Asthma involves bronchospasms, edema, and mucus, not dense exudate. This choice misrepresents asthma’s acute inflammatory process, which is reversible and driven by smooth muscle contraction and mucosal swelling, making it incorrect.

Choice C reason: Chronic inflammation of the bronchi/trachea from infection suggests chronic bronchitis or tracheitis, not asthma. Asthma exacerbations are acute, triggered by non-infectious stimuli, causing spasms and edema. This chronic infectious process does not align with asthma’s reversible, allergic pathophysiology, making it an incorrect description.

Choice D reason: Reduced lung surface area from alveolar damage occurs in emphysema, not asthma. Asthma affects airways via spasms and inflammation, not alveoli. This choice describes a different obstructive disease, unrelated to asthma’s acute, reversible airway pathology, making it incorrect for an exacerbation’s pathophysiological mechanism.

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Correct Answer is B

Explanation

Choice A reason: Macrophages, lymph, and cytokines are part of the innate immune response, acting after pathogens breach initial barriers. First-line defenses are physical and chemical barriers like mucosa and secretions, not immune cells or fluids. This choice represents secondary defenses, making it incorrect for the primary barrier role.

Choice B reason: Lung epithelium, gastric mucosa, and tears are first-line defenses, preventing pathogen entry. Lung cilia trap microbes, gastric acid kills bacteria, and tears’ lysozymes neutralize pathogens. These physical and chemical barriers form the body’s initial protection, aligning with immunology principles for primary defense against infection.

Choice C reason: Interferon, T cells, and neutrophils are part of adaptive and innate immunity, activated after pathogen penetration. First-line defenses involve barriers like mucosa, not immune mediators or cells. This choice describes secondary immune responses, making it incorrect for the initial protective structures in humans.

Choice D reason: Thymus, bone marrow, and pancreas are involved in immune cell production and metabolism, not direct pathogen defense. First-line defenses are external barriers like lung epithelium or tears. These internal organs support immunity but are not primary barriers, making this incorrect for first-line defense structures.

A. Tissue ischemia due to acute vasospasm. B. Destruction of norepinephrine receptors. C. Progressive scarring of the myelin sheath. D. Over-secretion of excitatory neurotransmitters.

Correct Answer is C

Explanation

Choice A reason: Tissue ischemia from vasospasm is associated with conditions like stroke, not multiple sclerosis (MS). MS involves immune-mediated demyelination of the central nervous system, causing exacerbations. Ischemia does not drive MS exacerbations, making this incorrect, as scarring of the myelin sheath is the hallmark pathological change.

Choice B reason: Destruction of norepinephrine receptors is unrelated to multiple sclerosis. MS exacerbations result from immune attacks on myelin, leading to scarred plaques that disrupt nerve conduction. Norepinephrine receptor issues may affect autonomic functions, but they are not part of MS’s pathophysiology, making this an incorrect choice.

Choice C reason: Multiple sclerosis exacerbations result from immune-mediated destruction and scarring (sclerosis) of the myelin sheath, forming plaques that impair nerve signal transmission. This causes neurological symptoms like weakness or sensory loss. Progressive demyelination and scarring are the core pathologic changes, aligning with MS’s clinical and histopathological features.

Choice D reason: Over-secretion of excitatory neurotransmitters may occur in epilepsy or neurotoxicity, not multiple sclerosis. MS exacerbations stem from myelin sheath scarring, disrupting nerve conduction, not neurotransmitter imbalances. This choice is incorrect, as it does not reflect the immune-driven demyelination central to MS’s pathological process.

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The nurse is caring for a client suffering from an acute asthma exacerbation. Which pathology occurs with an asthma exacerbation?

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