What is the physiologic mechanism behind the development of pyrexia?
Release of pyrogens resetting the hypothalamic thermostat
Increased peripheral vasoconstriction reducing heat loss
Decreased metabolic rate increasing heat production
Inhibition of prostaglandin synthesis in the hypothalamus
The Correct Answer is A
Choice A reason: Pyrexia (fever) occurs when pyrogens, like cytokines (IL-1, IL-6), released during infection or inflammation, act on the hypothalamus to raise the body’s temperature set point. This triggers heat production via shivering and vasoconstriction, conserving heat to create a fever, enhancing immune response. This statement accurately describes the primary mechanism of pyrexia.
Choice B reason: Peripheral vasoconstriction occurs during fever to conserve heat but is a response, not the cause, of pyrexia. It results from hypothalamic signaling after pyrogens reset the thermostat. This statement is inaccurate, as vasoconstriction is a secondary effect, not the initiating physiologic mechanism of fever development.
Choice C reason: Fever increases, not decreases, metabolic rate to generate heat via thermogenesis. Pyrogens elevate the hypothalamic set point, prompting energy expenditure through shivering and muscle activity. This statement is inaccurate, as reduced metabolism would lower body temperature, counteracting the fever response triggered by infection or inflammation.
Choice D reason: Prostaglandin synthesis, particularly PGE2, in the hypothalamus is stimulated by pyrogens, raising the temperature set point to cause fever. Inhibiting prostaglandin synthesis (e.g., by NSAIDs) reduces fever, not causes it. This statement is inaccurate, as prostaglandin inhibition opposes the physiologic mechanism of pyrexia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Insulin lispro, a rapid-acting insulin, peaks 1-2 hours after administration (around 8:30-9:30 am for a 7:30 am dose). This peak coincides with maximum glucose-lowering effect, increasing hypoglycemia risk, especially if breakfast is inadequate or delayed. This time is the most likely for low blood sugar due to insulin’s pharmacodynamics.
Choice B reason: At 7:45 am, insulin lispro is just beginning to act (onset 15-30 minutes), and breakfast is likely being consumed, providing glucose to counter insulin’s effect. Hypoglycemia risk is lower than at peak action (1-2 hours), making this time less critical for hypoglycemia monitoring.
Choice C reason: By 12:30 pm, insulin lispro’s effect (duration 3-5 hours) is waning, and glucose from breakfast is metabolized. Hypoglycemia risk is lower unless additional insulin or activity occurs. This time is less likely for hypoglycemia compared to the peak action period around 8:30 am.
Choice D reason: Tomorrow at 6:30 am is beyond insulin lispro’s duration of action (3-5 hours). Hypoglycemia risk from the 7:30 am dose is negligible 23 hours later, as insulin is cleared. This time is irrelevant to the dose’s effect, making it the least likely for hypoglycemia.
Correct Answer is D
Explanation
Choice A reason: PPIs are used for short-term treatment of ulcers and gastroesophageal reflux disease (GERD), typically 4-8 weeks, not long-term, due to risks like nutrient deficiencies or infections. Long-term use is reserved for specific conditions like Barrett’s esophagus, making this statement inaccurate for general use.
Choice B reason: While PPIs are available orally and intravenously, this is not the primary focus of patient education. Their efficacy in suppressing acid production is more critical than administration routes. This statement is less relevant, as it does not address therapeutic use or safety considerations.
Choice C reason: PPIs cause adverse effects in older adults, including increased risks of fractures, Clostridium difficile infection, and vitamin B12 deficiency due to prolonged acid suppression. This statement is inaccurate, as older clients are particularly susceptible to these risks, requiring careful monitoring during PPI therapy.
Choice D reason: PPI treatment emphasizes the lowest effective dose for the shortest duration to minimize risks like infections, fractures, or nutrient malabsorption. This approach balances acid suppression with safety, especially for ulcers or GERD, making this statement accurate and critical for patient education on safe use.
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