What structural change is characteristic of chronic bronchitis?
Bullae development in the lungs.
Destruction of the alveolar walls.
Hypertrophy of mucous glands.
Increased surfactant production.
The Correct Answer is C
Choice A rationale
Bullae development refers to the formation of large air-filled spaces within the lung parenchyma. While these can occur in advanced chronic obstructive pulmonary disease, specifically emphysema, they are not the defining structural change of chronic bronchitis. Chronic bronchitis is primarily a disease of the conducting airways rather than the distal air spaces. Bullae result from the breakdown of alveolar walls, which is a separate pathologic process from the airway inflammation seen in bronchitis.
Choice B rationale
The destruction of alveolar walls is the primary structural change seen in emphysema, not chronic bronchitis. In emphysema, the loss of elastic recoil and surface area for gas exchange leads to permanent enlargement of the air spaces. In contrast, chronic bronchitis involves the larger and smaller bronchi. While both conditions often coexist in patients with COPD, the specific pathology of chronic bronchitis is centered on the hypersecretion of mucus and airway narrowing.
Choice C rationale
Hypertrophy of the mucous glands and an increase in the number of goblet cells are the classic structural changes of chronic bronchitis. Chronic exposure to irritants, such as cigarette smoke, triggers a chronic inflammatory response that leads to the enlargement of these glands in the submucosa of the large airways. This results in the hallmark symptom of a persistent, productive cough lasting for at least three months in two consecutive years due to excessive mucus.
Choice D rationale
Increased surfactant production does not occur in chronic bronchitis. Surfactant is produced by type II alveolar cells to reduce surface tension and prevent alveolar collapse. In chronic inflammatory lung diseases, surfactant function may actually be impaired or diluted by the presence of inflammatory exudates and excessive mucus. There is no physiologic mechanism in chronic bronchitis that leads to an increase in surfactant; rather, the focus is on the overproduction of thick, tenacious mucus.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Type 2 diabetes mellitus is primarily characterized by insulin resistance, a condition where the body cells, particularly in the liver, muscle, and adipose tissue, fail to respond adequately to insulin. Although the pancreas may initially produce sufficient or even elevated levels of insulin to compensate for this resistance, the glucose remains in the bloodstream rather than entering cells. This metabolic dysfunction leads to chronic hyperglycemia and subsequent vascular complications over time.
Choice B rationale
While hyperinsulinemia may occur during the early compensatory phase of type 2 diabetes, the disease is not defined by overstimulation of the pancreas. Instead, chronic overstimulation of beta cells often leads to their eventual exhaustion and dysfunction. The primary pathology is the inability of peripheral tissues to utilize the available insulin effectively. Elevated insulin levels are a secondary response to high blood glucose rather than the fundamental cause of the diabetic state itself.
Choice C rationale
An absolute lack of insulin production is the hallmark of type 1 diabetes mellitus, which results from autoimmune destruction of the pancreatic beta cells. In type 2 diabetes, insulin is typically present, but its biological effect is diminished due to receptor or post-receptor signaling defects. While the end result in both types is the inability of glucose to enter cells, the underlying mechanism in type 2 is functional resistance rather than a manufacturing failure.
Choice D rationale
Stress induces the release of cortisol and catecholamines, which are counter-regulatory hormones that increase blood glucose through gluconeogenesis and glycogenolysis. This physiological response actually prompts the pancreas to increase insulin production to manage the glucose surge. Stress does not stimulate the pancreas to reduce insulin production; rather, the persistent metabolic demand and hormonal imbalance can exacerbate existing insulin resistance and complicate the management of blood glucose levels in diabetic patients.
Correct Answer is C
Explanation
Choice A rationale
Prolonged immobility does not typically cause a decrease in the production of red blood cells. Red blood cell production, or erythropoiesis, is primarily regulated by the hormone erythropoietin, which is released by the kidneys in response to low tissue oxygen levels. While immobility can lead to various systemic issues, the bone marrow's ability to synthesize erythrocytes remains largely unaffected unless there are concurrent nutritional deficiencies, chronic diseases, or primary hematologic disorders present in the patient.
Choice B rationale
Immobility is more frequently associated with orthostatic hypotension rather than sustained high blood pressure. When a person remains bedridden for long periods, the baroreceptor reflex becomes less efficient, and there is a decrease in circulating blood volume. Upon standing, the body cannot effectively constrict vessels to maintain pressure, leading to a drop in blood pressure. Chronic hypertension is usually linked to factors like genetics, diet, stress, and vascular resistance rather than lack of movement.
Choice C rationale
Immobility leads to venous stasis, particularly in the deep veins of the lower extremities. This stasis, combined with potential hypercoagulability and endothelial injury, completes Virchow's triad, significantly increasing the risk of deep vein thrombosis. If a thrombus dislodges, it travels through the right side of the heart and into the pulmonary vasculature, causing a pulmonary embolus. This is a life-threatening complication of immobility that obstructs blood flow and severely impairs pulmonary gas exchange.
Choice D rationale
The body's iron supply is managed through dietary intake and the recycling of iron from aged red blood cells within the spleen and liver. Immobility does not interfere with these metabolic pathways or lead to a depletion of iron stores. Iron deficiency anemia is usually the result of chronic blood loss, poor dietary habits, or malabsorption issues in the gastrointestinal tract. There is no physiological evidence suggesting that a lack of physical activity reduces the body's iron.
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