What term describes a blockage in the pulmonary artery by a blood clot or mass of other material?
Pneumothorax.
Pulmonary hypertension.
Pulmonary embolus.
Pulmonary edema.
The Correct Answer is C
Choice C rationale
A pulmonary embolus is an obstruction in the pulmonary vasculature, typically caused by a blood clot, but it can also be composed of fat, air, or amniotic fluid. This blockage prevents deoxygenated blood from reaching the alveolar-capillary membrane for gas exchange. The most common source is a deep vein thrombosis from the lower extremities that breaks loose and travels to the lungs. This condition causes a ventilation-perfusion mismatch, leading to hypoxemia and potential right heart strain.
Choice A rationale
A pneumothorax is defined by the presence of air in the pleural space, which is the area between the visceral and parietal pleura. This accumulation of air disrupts the negative pressure required for lung expansion, leading to a partial or total collapse of the lung. While it causes sudden respiratory distress similar to an embolism, it is a structural problem involving air outside the lung tissue rather than a vascular blockage within the pulmonary arterial system.
Choice B rationale
Pulmonary hypertension is characterized by abnormally high blood pressure within the pulmonary arteries, often defined as a mean pulmonary artery pressure > 20 mmHg at rest. While a large or chronic pulmonary embolus can lead to pulmonary hypertension by increasing resistance to blood flow, the term describes the hemodynamic state of elevated pressure rather than the actual physical mass or clot that causes an acute blockage. It involves remodeling of the vessel walls over time.
Choice D rationale
Pulmonary edema refers to the accumulation of excess fluid in the alveoli and interstitial spaces of the lungs. It is most commonly caused by left-sided heart failure, where high pulmonary venous pressure forces fluid into the air sacs. This interferes with gas exchange and causes severe dyspnea. Unlike a pulmonary embolus, which is a discrete blockage within a vessel, pulmonary edema is a diffuse fluid distribution issue that impairs the oxygenation capacity of the lung parenchyma.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D"]
Explanation
Choice A rationale
Joint contractures are a common complication of prolonged immobility. When joints are not moved through their full range of motion, the connective tissues, including muscles, tendons, and ligaments, begin to shorten and harden. This permanent shortening leads to a loss of joint mobility and can result in fixed deformities. Regular passive and active range of motion exercises are necessary to maintain tissue elasticity and prevent the functional limitations associated with these debilitating contracture formations.
Choice B rationale
Pressure ulcers, or decubitus ulcers, occur when prolonged pressure on bony prominences compromises blood flow to the skin and underlying tissues. This localized ischemia leads to tissue hypoxia and eventual necrosis. Patients who are immobile cannot shift their weight to relieve this pressure. Consistent turning schedules every two hours and the use of pressure-relieving devices are critical interventions to prevent the breakdown of skin integrity and the development of these painful, infection-prone wounds.
Choice C rationale
Polyuria is not a result of immobility. Immobility is more likely to cause urinary stasis because the lack of gravity-assisted drainage from the kidneys to the bladder allows urine to pool in the renal pelvis. This stasis increases the risk of urinary tract infections and the formation of renal calculi. Polyuria is typically associated with endocrine disorders like diabetes or the use of diuretic medications rather than a lack of physical movement or activity.
Choice D rationale
Increased calcium levels, or hypercalcemia, can result from prolonged immobility because the lack of weight-bearing activity leads to bone demineralization. When bones do not experience the stress of movement and gravity, osteoclast activity increases, causing calcium to be released from the bone matrix into the bloodstream. This can lead to serum calcium levels rising above the normal range of 8.5 to 10.5 mg/dL, potentially causing kidney stones and further weakening the skeleton.
Choice E rationale
Diarrhea is not a standard complication of immobility. In fact, the opposite is true; immobility significantly increases the risk of constipation. Reduced physical activity slows down gastrointestinal motility and peristalsis. Furthermore, being in a recumbent position makes it more difficult for patients to have effective bowel movements. This slowing of the digestive tract often leads to fecal impaction or chronic constipation rather than the frequent, loose stools characterized by diarrhea.
Correct Answer is C
Explanation
Choice A rationale
A decrease in red blood cells, known as anemia, leads to symptoms such as fatigue, pallor, and shortness of breath. Red blood cells carry oxygen via hemoglobin to the tissues. While aplastic anemia involves a reduction in red blood cells, this specific deficiency does not cause petechiae. Petechiae are small, pinpoint purple or red spots on the skin caused by minor hemorrhaging from broken capillary vessels, which is related to clotting factors.
Choice B rationale
A decrease in leukocytes, or white blood cells, is known as leukopenia. This condition significantly increases the risk of infection and reduces the body's ability to mount an immune response. While leukopenia is a component of the pancytopenia seen in aplastic anemia, it does not manifest as petechiae. The normal white blood cell count ranges from 4,500 to 11,000 cells per microliter; levels below this indicate an increased susceptibility to pathogens.
Choice C rationale
Petechiae occur because of a decrease in platelets, a condition called thrombocytopenia. Platelets are essential for blood clotting and maintaining the integrity of the capillary walls. In aplastic anemia, the bone marrow fails to produce enough platelets. When the platelet count drops below the normal range of 150,000 to 450,000 per microliter, spontaneous bleeding into the skin occurs. This manifests as the small, red or purple spots known as petechiae.
Choice D rationale
Hemoglobin is the protein in red blood cells that binds to oxygen. A decrease in hemoglobin levels, which are normally 12 to 16 g/dL for women and 14 to 18 g/dL for men, results in tissue hypoxia. While low hemoglobin is a feature of aplastic anemia, its primary clinical manifestations are related to oxygenation rather than skin hemorrhages. Hemoglobin levels do not influence the primary hemostasis required to prevent the formation of petechiae.
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