Which condition can result when the manifestations of asthma are not reversed by therapy such as breathing treatments and inhalers?
Extrinsic asthma.
Bronchospasm.
Intrinsic asthma.
Status asthmaticus.
The Correct Answer is D
Choice D rationale
Status asthmaticus is an acute, severe asthma exacerbation that remains unresponsive to initial therapeutic interventions, such as repeated doses of inhaled bronchodilators and systemic corticosteroids. This is a life-threatening medical emergency where the airway obstruction is so profound that it leads to hypoxia, hypercapnia, and secondary respiratory failure. It requires aggressive treatment, potentially including intravenous magnesium sulfate, continuous nebulization, or mechanical ventilation, to prevent respiratory arrest. Normal peak flow readings are significantly reduced during such an episode.
Choice A rationale
Extrinsic asthma is a classification of asthma based on its cause, specifically an allergic reaction to external triggers like pollen or animal dander. While an extrinsic asthma attack can be severe, the term does not imply that the symptoms are resistant to treatment. Most cases of extrinsic asthma respond well to standard rescue inhalers and maintenance therapy. Status asthmaticus can occur in patients with either extrinsic or intrinsic asthma if the exacerbation becomes severe and refractory.
Choice B rationale
Bronchospasm is the physiological tightening of the smooth muscle bands around the bronchioles, which is a standard feature of any asthma attack. It is a symptom of the disease rather than a term for a treatment-resistant state. While bronchospasm causes the wheezing and shortness of breath associated with asthma, it is usually reversible with the administration of beta-2 agonists. When bronchospasm persists despite these medications, the clinical situation has progressed to status asthmaticus.
Choice C rationale
Intrinsic asthma refers to asthma that is triggered by non-allergic factors such as cold air, emotional stress, or viral infections. Like extrinsic asthma, it describes the etiology of the condition. It does not mean the asthma is inherently resistant to treatment. Patients with intrinsic asthma typically use the same medications as those with extrinsic asthma. If their symptoms fail to reverse with standard breathing treatments and inhalers, they are then diagnosed with status asthmaticus.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Increased usable oxygen in the environment, such as that provided by supplemental oxygen therapy or a hyperbaric chamber, generally improves the pressure gradient between the alveoli and the pulmonary capillaries. This enhancement actually facilitates better gas exchange by increasing the amount of oxygen available for diffusion into the blood. Therefore, more oxygen in the environment is a treatment for impaired gas exchange rather than a cause of the impairment itself under normal conditions.
Choice B rationale
Hemoglobin is the primary protein responsible for the transport of oxygen from the lungs to the peripheral tissues. An increased amount of functional hemoglobin, provided the cardiovascular system is intact, typically enhances the oxygen-carrying capacity of the blood. This improves the overall efficiency of gas delivery to cells. Impaired gas exchange is more likely to occur when hemoglobin levels are low, such as in severe anemia, where the blood cannot carry enough oxygen.
Choice C rationale
An increased concentration of carbon dioxide in the ambient environment reduces the partial pressure gradient necessary for carbon dioxide to diffuse out of the blood and into the alveoli. This can lead to hypercapnia and respiratory acidosis. Furthermore, if the environment is saturated with carbon dioxide, it often displaces available oxygen, leading to hypoxia. High levels of environmental carbon dioxide actively interfere with the body's ability to maintain normal blood gas homeostasis.
Choice D rationale
The total surface area available for gas exchange is determined by the number of healthy, functioning alveoli. An increased number of alveoli, or maintaining the integrity of existing ones, ensures a larger area for the diffusion of gases across the alveolar-capillary membrane. Conditions that decrease the number of functioning alveoli, such as emphysema or pulmonary fibrosis, are what lead to impaired gas exchange. Having more alveoli would naturally support better respiratory function and efficiency.
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.
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