Which long-term resident is most likely to be exhibiting the signs and symptoms of chronic obstructive pulmonary disease (COPD)?
A 79 year old lifetime smoker who is complaining of shortness of breath and pain on deep inspiration
An 88 year old female who experiences acute shortness of breath and airway constriction when exposed to tobacco smoke
An 81 year old smoker who has increased exercise intolerance, a fever and increased white blood cells
An 81 year old male who has a productive cough and recurrent respiratory infections
The Correct Answer is A
A. A 79-year-old lifetime smoker who is complaining of shortness of breath and pain on deep inspiration: Chronic obstructive pulmonary disease (COPD) is most commonly seen in individuals with a significant smoking history. Progressive shortness of breath is a hallmark symptom of COPD, resulting from chronic airway inflammation and airflow limitation. While pain on deep inspiration is not a classic COPD symptom, it could indicate pleuritic involvement or hyperinflation-related chest discomfort.
B. An 88-year-old female who experiences acute shortness of breath and airway constriction when exposed to tobacco smoke: Acute shortness of breath and airway constriction in response to tobacco smoke suggests an asthma-like reaction rather than COPD. COPD symptoms tend to be persistent and progressive rather than episodic.
C. An 81-year-old smoker who has increased exercise intolerance, a fever, and increased white blood cells: Fever and increased white blood cells indicate an acute infection rather than chronic lung disease. While COPD exacerbations can cause worsening symptoms, an isolated fever and elevated white blood cells suggest pneumonia or another infectious process rather than COPD alone.
D. An 81-year-old male who has a productive cough and recurrent respiratory infections: A productive cough and recurrent respiratory infections are common in chronic bronchitis, a component of COPD. However, this presentation alone is not specific to COPD, as other conditions, such as bronchiectasis, can also cause these symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Left heart failure: COPD primarily affects the lungs and increases pulmonary vascular resistance, leading to right-sided heart strain rather than left heart failure. Left heart failure is more commonly associated with conditions such as hypertension, myocardial infarction, and valvular diseases, which impair the heart’s ability to pump blood systemically.
B. Restrictive cardiomyopathy: Restrictive cardiomyopathy is a condition where the heart muscle becomes stiff and loses its ability to relax and fill properly, often due to infiltrative diseases such as amyloidosis or sarcoidosis. COPD does not directly lead to restrictive cardiomyopathy, as its primary cardiovascular complication is increased pulmonary resistance causing right heart strain.
C. Hypertrophic cardiomyopathy: Hypertrophic cardiomyopathy is characterized by abnormal thickening of the heart muscle, usually due to genetic mutations. It primarily affects the left ventricle and impairs diastolic filling. COPD does not cause hypertrophic cardiomyopathy, as its cardiovascular effects are due to pulmonary hypertension and right ventricular overload rather than structural abnormalities of the myocardium.
D. Right heart failure: Chronic COPD leads to persistent pulmonary hypertension due to hypoxic vasoconstriction and remodeling of pulmonary vessels. This increased pulmonary vascular resistance forces the right ventricle to work harder to pump blood into the lungs, leading to right ventricular hypertrophy and eventual right heart failure, also known as cor pulmonale. Symptoms include peripheral edema, jugular vein distention, and hepatomegaly due to systemic venous congestion.
Correct Answer is C
Explanation
A. Fungus: While fungal infections can cause infective endocarditis, they are much less common compared to bacterial infections. Fungal endocarditis typically occurs in immunocompromised individuals or those with specific risk factors.
B. Virus: Viral infections can affect the heart, but they are not a common cause of infective endocarditis. Most cases of endocarditis are associated with bacterial infections rather than viral ones.
C. Bacterium: The most common cause of infective endocarditis is bacterial infection. Bacteria, particularly Staphylococcus aureus, Streptococcus viridans, and Enterococcus, are frequently implicated in this condition. These bacteria can enter the bloodstream and adhere to heart valves or damaged cardiac tissue, leading to infection and inflammation.
D. Rickettsiae: Rickettsial infections are caused by a specific type of bacteria that are typically transmitted through arthropod vectors, such as ticks. While they can cause various illnesses, they are not a common cause of infective endocarditis.
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