Which of the following pathophysiological processes primarily contributes to the development of wheezing in an asthmatic individual?
Pulmonary fibrosis and scarring
Decreased lung compliance and atelectasis
Alveolar fluid accumulation and edema
Airway inflammation and bronchoconstriction
The Correct Answer is D
Rationale:
A. Pulmonary fibrosis and scarring is incorrect. Pulmonary fibrosis involves thickening and stiffening of lung tissue, which leads to restrictive lung disease and reduced lung compliance. While it impairs gas exchange, it does not cause the characteristic wheezing seen in asthma, which is primarily due to airway obstruction rather than tissue stiffness.
B. Decreased lung compliance and atelectasis is incorrect. Decreased compliance and alveolar collapse (atelectasis) can impair ventilation and oxygenation, but they are not the primary mechanism for wheezing. Wheezing results from airflow limitation in the bronchi and bronchioles, not alveolar collapse.
C. Alveolar fluid accumulation and edema is incorrect. Pulmonary edema, often seen in heart failure or acute lung injury, causes crackles (rales) and shortness of breath, but it is not the main cause of wheezing in asthma. Wheezing is due to obstruction in small airways, not fluid in alveoli.
D. Airway inflammation and bronchoconstriction is correct. Asthma is characterized by chronic inflammation of the airways, leading to edema, mucus production, and hyperreactivity of bronchial smooth muscle. During an asthma attack, bronchoconstriction narrows the airways, causing turbulent airflow, which produces the high-pitched, musical sound known as wheezing. This pathophysiological process also contributes to symptoms such as shortness of breath, chest tightness, and cough, making it the primary mechanism underlying asthma-related wheezing.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Wheezing occurs when airflow passes through narrowed or obstructed airways, as seen in conditions like asthma, chronic bronchitis, or bronchiolitis. The turbulence created by bronchospasm, inflammation, or mucus accumulation produces a characteristic high-pitched, musical sound, typically heard during expiration, although severe obstruction can produce wheezing during both inspiration and expiration.
B. Crackles (rales) are intermittent, popping sounds caused by the sudden opening of small, fluid-filled airways in conditions such as pulmonary edema, pneumonia, or interstitial lung disease. They are not associated with airway narrowing from bronchospasm.
C. This description corresponds to rhonchi, which are caused by airflow through larger airways obstructed with thick secretions. Rhonchi are different from wheezing, which is high-pitched and usually occurs in smaller bronchioles.
D. Silent breathing indicates severe airway obstruction or near-complete airway closure, which is a medical emergency. While it may occur in extreme cases of asthma, it is not a characteristic feature of wheezing in narrowed airways.
Correct Answer is C
Explanation
Rationale:
A. High urine pH is not a primary factor contributing to recurrent UTIs in older men. While urine pH can influence bacterial growth, it is not the most significant predisposing factor in this population.
B. Use of cotton underwear is more relevant for women, as cotton can help reduce moisture and bacterial growth. In older men, underwear type has minimal impact on UTI risk, especially compared with underlying urinary tract abnormalities.
C. Urine retention caused by prostatic hypertrophy is correct. In older men, benign prostatic hyperplasia (BPH) is common and can partially obstruct urine flow. This obstruction leads to urinary stasis, which provides a favorable environment for bacterial proliferation and increases the risk of recurrent urinary tract infections. Chronic retention can also lead to incomplete bladder emptying, further exacerbating infection risk.
D. Increased fluid intake is protective, not causative. Adequate hydration helps flush bacteria from the urinary tract and reduces the likelihood of infection.
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