Which signs and symptoms of acute infection are related to the local inflammatory response triggered by the invading pathogen?
Swelling and redness.
Fever and headache.
Weakness and malaise.
Nausea and anorexia.
The Correct Answer is A
Choice A rationale
Swelling (edema) and redness (erythema) are cardinal signs of localized acute inflammation. Redness results from vasodilation and increased blood flow to the injured site, while swelling is caused by increased capillary permeability, allowing fluid, proteins, and leukocytes to exude into the extravascular tissue space, a process known as exudation.
Choice B rationale
Fever (systemic elevation of body temperature, normal range 36.5°C-37.5°C or 97.7°F-99.5°F) and headache are generally considered systemic manifestations of infection, often resulting from the release of endogenous pyrogens like interleukins and tumor necrosis factor α into the circulation, acting on the hypothalamus's thermoregulatory center.
Choice C rationale
Weakness and malaise (a general feeling of discomfort, illness, or uneasiness) are non-specific systemic symptoms frequently associated with the body's overall response to systemic illness or infection, not specific indicators of the localized pathological changes occurring at the initial site of pathogen entry.
Choice D rationale
Nausea and anorexia (loss of appetite) are typically considered systemic or gastrointestinal symptoms of illness. They are mediated by systemic inflammatory mediators and hormonal changes, often reflecting the widespread physiological impact of the infection rather than the direct local response at the focus of inflammation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Selective serotonin receptor agonists (SSRAs), like triptans, are used to treat acute migraine headaches by stimulating serotonin receptors, causing vasoconstriction. While the patient has chronic headaches, taking high doses of acetaminophen is associated with hepatotoxicity, not direct SSRA indications. The priority order would address potential liver damage before starting migraine-specific therapy, as SSRAs are not used for chronic, non-migraine headaches.
Choice B rationale
Docusate sodium, a stool softener, is used to prevent constipation by increasing water incorporation into the stool, making it easier to pass. Although opioids, which can cause constipation, are sometimes used for severe pain, this patient is taking acetaminophen, which does not commonly cause constipation. The primary concern with chronic, high-dose acetaminophen is potential hepatotoxicity, making liver function assessment the priority.
Choice C rationale
Chronic high-dose acetaminophen ingestion (above the maximum recommended 4,000 mg/day) puts the patient at significant risk for hepatotoxicity due to the accumulation of a toxic metabolite, N-acetyl-p-benzoquinone imine (NAPQI), which depletes hepatic glutathione stores. Alanine transaminase (ALT) and aspartate transaminase (AST) are liver enzymes; elevated levels (normal ALT is about 7 to 55 U/L and AST is about 8 to 48 U/L) are key indicators of hepatocellular damage.
Choice D rationale
A basic metabolic profile (BMP) assesses electrolytes and kidney function, while a complete blood count (CBC) evaluates formed blood elements. While helpful for a general assessment, BMP and CBC are less specific for the immediate, high-priority concern of acetaminophen-induced liver damage than ALT and AST. Acetaminophen overdose primarily targets the liver, not causing immediate, profound electrolyte or hematological derangements.
Correct Answer is B
Explanation
Choice A rationale
Immunoglobulin A (IgA) is the predominant antibody found in mucosal secretions like saliva, tears, breast milk, and gastrointestinal fluid, providing local mucosal immunity against ingested or inhaled pathogens. While vital for defense, IgA does not typically trigger the systemic mast cell degranulation and massive mediator release characteristic of anaphylaxis.
Choice B rationale
Immunoglobulin E (IgE) is the antibody that mediates Type I hypersensitivity reactions, including anaphylaxis. IgE is bound to the surface of mast cells and basophils. Upon re-exposure to a specific antigen (allergen), cross-linking of these IgE molecules triggers a massive, rapid release of pre-formed mediators, such as histamine and leukotrienes, causing the severe, systemic symptoms like profound vasodilation and bronchoconstriction.
Choice C rationale
Immunoglobulin G (IgG) is the most abundant antibody in plasma, providing long-term humoral immunity and crossing the placenta to confer passive immunity to a fetus. It is a primary mediator of Type II and Type III hypersensitivity reactions. Although it can activate the complement cascade, IgG does not play the principal role in the immediate, IgE-driven pathogenesis of anaphylaxis.
Choice D rationale
Immunoglobulin M (IgM) is the largest antibody, often existing as a pentamer, and is the first antibody produced during a primary immune response, primarily located in the blood and lymph fluid. It is highly effective at activating the complement system and agglutination but is not the specific key mediator responsible for initiating the rapid mast cell degranulation that defines anaphylaxis.
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