A client with asthma is exposed to a trigger and has an asthma attack within 30 minutes of the exposure. The client uses their albuterol inhaler as prescribed and experiences relief of symptoms. Six hours later, the client's asthma symptoms return. Which of the following is true about the late-phase response of asthma?

The late-phase response occurs due to an influx of additional inflammatory cells

The symptoms of the late-phase response tend to respond better to a rescue inhaler than the symptoms of the early-phase response

The late-phase response occurs because the client did not use their rescue inhaler properly

The late-phase response only occurs if the client continues to be exposed to their trigger after the initial attack

Answer and Explanation

The Correct Answer is A

A.   The late-phase response in asthma is characterized by a delayed and prolonged inflammatory reaction that can occur 4 to 6 hours after exposure to a trigger. It involves the recruitment of additional inflammatory cells, such as eosinophils and T cells, which contribute to ongoing airway inflammation, increased mucus production, and bronchoconstriction. This phase often leads to a return of symptoms or worsening of symptoms after the initial relief provided by a rescue inhaler.
B.   The late-phase response does not typically respond as well to rescue inhalers (such as albuterol) as the early-phase response does. Rescue inhalers are primarily effective for the immediate, bronchospastic component of asthma (early-phase response).
C.   The late-phase response occurs as part of the natural progression of asthma inflammation and is not necessarily related to improper use of a rescue inhaler. Even with proper use of a rescue inhaler, the late-phase response can still occur due to the underlying inflammatory processes.
D.   The late-phase response can occur even if the trigger is no longer present. It is related to the ongoing inflammatory process rather than continued exposure to the trigger. Although continued exposure to triggers can exacerbate symptoms, the late-phase response can still occur independently of further exposure.

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Correct Answer is A

Explanation

A. Elevated serum cholesterol is a common finding in hypothyroidism. The thyroid hormones play a role in regulating lipid metabolism, so low levels of thyroid hormones can lead to increased cholesterol levels. This is a typical finding in Hashimoto's disease, as it often results in hypothyroidism.
B. In Hashimoto's disease, which leads to hypothyroidism, TSH levels are usually elevated rather than low. TSH is produced by the pituitary gland and stimulates the thyroid gland to produce thyroid hormones (T3 and T4). When the thyroid gland is underactive and not producing enough hormones, the pituitary gland compensates by increasing TSH production. Therefore, a low TSH level would not be expected in Hashimoto's disease.
C. Free T4 (thyroxine) is typically low in hypothyroidism. Hashimoto's disease causes an underactive thyroid gland, which leads to decreased production of thyroid hormones, including free T4. Elevated free T4 would not be consistent with the diagnosis of Hashimoto's disease.
D. Elevated ACTH is more relevant to conditions involving the adrenal glands, such as Addison's disease or Cushing's syndrome. It is not a typical finding in Hashimoto's disease. Hashimoto's primarily affects thyroid function and does not directly impact ACTH levels.

A. A client who is being treated for otitis media B. A client who has experienced an injury to the eardrum C. A client who works in a loud environment D. A client whose ear canal is impacted with wax

Correct Answer is C

Explanation

A. Otitis media is an infection or inflammation of the middle ear. This condition primarily affects the middle ear structures and can cause conductive hearing loss, which is due to problems with sound transmission through the outer or middle ear.
B. An injury to the eardrum, such as a perforation, can lead to conductive hearing loss. This occurs because the eardrum (tympanic membrane) is crucial for transmitting sound waves from the outer ear to the middle ear. While an eardrum injury affects sound transmission, it does not directly damage the inner ear or auditory nerve, so it does not typically cause sensorineural hearing loss.
C. Exposure to loud noise is a common cause of sensorineural hearing loss. Prolonged or intense noise exposure can damage the sensory hair cells in the cochlea or the auditory nerve pathways, leading to permanent hearing loss. This type of hearing loss is due to damage in the inner ear or auditory nerve rather than the outer or middle ear structures.
D. Impacted earwax can cause conductive hearing loss by blocking sound transmission through the ear canal. This type of hearing loss is due to a blockage and is usually reversible once the wax is removed. It does not cause sensorineural hearing loss, which involves damage to the inner ear or auditory nerve.

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing the laboratory results of a client who has a new diagnosis of Hashimoto's disease. Which of the following lab results would the nurse expect to find?

Correct Answer is A

Explanation

Which of the following clients is at risk for sensorineural hearing loss?

Correct Answer is C

Explanation

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