A nurse is caring for a client who has a pulmonary embolism. The nurse should identify that the release of inflammatory mediators leads to which of the following pathologic findings?
Decreased pulmonary vascular resistance
Hypercapnia
Hypoventilation
Respiratory alkalosis
The Correct Answer is D
Correct answer: D
Choice A Reason:
Decreased pulmonary vascular resistance is incorrect. Inflammatory mediators released in response to a pulmonary embolism can lead to vasoconstriction and increased pulmonary vascular resistance. This is part of the body's response to redirect blood flow away from the affected area of the lung and maintain adequate perfusion to other areas.
Choice B Reason:
Hypercapnia is incorrect. Hypercapnia refers to elevated levels of carbon dioxide (CO2) in the blood. Hypocapnia usually is present with embolism; hypercapnia, on the other hand, is rare.
Choice C Reason:
Hypoventilation is incorrect. Hypoventilation occurs when there is inadequate ventilation of the lungs relative to metabolic demands. In the context of a pulmonary embolism, hypoventilation can occur due to factors such as pain, respiratory muscle fatigue, or impaired gas exchange, all of which can be influenced by the release of inflammatory mediators.
Choice D Reason:
Respiratory alkalosis is correct. In response to the blockage and the resulting inflammation, the body often increases the respiratory rate as a compensatory mechanism to maintain adequate oxygen levels and remove carbon dioxide. Due to the increased breathing rate, there is excessive exhalation of carbon dioxide, leading to a decrease in the partial pressure of CO2 in the blood. This results in an increase in blood pH, causing respiratory alkalosis.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Primary progressive multiple sclerosis (PPMS) is false. This subtype of MS is characterized by a gradual worsening of symptoms from the onset of the disease, without distinct relapses or remissions. It typically leads to a progressive accumulation of disability over time, without periods of remission. The pattern described by the client, with alternating periods of active symptoms and symptom-free periods, does not align with the continuous progression seen in PPMS.
Choice B Reason:
Relapsing-remitting multiple sclerosis (RRMS) is true. RRMS is characterized by distinct relapses, during which new symptoms may appear or existing symptoms may worsen, followed by periods of partial or complete recovery (remissions), during which the symptoms improve or may even disappear entirely. This pattern matches the description provided by the client, indicating RRMS as the likely subtype.
Choice C Reason:
Clinically isolating syndrome (CIS) is false. CIS refers to a single episode of neurological symptoms caused by inflammation or demyelination in the central nervous system, which may or may not progress to MS. However, CIS does not involve the characteristic pattern of relapses and remissions seen in RRMS.
Choice D Reason:
Secondary progressive multiple sclerosis (SPMS) is false. SPMS is characterized by a gradual worsening of symptoms and disability over time, following an initial period of relapsing-remitting disease. It may or may not involve distinct relapses and remissions, depending on the individual's disease course. While SPMS can involve periods of symptom exacerbation, it typically lacks the clear pattern of relapses followed by remissions seen in RRMS.
Correct Answer is ["A","D","E"]
Explanation
Choice A Reason:
Epithelial cells is correct. Epithelial cells lining the airways play a role in initiating the inflammatory response in asthma by releasing cytokines and other inflammatory mediators. These cells can contribute to the circulatory surge of inflammatory cells and cytokines seen in status asthmaticus.
Choice B Reason:
OT lymphocytes is incorrect. There is no specific cell type known as "OT lymphocytes." It's possible this may refer to T lymphocytes (T cells), which are involved in the immune response in asthma but are not typically associated with a circulatory surge in status asthmaticus.
Choice C Reason:
Hyperreactivity is incorrect. Hyperreactivity refers to the exaggerated response of the airways to various stimuli, leading to bronchoconstriction and inflammation. While hyperreactivity is a characteristic feature of asthma, it does not directly contribute to a circulatory surge of inflammatory cells and cytokines.
Choice D Reason:
Mast cells is correct. Mast cells are key players in the pathophysiology of asthma. They release various inflammatory mediators, including histamine and leukotrienes, which contribute to airway inflammation, bronchoconstriction, and mucus production. Mast cells can participate in the circulatory surge of inflammatory cells and cytokines in status asthmaticus.
Choice E Reason:
Inflammation is correct. Inflammation is a hallmark feature of asthma and plays a central role in the pathogenesis of status asthmaticus. The inflammatory response involves the recruitment and activation of various inflammatory cells, release of cytokines, and other mediators that contribute to airway obstruction and systemic effects.
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