The nurse provides care for a client diagnosed with pulmonary emphysema. The nurse observes the following: respiratory rate 20 breaths/minute, use of intercostal muscles, and decreased mental alertness. Which is the best explanation for these observations?

Bronchial constriction after inhalation of an irritant

Damage to the mucociliary lining of the segmental bronchi

Infiltration of bacteria and inflammatory exudates into the alveoli

Enlargement of the alveoli with destruction of the alveolar walls

Answer and Explanation

The Correct Answer is D

Choice A reason: Bronchial constriction after inhalation of an irritant is a possible trigger for an asthma attack, not emphysema. It causes wheezing, coughing, and dyspnea, but it does not affect the alveolar structure or function.

Choice B reason: Damage to the mucociliary lining of the segmental bronchi is a consequence of chronic bronchitis, not emphysema. It impairs the clearance of mucus and pathogens from the airways, leading to recurrent infections and inflammation.

Choice C reason: Infiltration of bacteria and inflammatory exudates into the alveoli is a sign of pneumonia, not emphysema. It causes fever, chills, productive cough, and chest pain, but it does not cause permanent damage to the alveoli.

Choice D reason: Enlargement of the alveoli with destruction of the alveolar walls is the hallmark of emphysema. It reduces the surface area for gas exchange, increases the dead space, and decreases the elastic recoil of the lungs. It causes tachypnea, use of accessory muscles, and hypoxia, which can lead to decreased mental alertness.

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Correct Answer is C

Explanation

Choice A reason: Macrophages, monocytes, and bradykinin are involved in the inflammatory response, but they do not directly cause the symptoms of asthma. They may activate other cells and mediators that contribute to bronchoconstriction and mucus production.

Choice B reason: B lymphocytes, serotonin, and immunoglobulin D are not major players in the pathophysiology of asthma. B lymphocytes produce immunoglobulins, but immunoglobulin E (IgE) is the main antibody involved in allergic asthma. Serotonin is a neurotransmitter that may affect mood and sleep, but it does not cause bronchospasm. Immunoglobulin D is a rare antibody that has no known role in asthma.

Choice C reason: Histamine, leukotrienes, and prostaglandins are the main inflammatory mediators that cause the clinical manifestations of asthma. They are released by mast cells and other cells in response to allergens or irritants. They cause bronchial smooth muscle contraction, increased vascular permeability, edema, mucus secretion, and airway inflammation.

Choice D reason: Helper T lymphocytes, natural killer cells, and interleukin-1 are involved in the immune response, but they do not directly cause the symptoms of asthma. They may modulate the activation and differentiation of other cells and mediators that contribute to airway hyperresponsiveness and inflammation.

A. Weight gain B. Perianal fistula C. Vomiting after meals D. Urinary tract infections

Correct Answer is B

Explanation

Choice A reason: Weight gain is not a common complication of Crohn's disease because Crohn's disease causes inflammation and ulceration of the digestive tract, which can lead to malabsorption, diarrhea, and weight loss.

Choice B reason: Perianal fistula is a common complication of Crohn's disease because Crohn's disease can cause deep ulcers that penetrate the bowel wall and create abnormal connections between the bowel and the skin around the anus. Perianal fistulas can cause pain, bleeding, infection, and fecal incontinence.

Choice C reason: Vomiting after meals is not a common complication of Crohn's disease because Crohn's disease mainly affects the small intestine and the colon, not the stomach. Vomiting after meals can be a sign of gastric ulcers, gastritis, or gastroparesis.

Choice D reason: Urinary tract infections are not a common complication of Crohn's disease because Crohn's disease does not directly affect the urinary system. However, some people with Crohn's disease may develop enterovesical fistulas, which are abnormal connections between the bowel and the bladder. Enterovesical fistulas can cause urinary tract infections, hematuria, and pneumaturia.

Anal Fistula: What It Is, Symptoms, Treatment & Surgery

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The nurse provides care for a client diagnosed with pulmonary emphysema. The nurse observes the following: respiratory rate 20 breaths/minute, use of intercostal muscles, and decreased mental alertness. Which is the best explanation for these observations?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which inflammatory mediators cause the clinical manifestations of asthma?

Correct Answer is C

Explanation

The nurse provides care for a client with a 10-year history of Crohn's disease. Which finding best describes a common complication of Crohn's disease?

Correct Answer is B

Explanation

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