NURS 6501: MIDTERM EXAM: Please contact Assignment Samurai for help with NURS 6501: Midterm Exam or any other assignment. Email: assignmentsamurai@gmail.com   A middle-aged adult patient, a former smoker with a history of recurrent respiratory infections, presents with a chronic cough and increased sputum production. The patient reports multiple episodes of pneumonia over the past few years. On physical examination, coarse crackles are heard on lung auscultation. Chest imaging reveals dilated bronchi with thickened walls and mucous plugging. Which of the following is the correct sequence of events that led to this condition? Group of answer choices

• Infection, inflammation, obstruction, bronchodilation
• Obstruction, bronchodilation
• Bronchospasm, inflammation, bronchoconstriction, bronchodilation
• Inflammation, infection, atrophy, fibrosis, bronchodilation

  The correct answer is Inflammation, infection, atrophy, fibrosis, bronchodilation.   Explanation: This clinical scenario is consistent with bronchiectasis, a condition where there is irreversible dilation and thickening of the bronchi due to chronic inflammation and infection. The patient’s history of recurrent respiratory infections, chronic cough, increased sputum production, and the imaging findings of dilated bronchi and mucous plugging are typical signs of bronchiectasis. Here's the sequence of events that typically leads to bronchiectasis:

1. Inflammation: Chronic inflammation of the airways occurs due to repeated infections, smoking, or other irritants. This leads to damage to the bronchial walls.
2. Infection: Recurrent infections exacerbate the inflammation and cause further damage to the bronchi. Infections can lead to mucous plugging and further dilation of the airways.
3. Atrophy: Over time, the airway walls undergo atrophic changes due to prolonged inflammation, which leads to thinning and weakening of the airway structure.
4. Fibrosis: The ongoing inflammatory process results in fibrosis (scarring) of the airway walls, contributing to the thickening of the bronchial walls.
5. Bronchodilation: Finally, the damaged and scarred airways undergo dilation (bronchiectasis), leading to the permanent widening of the bronchi.

Thus, the condition progresses through inflammation, infection, atrophy, fibrosis, and finally bronchodilation.