Correct Answer: B

Rationale: The correct answer is B: vasoconstriction, vasospasms.
1. Raynaud's disease involves exaggerated vasoconstriction and vasospasms of blood vessels in response to cold or stress.
2. Smoking aggravates vasoconstriction and vasospasms by constricting blood vessels further.
3. This can worsen symptoms for individuals with Raynaud's disease.
4.

Choices A, C, and D do not directly relate to the mechanism of Raynaud's disease and smoking.

Correct Answer: A

Rationale: The correct answer is A because asthma is characterized by inflammation and bronchoconstriction of the airways, leading to difficulty breathing. This explanation accurately describes the pathophysiology of asthma.

Explanation for other choices:
B: Fluid in the lungs is more indicative of conditions like pneumonia or pulmonary edema, not asthma.
C: Asthma involves airway constriction and inflammation, not stretching and non-functionality.
D: Asthma is not caused by infection but rather triggered by factors like allergens or irritants.

Correct Answer: D

Rationale: The correct answer is D: Hypomagnesemia. Dehydration can lead to electrolyte imbalances, and hypomagnesemia can cause confusion in elderly patients. Magnesium plays a crucial role in brain function and its deficiency can result in cognitive impairment. Hyponatremia (
A) typically presents with symptoms like weakness and confusion but not necessarily dehydration. Hypercalcemia (
B) and hyperkalemia (
C) are less likely to cause confusion in this scenario.
Therefore, hypomagnesemia is the most likely electrolyte imbalance involved in the elderly nursing home resident's confusion.

Correct Answer: B

Rationale: The correct answer is B, Altered level of consciousness, because it is a critical assessment in determining Mr. Reyes's neurological status and overall well-being. Assessing for altered level of consciousness helps identify potential neurological issues, such as brain injury or stroke, which require immediate intervention.

A: Decreased carotid pulses - This is related to cardiovascular assessment, not specific to Mr. Reyes's neurological status.
C: Bleeding from oral cavity - While important to assess for, it is not directly related to Mr. Reyes's neurological status.
D: Absence of deep tendon-reflexes - This is a specific neurological assessment, but altered level of consciousness takes priority in this scenario.

Correct Answer: C

Rationale: The correct answer is C: “Are you feeling frightened? I’m here and I will help you.” This response acknowledges the resident’s feelings, offers reassurance, and provides support, focusing on the resident's emotional needs rather than the accuracy of her statements. It shows empathy and validation of her feelings, which can help calm the resident and build trust.


Choice A is incorrect because it dismisses the resident's feelings and reality, which can lead to increased distress and confusion.
Choice B is incorrect as it doesn't address the resident's emotional state or offer immediate support.
Choice D is incorrect as it focuses on correcting the resident's perception rather than providing emotional support, which may lead to further distress.