A 64-year-old female is admitted to the hospital. She has smoked two packs per day for 30 years. While providing her history, she becomes dyspneic and appears very anxious. She has a cough with thick white sputum production. Her chest is barrel shaped. Based on these data, the nurse will need to develop a plan of care for a client with?

Correct Answer: B

Rationale: The correct answer is B: Chronic obstructive pulmonary disease (COPD). The patient's smoking history, dyspnea, anxiety, chronic cough with sputum production, and barrel-shaped chest are indicative of COPD. Smoking is the primary cause of COPD, leading to airway inflammation and airflow limitation. The dyspnea, cough, and sputum production are common symptoms of COPD due to air trapping and mucus hypersecretion. The barrel-shaped chest is a sign of hyperinflation of the lungs seen in COPD patients. Pneumonia (A) typically presents with symptoms like fever and productive cough, not necessarily dyspnea and barrel chest. Tuberculosis (C) commonly presents with weight loss, night sweats, and hemoptysis, not the symptoms described. Asthma (D) often presents with wheezing, chest tightness, and reversible airflow obstruction, not the chronic symptoms described in this case.

Correct Answer: B

Rationale: The correct answer is B (0.04 percent) because the concentration of carbon dioxide in the Earth's atmosphere is around 400 parts per million (ppm), which is equivalent to 0.04 percent. This concentration is widely accepted by scientific research and measurements. Choice A (0.004 percent) is too low and doesn't accurately reflect the actual concentration. Choice C (0.4 percent) and choice D (4.0 percent) are both too high, which are significantly above the current levels of carbon dioxide in the atmosphere. Therefore, B is the correct choice as it aligns with the established scientific data on carbon dioxide concentration in the atmosphere.

Correct Answer: C

Rationale: The correct answer is C: over 12 years. Life-long nonsmokers live significantly longer than those who smoke heavily in their mid-twenties. Smoking two packs of cigarettes a day significantly increases the risk of various health conditions leading to premature death. On average, smoking can reduce life expectancy by over 10 years. Therefore, the correct answer is over 12 years. Choices A, B, and D are incorrect as they underestimate the impact of smoking on life expectancy and do not adequately reflect the significant difference in longevity between smokers and life-long nonsmokers.

Correct Answer: D

Rationale: The correct answer is D: Diaphragm and intercostal muscles. The diaphragm is the primary muscle responsible for inhalation and exhalation by contracting and relaxing, respectively. Intercostal muscles aid in expanding and contracting the rib cage to assist in breathing. The combination of the diaphragm and intercostal muscles working together ensures efficient ventilation of the lungs in mammals. Choices A and B are incorrect because the muscular wall of the lungs and intercostal muscles alone are not solely responsible for regulating ventilation. Choice C is incorrect because the diaphragm alone does not govern ventilation movements without the assistance of the intercostal muscles. Therefore, the correct answer is D as it accurately reflects the coordinated effort of both the diaphragm and intercostal muscles in regulating lung ventilation.

Correct Answer: B

Rationale: The correct answer is B: CO2 concentration increases. When CO2 levels rise in the blood, it leads to an increase in the acidity of the blood, triggering the respiratory centers in the brain to increase the rate and depth of respiration in order to expel excess CO2 and restore the pH balance. Explanation for other choices: A: Oxygen concentration increases - An increase in oxygen concentration does not directly stimulate an increase in respiration rate or depth. The respiratory drive is primarily regulated by CO2 levels. C: Bicarbonate concentration increases - While bicarbonate is involved in the acid-base balance in the body, it does not directly influence the rate and depth of respiration. D: Bicarbonate concentration decreases - A decrease in bicarbonate concentration may affect acid-base balance, but it does not have a direct effect on respiratory rate and depth.