A 67-year-old client is seen in the health clinic for influenza. The nurse knows that influenza markedly increases the client's risk of developing which condition?

Correct Answer: D

Rationale: Influenza in a 67-year-old increases the risk of sinusitis and otitis media, secondary infections stemming from viral irritation of the upper respiratory tract. Sinusitis arises when flu causes sinus inflammation, trapping bacteria, while otitis media follows eustachian tube dysfunction from nasal congestion, common in older adults with weakened immunity. Arthritis and Cushing's syndrome are unrelated flu doesn't affect joints or cortisol long-term. Aortic valve prolapse involves heart structure, not infection risk. Gastritis and goiter concern the stomach and thyroid, not respiratory complications. The nurse recognizes sinusitis and otitis media as frequent flu sequelae in seniors, whose immune response and mucosal clearance decline with age, necessitating monitoring for symptoms like ear pain or sinus pressure to prevent untreated bacterial superinfections that could worsen the client's condition.

Correct Answer: A

Rationale: For pneumonia secondary to influenza, ineffective breathing pattern is a key nursing diagnosis, reflecting lung inflammation and mucus obstructing airflow, causing shortness of breath or hypoxia central to this condition's threat. Disturbed sleep pattern fits, as coughing and discomfort disrupt rest, hindering recovery. Self-care deficit: bathing applies if weakness limits hygiene, common in severe respiratory illness. Chronic pain, implying long-term issues, doesn't match pneumonia causes acute pain (e.g., pleuritic), not chronic. The nurse prioritizes ineffective breathing due to its life-threatening potential, guiding interventions like oxygen or positioning, while addressing sleep and self-care supports holistic care, aligning with the client's acute respiratory and fatigue challenges.

Correct Answer: B

Rationale: Centriacinar emphysema (B) is commonly caused by smoking, affecting proximal acini while sparing distal parts, often with bronchitis'. Pan acinar (A) involves entire acini, linked to α₁-antitrypsin deficiency, not smoking alone. Distal acinar (C) occurs near fibrosis, causing pneumothorax in young adults. Irregular (D) is scarring-related, the most common overall but not smoking-specific. Choice E is false. Page 718 notes centriacinar's association with smokers neutrophil/macrophage elastase damages central lobules, creating normal-emphysematous mosaics, making B the smoking-related type.

Correct Answer: B

Rationale: Bronchial wall smooth muscle is hypertrophic/hyperplastic (B) in asthma, not atrophic. Choice A is false; extrinsic asthma is a Type I hypersensitivity (immune). Choice C is incorrect; IgE, not IgG, drives allergic asthma. Choice D is wrong; vagal receptors are hypersensitive to irritants. Choice E (eosinophil/neutrophil mediators) is true. Page 724 details B's muscle thickening chronic inflammation causes hypertrophy, increasing bronchoconstriction, contrasting with A's mechanism or D's sensitivity error.

Correct Answer: D

Rationale: Silica-induced fibrosis is less pronounced when mixed with other minerals (D), diluting its effect. Choice A is false; silicosis is the most prevalent pneumoconiosis. Choice B is incorrect; crystalline quartz is more fibrogenic than amorphous silica. Choice C is wrong; silica activates macrophages to release mediators (e.g., IL-1), not destroys them. Choice E (late detection) is true. Page 735 notes D's modification mixed dust (e.g., with coal) reduces nodule formation, contrasting with A's prevalence or B's form error.