Correct Answer: A

Rationale: Rationale: Intrinsic factor is a glycoprotein produced by the stomach that is essential for the absorption of vitamin B12 in the ileum. Without intrinsic factor, vitamin B12 absorption is impaired, leading to megaloblastic anemia. Histamine and hydrochloric acid are not directly involved in vitamin B12 absorption. Liver enzymes are not implicated in the absorption process. Therefore, the correct answer is A.

Correct Answer: B

Rationale: The correct answer is B: Stage 2 hypertension. The patient's BP readings consistently fall within the range of 160-179 systolic or 100-109 diastolic, which aligns with the criteria for Stage 2 hypertension based on the current guidelines. This classification indicates a higher level of hypertension that requires prompt medical attention and intervention to reduce the risk of complications. Choices A, C, and D are incorrect because they do not correspond to the BP readings provided, falling outside the range for prehypertension, Stage 1 hypertension, and posthypertension.

Correct Answer: D

Rationale: The correct answer is D: Dysphagia or hoarseness. In laryngeal cancer, dysphagia and hoarseness are early symptoms due to vocal cord involvement. Hoarseness results from vocal cord paralysis, while dysphagia occurs when the tumor obstructs the esophagus. Anemia and fatigue (choice A) are nonspecific symptoms seen in various conditions. A noticeable lump in the neck (choice B) typically indicates metastasis to the lymph nodes, which occurs later in laryngeal cancer. Crackles and stridor (choice C) are more associated with respiratory conditions rather than laryngeal cancer.

Correct Answer: B

Rationale: The correct answer is B: Have him breathe into a paper bag. Breathing into a paper bag helps increase the carbon dioxide levels in the blood, which can help reverse respiratory alkalosis caused by hyperventilation during an anxiety attack. This intervention helps to normalize the blood pH and alleviate symptoms. Incorrect choices: A: Making sure oxygen is administered as ordered is not appropriate for respiratory alkalosis due to hyperventilation. Oxygen therapy can worsen the condition by further reducing carbon dioxide levels. C: Placing the student in a semi-fowler's position does not directly address the primary issue of respiratory alkalosis and anxiety-induced hyperventilation. D: Coughing and deep breathing exercises may exacerbate the hyperventilation and worsen the respiratory alkalosis rather than alleviate the symptoms.

Correct Answer: B

Rationale: The correct answer is B: 45-year old woman who has never been pregnant. This client has the highest risk of ovarian cancer due to nulliparity, which is a known risk factor. Women who have never been pregnant have a higher risk of developing ovarian cancer compared to those who have had children. Other choices are incorrect because contraceptives actually reduce the risk of ovarian cancer, having children can slightly decrease the risk, and having a child at a young age does not increase the risk significantly.