A female adult client has a tracheostomy but doesn't require continuous mechanical ventilation. When weaning the client from the tracheostomy tube, the nurse initially should plug the opening in the tube for:

Correct Answer: B

Rationale: The correct answer is B: 5 to 20 minutes. Plugging the tracheostomy tube for this duration allows the client to gradually adapt to breathing without the assistance of the tube. Initially, the client may experience increased respiratory effort, which helps improve lung function. Plugging the tube for too short a time (A) may not provide enough challenge for the client, while plugging it for too long (C, D) may cause distress or potential complications due to lack of oxygen. Therefore, the optimal time frame of 5 to 20 minutes ensures a safe and effective weaning process for the client.

Correct Answer: B

Rationale: The correct answer is B: Isoniazid. Isoniazid is the most common preventive drug therapy for tuberculosis due to its effectiveness in treating latent TB infections. It works by killing the bacteria that cause TB. Prednisone is a steroid and not used as a preventive therapy for TB. Gamma globulin is used for immune deficiency disorders, not TB prevention. Aminophylline is a bronchodilator used for asthma, not TB prevention. In summary, isoniazid is the preferred choice for TB prevention due to its specific antimycobacterial action, while the other options are unrelated or ineffective for this purpose.

Correct Answer: D

Rationale: The correct answer is D: muscle. Lung tissue does not contain muscle tissue; instead, it is primarily composed of alveolar sacs for gas exchange, blood capillaries for oxygen exchange, and interstitial fluid for support. Muscles are not part of the structure of the lungs as they are not involved in the respiratory process. In summary, muscles are not found in lung tissue, making option D the correct choice.

Correct Answer: B

Rationale: When the diaphragm and external intercostals contract, the thoracic cavity expands, causing the lungs to expand and the intrapulmonary pressure to decrease (choice D). This decrease in pressure allows air to flow into the lungs (choice A). The diaphragm moves inferiorly during contraction, not superiorly (choice C). The intrapleural pressure actually decreases when these muscles contract, not increases, due to increased thoracic volume and decreased intrapleural pressure acting as a suction to keep the lungs inflated (choice B). Therefore, the correct answer is B, as the intrapleural pressure actually decreases when the diaphragm and external intercostals contract.

Correct Answer: D

Rationale: During inspiration, the diaphragm contracts and moves downward, while the intercostal muscles contract to lift the rib cage and sternum upward and outward to increase lung volume for air intake. This creates a negative pressure in the lungs, allowing air to be drawn in. In contrast, expiration involves relaxation of the diaphragm and intercostal muscles, leading to the rib cage and sternum moving downward and inward to expel air. Therefore, the correct answer is D: Inspiration. Choices A, B, and C are incorrect as they do not specifically involve the physiological process of rib cage and sternum movement related to breathing.