A patient has chronic respiratory acidosis related to long-standing lung disease. Which of the following problems is the cause?

Correct Answer: C

Rationale: Chronic respiratory acidosis is a condition where there is an excess of carbon dioxide (CO2) in the blood due to inadequate exhalation of CO2. This typically occurs as a result of hypoventilation, which is characterized by breathing at an abnormally slow rate or shallow depth. In patients with long-standing lung disease, the ability to effectively exchange gases in the lungs is compromised, leading to a buildup of CO2 in the bloodstream and subsequent respiratory acidosis. Hyperventilation, on the other hand, would result in a decrease in CO2 levels in the blood, while the loss of acid or base by the kidneys is related to metabolic acidosis or alkalosis, not respiratory acidosis. Therefore, in this case, the primary problem causing chronic respiratory acidosis is hypoventilation.

Correct Answer: B

Rationale: IV morphine is the most appropriate choice among the options provided for quickly reducing shortness of breath (SOB) in a crisis situation for a patient with end-stage respiratory disease. Morphine is commonly used in palliative care for symptom management in patients with severe respiratory distress. It acts as a respiratory depressant by reducing the perception of breathlessness, which can help alleviate the distressing symptoms of dyspnea. The rapid onset of action of IV morphine makes it an effective option for immediate relief in emergency situations for patients experiencing significant SOB due to end-stage respiratory disease. Oral cortisone, IM meperidine (Demerol), and IV propranolol (Inderal) are not primary choices for quickly reducing SOB in this context.

Correct Answer: C

Rationale: The erythrocyte sedimentation rate (ESR) is an important diagnostic test that can help identify inflammation in the body, including inflammation in the heart. Elevated ESR levels may indicate the presence of an underlying condition that could potentially lead to cardiac complications if left untreated. Regular monitoring of ESR levels can help in the early detection and prevention of cardiac issues. The other options (A. Chest x-ray examination, B. Throat culture, and D. White blood cell count) are not specific diagnostic tests for assessing cardiac complications.

Correct Answer: B

Rationale: The classic diagnostic sign for pericarditis is the presence of a pericardial friction rub upon auscultation. This sound is caused by the inflamed pericardial layers rubbing against each other during the cardiac cycle. While precordial pain is a common symptom of pericarditis, it is not a specific diagnostic sign. Hypotension and rapid/labored respirations may occur in severe cases or complications but are not definitive diagnostic signs for pericarditis.

Correct Answer: C

Rationale: Hashimoto's thyroiditis is an autoimmune disorder where the body's immune system mistakenly attacks the thyroid gland. In this condition, the immune system produces autoantibodies that target proteins in the thyroid tissue, causing inflammation and destruction of the thyroid gland over time. This process leads to hypothyroidism, as the damaged thyroid is no longer able to produce sufficient thyroid hormones. Autoantibodies are a hallmark of Hashimoto's thyroiditis and are responsible for the destruction of the thyroid gland in this condition.