After a week of caring for a client with the flu, the home care nurse modifies a nursing intervention concerning fluids; adds a new nursing diagnosis and intervention related to ineffective airway clearance; and discontinues a nursing diagnosis of fatigue. Which phase of the nursing process does this activity represent?

Correct Answer: B

Rationale: This activity represents the evaluation phase, where the nurse assesses the client's progress after a week, modifying care based on outcomes. Adjusting the fluid intervention reflects reassessment of hydration needs, adding ineffective airway clearance addresses a new issue like mucus buildup, and discontinuing fatigue suggests it's resolved. Planning sets initial goals, not adjustments. Implementation is executing interventions, not revising them. Assessment gathers data but doesn't alter diagnoses this comes later. Evaluation ensures care evolves with the client's condition, critical in flu where symptoms shift (e.g., fatigue lessens, breathing worsens). The nurse's actions show ongoing judgment, refining the care plan to match the client's current state, a hallmark of this phase.

Correct Answer: D

Rationale: Post-chemotherapy, the client's weakened immunity from treatment increases flu susceptibility and severity, making the inactivated flu shot wise it lowers this modifiable risk safely. The shot, not the live nasal spray (contraindicated in immunocompromised), boosts protection without infection risk, per CDC. Saying it causes flu is false the inactivated form can't infect. The nurse stresses vaccination's value for this vulnerable client, reducing infection odds and complications like pneumonia, even if immunity's still recovering, ensuring accurate, actionable advice tailored to her health status.

Correct Answer: C

Rationale: Mucus gland hypertrophy (C) characterizes chronic bronchitis, increasing mucosal gland depth'. Choice A (smooth muscle hypertrophy) is asthma-specific. Choice B is true but vague; lymphocyte infiltration occurs, not 'leukocyte.' Choice D is correct; goblet cells enlarge. Choice E (persistent cough 3 months, 2 years) defines it clinically but isn't listed. Page 722 highlights C's morphological hallmark Reid index rises with gland hyperplasia from smoke irritation, driving mucus hypersecretion, distinguishing it over A's asthma feature or B's imprecision.

Correct Answer: B

Rationale: Bronchiectasis can arise as a complication of rheumatoid arthritis (B), via chronic inflammation. Choice A is false; it stems from infection/obstruction, not bronchoconstriction (asthma-related). Choice C is incorrect; dilation is irreversible (pneumonia's is temporary). Choice D is wrong; it's uncommon now due to antibiotics. Choice E (mucus hypersecretion) fits bronchitis. Page 727 links B to systemic diseases RA's immune damage weakens airways, predisposing to infection/dilation, unlike A's mechanism or C's reversibility.

Correct Answer: C

Rationale: Asteroid bodies within giant cells (C) are a sarcoid feature. Choice A is false; granulomas affect multiple tissues (e.g., lymph nodes). Choice B is incorrect; necrosis is rare (unlike TB). Choice D is wrong; Schaumann bodies occur in TB too, not pathognomonic. Choice E (lymph node involvement) is true. Page 738 details C's morphology stellate inclusions in granulomas are characteristic, though not unique, distinguishing it over A's lung-only claim or D's specificity error.