Appropriate nursing diagnoses for a client admitted with pneumonia secondary to influenza include which of the following? (Select all that apply.)

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: 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.

Correct Answer: B

Rationale: Pulmonary infarcts from emboli are classically hemorrhagic (B), due to dual blood supply. Choice A is false; only 10% cause infarction (most resolve). Choice C is incorrect; death is from acute right heart failure (cor pulmonale). Choice D is wrong; recurrence risk is 30%, not 3%. Choice E (fever) is true. Page 742 details B's morphology red infarcts from bronchial artery bleeding distinguish it over A's frequency or C's heart error.

Correct Answer: D

Rationale: Suppurative arthritis (D) is not a typical pneumonia complication; dissemination targets heart, brain, or kidneys, not joints. Choice A (abscess) occurs with Klebsiella/type 3 pneumococci. Choice B (empyema) is pus in pleura. Choice C (organization) solidifies lung tissue. Choice E (metaplasia) is a response, not complication. Page 750 lists A-C as direct sequelae abscess from necrosis, empyema from spread, organization from fibrosis but arthritis, while possible in septicemia, isn't standard, distinguishing D as the outlier.