Nurse Reese is caring for a client hospitalized with acute exacerbation of chronic obstructive pulmonary disease. Which of the following would the nurse expect to note on assessment of this client?

Correct Answer: B

Rationale: The correct answer is B: A hyperinflated chest noted on the chest x-ray. In COPD, air trapping leads to hyperinflation of the lungs, causing the chest to appear hyperinflated on x-ray. This is due to the increased residual volume and decreased expiratory flow rates in COPD. Incorrect choices: A: Hypocapnia is unlikely in COPD as patients typically retain carbon dioxide due to impaired gas exchange. C: Increased oxygen saturation with exercise is unlikely in COPD as these patients often have decreased oxygen saturation due to impaired gas exchange. D: A widened diaphragm would not be a typical finding on chest x-ray in COPD; hyperinflated lungs are more characteristic.

Correct Answer: C

Rationale: The correct answer is C, a 43-year-old homeless man with a history of alcoholism. This choice is most likely to have TB because individuals who are homeless and have a history of alcoholism are at higher risk for TB due to weakened immune systems and living conditions. Homelessness and alcoholism increase the likelihood of exposure to TB. Explanation for other choices: A: A 16-year-old female high school student - Less likely to have TB compared to homeless individuals with risk factors. B: A 33-year-old day-care worker - Possible but less likely compared to the homeless man with a history of alcoholism. D: A 54-year-old businessman - Least likely to have TB compared to the homeless individual with risk factors.

Correct Answer: C

Rationale: The correct answer is C: bronchioles. After air passes through the trachea, it enters the bronchi, which further divide into bronchioles. The bronchioles are the last structures where air passes before reaching the alveoli for gas exchange. The larynx is involved in sound production and the glottis is the opening between the vocal cords in the larynx. While the trachea is the initial passage for air into the respiratory system, the bronchioles are the final branching structures where air reaches the alveoli, making them the correct answer.

Correct Answer: D

Rationale: The correct answer is D because carbonic anhydrase catalyzes the conversion of carbon dioxide and water into bicarbonate ions and protons, not the formation of oxyhemoglobin. Step-by-step rationale: 1. Hemoglobin functions as a buffer by binding to hydrogen ions to help regulate pH levels in the blood. 2. Bicarbonate ions do tend to diffuse out of red blood cells into the plasma to maintain the balance of CO2 and pH. 3. The movement of molecules is indeed different in metabolically active tissues (where oxygen is released and CO2 is taken up) compared to the alveoli (where the opposite occurs). Therefore, choices A, B, and C are all correct statements, making D the false statement.

Correct Answer: D

Rationale: The correct order of structures in the respiratory passageways is D: pharynx, larynx, trachea, bronchi, bronchioles. This is the correct order because air enters the body through the pharynx, then passes through the larynx (voice box), followed by the trachea (windpipe), which branches into the bronchi, and then further divides into bronchioles. The other choices are incorrect because they do not follow the natural flow of air through the respiratory system. Choice A has the incorrect order starting with the pharynx, followed by the trachea, larynx, bronchi, and bronchioles. Choice B starts with the larynx, then pharynx, trachea, bronchioles, and bronchi, which is out of sequence. Choice C begins with the trachea, then pharynx, larynx, bronchi, and bronchioles, which is also incorrect