The clinic nurse is preparing to give an antiviral drug to an older client with chronic obstructive pulmonary disease (COPD) and sickle cell disease. Which ordered medication would cause the nurse to notify the prescriber?

Correct Answer: C

Rationale: Zanamivir is an inhaled antiviral used for influenza but is contraindicated in clients with COPD because it can cause bronchospasm, worsening airway obstruction and potentially leading to respiratory distress. For an older client with COPD and sickle cell disease, this risk is amplified, as both conditions compromise oxygen delivery COPD via lung function and sickle cell via reduced blood oxygenation. Oseltamivir (also known as Tamiflu) is an oral antiviral safe for such clients, making it a better choice. Xanax, an anti-anxiety drug, isn't an antiviral and is irrelevant here. The nurse must notify the prescriber about Zanamivir due to its potential to exacerbate the client's respiratory condition, requiring an alternative like Oseltamivir. This decision reflects the nurse's duty to assess medication appropriateness based on the client's comorbidities, preventing harm and ensuring treatment aligns with the client's fragile health status.

Correct Answer: B

Rationale: The statement about avoiding fluids signals a need for more teaching fluids are essential during flu to prevent dehydration from fever and thin mucus for easier clearance, aiding recovery. Hand washing after nose-blowing prevents spread, showing good understanding. Needing a flu shot every 2 years is incorrect but less urgent annual shots are ideal due to strain shifts, though the client grasps variability. Covering the mouth with a hand when sneezing spreads germs unless washed immediately; an elbow is better, but fluid avoidance is the most harmful misconception. The nurse corrects this to emphasize hydration's role in supporting immunity and comfort, countering a dangerous myth that could worsen outcomes, ensuring clients manage flu effectively.

Correct Answer: A

Rationale: The nurse asks if the 6-month-old has trouble breathing to gauge acuity, as respiratory distress (e.g., rapid breathing, grunting) in infants signals severe flu complications like bronchiolitis, needing urgent care. Small airways and immature immunity make this critical too young for flu shots, they're at high risk. Fever matters, but alone doesn't define urgency. Nasal drainage is typical, not acute. Symptom onset aids context, not immediate severity. Prioritizing breathing aligns with pediatric triage, ensuring the parent seeks help if this red flag appears, protecting the infant from rapid deterioration common in flu-related respiratory crises.

Correct Answer: C

Rationale: The protease-antiprotease mechanism (C) is the most plausible explanation for emphysema'. Choice A is false; α₁-antitrypsin deficiency causes panacinar emphysema, not protects. Choice B is true; centriacinar destruction overinflates via obstruction. Choice D is incorrect; macrophages increase in alveolar spaces, not bronchi. Choice E (elastase up with radicals) is true but not listed. Page 721 links smoking's oxidative stress and neutrophil elastase to alveolar damage, with α₁-antitrypsin's protective role overwhelmed, making C's imbalance theory central, unlike A's reversal or D's location error.

Correct Answer: B

Rationale: Aspirin-induced asthma occurs in patients with allergic rhinitis and nasal polyps (B), part of the aspirin-exacerbated respiratory disease triad. Choice A is false; it's a contraindication (MIMS warns of bronchospasm). Choice C is incorrect; minute doses trigger it. Choice D is wrong; aspirin inhibits cyclooxygenase, shunting to leukotrienes (lipooxygenase), not inducing COX. Choice E (urticaria) is true but not listed. Page 726 explains B's association 10-20% of asthmatics with polyps/rhinitis react, with leukotrienes causing constriction, distinguishing it over A's safety or D's mechanism.