The pediatric nurse is talking to a young child's grandmother, who cares for the child during the work week. The grandmother can't remember whether she gave aspirin or acetaminophen when the child had a fever. What is the best advice the pediatric nurse can give the grandmother for the future?

Correct Answer: A

Rationale: Aspirin is contraindicated in children with fever, especially during viral illnesses like the flu, due to the risk of Reye's syndrome, a rare but severe condition affecting the liver and brain. Acetaminophen is a safer choice for fever reduction in children, widely recommended by healthcare providers. Advising the grandmother to avoid aspirin protects the child from this potentially fatal complication, which is linked to aspirin use in viral infections. Keeping a record of medications is helpful but secondary to ensuring safety by avoiding harmful drugs. Telling the grandmother not to use acetaminophen would be incorrect, as it's effective and safe when dosed properly. Claiming aspirin and acetaminophen are equally suitable ignores the significant risks associated with aspirin in this context. The nurse's primary responsibility is to prevent harm, making the advice to avoid aspirin the most critical and evidence-based recommendation for future fever management in the child.

Correct Answer: B

Rationale: Antiviral prophylaxis (e.g., oseltamivir) in a nursing home during a flu outbreak aims to prevent infection amid high-risk residents and staff. Stopping after 7 days with no new cases aligns with CDC guidance, indicating the outbreak is controlled transmission risk drops when no new infections emerge over a week, roughly the flu's incubation and contagious period. No deaths in 2 days doesn't confirm outbreak end cases could persist. Five days of medication is a treatment duration, not prophylaxis, which often extends longer (e.g., 7–14 days) in outbreaks. Immunity takes weeks via vaccination, not antivirals, which only suppress viral replication. The nurse administrator ensures safety by tying cessation to epidemiological evidence of outbreak resolution, protecting this vulnerable population where flu spreads rapidly, balancing efficacy and drug exposure.

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: Centriacinar emphysema (B) is commonly caused by smoking, affecting proximal acini while sparing distal parts, often with bronchitis'. Pan acinar (A) involves entire acini, linked to α₁-antitrypsin deficiency, not smoking alone. Distal acinar (C) occurs near fibrosis, causing pneumothorax in young adults. Irregular (D) is scarring-related, the most common overall but not smoking-specific. Choice E is false. Page 718 notes centriacinar's association with smokers neutrophil/macrophage elastase damages central lobules, creating normal-emphysematous mosaics, making B the smoking-related type.

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.