Which of the following does NOT increase synthesis of 2,3-DPG?

Correct Answer: B

Rationale: phosphate deficiency decreases 2,3-DPG synthesis, as phosphate is a substrate in glycolysis (1,3-BPG to 2,3-DPG via mutase). Choice A (growth hormone), C (thyroid hormone), D (exercise), and E (androgens) increase 2,3-DPG by boosting metabolism or hypoxia response, shifting the O₂ curve right (P₅₀ up). In hypoxia (e.g., altitude, exercise), 2,3-DPG rises (e.g., 15 to 20 µmol/g Hb) to aid O₂ unloading. Phosphate scarcity impairs this, reducing levels (e.g., in hypophosphatemia), distinguishing B as the non-stimulator among metabolic enhancers.

Correct Answer: A

Rationale: A runny nose during influenza occurs because cells lining the respiratory passages die due to viral infection, releasing fluid and triggering inflammation, which increases mucus production. This is a key immune response to trap and expel the virus, appropriate for fifth graders to understand as a body defense. Drinking water doesn't cause runny noses it hydrates, not floods, the nose. Insufficient coughing or sneezing might worsen congestion but isn't the root cause mucus forms regardless. Viruses don't ‘melt' into fluid; they're already microscopic and trigger fluid release via cell damage, not fever directly. The nurse teaches this cellular explanation to connect symptoms to infection, making it relatable and scientifically sound, encouraging tissue use to manage mucus and reduce germ spread among kids.

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.