The nurse provides care for an older adult client diagnosed with aspiration pneumonia as a complication of dysphagia. Which statement best explains the increased risk of infection in the older adult population?

Decreased dietary intake of proteins and vegetables

Decreased T cell function and antibody response

Atrophy of the bone marrow and spleen

Impaired absorption of vitamin B12

Answer and Explanation

The Correct Answer is B

Choice A reason: Decreased dietary intake of proteins and vegetables is not the best explanation because it is a factor that affects the nutritional status, not the immune system. Nutritional status is important for maintaining the health and function of the body, but it does not directly cause an increased risk of infection. Proteins and vegetables are sources of essential nutrients, such as amino acids, vitamins, minerals, and antioxidants, that support the growth and repair of the tissues and the prevention of oxidative stress.

Choice B reason: Decreased T cell function and antibody response is the best explanation because it is a factor that affects the immune system, which is the body's defense mechanism against foreign invaders, such as bacteria, viruses, and fungi. The immune system consists of two main components: the innate immunity and the adaptive immunity. The innate immunity is the first line of defense that provides a general and rapid response to any potential threat. The adaptive immunity is the second line of defense that provides a specific and long-lasting response to a particular antigen. T cells and antibodies are part of the adaptive immunity, which recognizes and remembers the antigens that have previously infected the body and eliminates them more efficiently. However, as people age, the T cell function and the antibody response decline, making the older adults more susceptible to infections, especially those that are new or unfamiliar to the body.

Choice C reason: Atrophy of the bone marrow and spleen is not the best explanation because it is a factor that affects the production and storage of immune cells, not the function and response. The bone marrow is the soft tissue inside the bones that produces the blood cells, including the white blood cells, which are the main components of the immune system. The spleen is an organ that filters the blood and removes the old or damaged blood cells, as well as stores some of the white blood cells and platelets. As people age, the bone marrow and the spleen shrink and lose some of their ability to produce and store the immune cells, which can reduce the number and diversity of the immune cells available to fight infections. However, this does not necessarily affect the function and response of the immune cells that are already circulating in the blood.

Choice D reason: Impaired absorption of vitamin B12 is not the best explanation because it is a factor that affects the nervous system and the blood cells, not the immune system. Vitamin B12 is a water-soluble vitamin that is essential for the synthesis of DNA, the maintenance of the myelin sheath, and the formation of red blood cells. As people age, the absorption of vitamin B12 decreases due to the reduced secretion of stomach acid and intrinsic factor, which are needed to break down and bind to the vitamin B12 in the food. This can lead to vitamin B12 deficiency, which can cause symptoms such as fatigue, weakness, numbness, tingling, memory loss, and anemia. Anemia is a condition where the blood has a low level of hemoglobin, which is the protein that carries oxygen in the red blood cells. Anemia can affect the oxygen delivery to the tissues, but it does not directly cause an increased risk of infection.

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Correct Answer is B

Explanation

Choice A reason: Facial muscle atrophy is not the expected finding because it is a condition where the facial muscles lose their mass and strength, which can be caused by various factors, such as aging, nerve damage, or muscular dystrophy. Facial muscle atrophy is not a common manifestation of myxedema, which is a severe form of hypothyroidism, which is a condition where the thyroid gland does not produce enough thyroid hormones, which regulate the metabolism and growth of the body.

Choice B reason: Facial and periorbital edema is the expected finding because it is a characteristic manifestation of myxedema, which is caused by the accumulation of mucopolysaccharides, which are complex carbohydrates that are normally found in the connective tissues. Mucopolysaccharides can attract water and cause swelling of the tissues, especially in the face and around the eyes. Facial and periorbital edema can also cause the facial features to appear coarse and puffy, and the eyelids to droop.

Choice C reason: Facial muscle twitching is not the expected finding because it is a condition where the facial muscles contract involuntarily, which can be caused by various factors, such as stress, fatigue, or caffeine. Facial muscle twitching is not a common manifestation of myxedema, which can cause the facial muscles to become weak and slow, and the facial expressions to become dull and flat.

Choice D reason: Unilateral ptosis is not the expected finding because it is a condition where one eyelid droops lower than the other, which can be caused by various factors, such as nerve damage, stroke, or tumor. Unilateral ptosis is not a common manifestation of myxedema, which can cause bilateral ptosis, which is the drooping of both eyelids, due to the edema and weakness of the eyelid muscles.

A. Serum glucose 158 mg/dL (8.77 mmol/L) B. Blood pressure 98/52 mm Hg C. Weight gain 3 pounds (1.36 kg) in 24 hours D. Insomnia and restlessness

Correct Answer is B

Explanation

Choice A reason: Serum glucose 158 mg/dL (8.77 mmol/L) is not the most significant observation for an acute adrenal crisis, but a mild elevation of blood sugar. A mild elevation of blood sugar may occur due to stress, infection, medication, or diet, among other factors. It does not indicate a severe deficiency of adrenal hormones, which is the cause of an acute adrenal crisis.

Choice B reason: Blood pressure 98/52 mm Hg is the most significant observation for an acute adrenal crisis, as it indicates a condition called hypotension. Hypotension is a low blood pressure that may cause dizziness, fainting, shock, or organ failure. It is a sign of an acute adrenal crisis, which is a life-threatening emergency that occurs when the adrenal glands fail to produce enough cortisol and aldosterone. Cortisol and aldosterone are hormones that regulate blood pressure, blood sugar, and electrolyte balance.

Choice C reason: Weight gain 3 pounds (1.36 kg) in 24 hours is not the most significant observation for an acute adrenal crisis, but a possible sign of fluid retention. Fluid retention may occur due to heart failure, kidney disease, liver disease, or medication, among other causes. It does not indicate a severe deficiency of adrenal hormones, which is the cause of an acute adrenal crisis.

Choice D reason: Insomnia and restlessness are not the most significant observations for an acute adrenal crisis, but possible symptoms of anxiety, stress, or hyperthyroidism. Anxiety, stress, and hyperthyroidism may cause difficulty sleeping, nervousness, or agitation, among other effects. They do not indicate a severe deficiency of adrenal hormones, which is the cause of an acute adrenal crisis.

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The nurse provides care for an older adult client diagnosed with aspiration pneumonia as a complication of dysphagia. Which statement best explains the increased risk of infection in the older adult population?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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