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 C

Explanation

Choice A reason: A client with a 10-year history of chronic lung disease is not the most at risk to develop metabolic acidosis because chronic lung disease causes respiratory acidosis, not metabolic acidosis. Respiratory acidosis is a condition where the lungs cannot eliminate enough carbon dioxide, resulting in a low pH and a high bicarbonate level in the blood.

Choice B reason: A client receiving parenteral nutrition for 2 weeks is not the most at risk to develop metabolic acidosis because parenteral nutrition does not affect the acid-base balance of the body, unless there is an infection or a complication. Parenteral nutrition is a method of providing nutrients through a vein, bypassing the digestive system.

Choice C reason: A client with a history of severe diarrhea for 5 days is the most at risk to develop metabolic acidosis because diarrhea causes loss of bicarbonate, which is a base that helps maintain the pH of the blood. Loss of bicarbonate leads to a low pH and a low bicarbonate level in the blood, indicating metabolic acidosis.

Choice D reason: A client with a temperature of 102°F (38.9°C) for 48 hours is not the most at risk to develop metabolic acidosis because fever does not directly cause metabolic acidosis, unless there is dehydration or sepsis. Fever is a symptom of an infection or inflammation, which can increase the metabolic rate and the production of carbon dioxide, but the lungs can usually compensate by increasing the ventilation.

A. Glomerulonephritis B. Fluid volume deficit C. Neurogenic bladder D. Renal calculus

Correct Answer is B

Explanation

Choice A reason: Glomerulonephritis is an inflammation of the glomeruli, the filtering units of the kidneys. It can cause damage to the renal tissue and lead to intrinsic acute kidney injury, not prerenal acute kidney injury.

Choice B reason: Fluid volume deficit is a condition in which the body loses more fluid than it takes in. It can cause hypovolemia, which reduces the blood flow to the kidneys and impairs their function. This is the most common cause of prerenal acute kidney injury, which is a result of decreased perfusion to the kidneys.

Choice C reason: Neurogenic bladder is a dysfunction of the bladder caused by a nerve problem. It can affect the ability to store or empty urine. It can cause urinary retention, which increases the pressure in the urinary tract and damages the kidneys. This is a type of postrenal acute kidney injury, which is a result of obstruction to the urine outflow.

Choice D reason: Renal calculus is a solid mass formed from crystals in the urine. It can block the ureter, the tube that carries urine from the kidney to the bladder. It can cause hydronephrosis, which is a swelling of the kidney due to accumulation of urine. This is another type of postrenal acute kidney injury.

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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 C

Explanation

Which risk factor is significant for development of prerenal acute kidney injury?

Correct Answer is B

Explanation

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