01-03-2008, 12:03 PM
5. An 87-year-old nursing home resident with dementia, Alzheimer's type, is admitted to the hospital because of progressive lethargy and decreased appetite for 3 days. She had a flu-like illness followed by a deep cough 1 week ago. Over the past 10 months, she has been hospitalized once for bacterial pneumonia. She is responsive only to painful stimuli. Her temperature is 38.6 C (101.5 F), blood pressure is 110/60 mm Hg, pulse is 123/min and regular, and respirations are 28/min. Examination shows dry mucous membranes. There is no adenopathy. Crackles are heard in the right lung base. An x-ray film of the chest shows an infiltrate at the right lung base. The remainder of the examination shows no abnormalities. Which of the following is the most likely predisposing factor for this patient's pneumonia?
A ) Decreased airway elasticity
B ) Decreased baroreflex
C ) Decreased gag reflex
D ) Decreased thyroid function
E ) Diastolic cardiac dysfunction
F ) Impaired cardiac response to exercise
G ) Impaired T-lymphocyte function
H ) Impaired thirst
I ) Increased lung compliance
J ) Renal salt wasting
A ) Decreased airway elasticity
B ) Decreased baroreflex
C ) Decreased gag reflex
D ) Decreased thyroid function
E ) Diastolic cardiac dysfunction
F ) Impaired cardiac response to exercise
G ) Impaired T-lymphocyte function
H ) Impaired thirst
I ) Increased lung compliance
J ) Renal salt wasting