A nurse is reviewing the chest x-ray of an older adult client. Which of the following findings is a normal age-related change in the thorax?

The correct answer is A.

Increased anteroposterior diameter.

This is a normal age-related change in the thorax that results from changes in the bones and muscles of the chest and spine.The ribcage becomes less flexible and more rounded, which increases the front-to-back dimension of the chest.

This can affect the lung function and breathing capacity of older adults.

Choice B is wrong because decreased kyphosis means reduced curvature of the spine, which is not a normal age-related change.In fact, kyphosis tends to increase with aging due to osteoporosis and vertebral compression fractures.

Choice C is wrong because increased lung expansion means greater ability to fill the lungs with air, which is not a normal age-related change.In fact, lung expansion tends to decrease with aging due to loss of elasticity and shape of the air sacs (alveoli) and weakening of the respiratory muscles.

Choice D is wrong because decreased calcification means reduced deposition of calcium in the tissues, which is not a normal age-related change.In fact, calcification tends to increase with aging, especially in the costal cartilages that connect the ribs to the sternum.

This can make the chest wall more rigid and less compliant.

Normal ranges for anteroposterior diameter vary depending on age, sex, height and weight, but generally it should be less than the transverse diameter (the side-to-side dimension of the chest).

A ratio of anteroposterior to transverse diameter greater than 0.9 is considered abnormal and may indicate chronic obstructive pulmonary disease (COPD).

The correct answer is C.

Decreased liver function.Older adults are at increased risk for adverse drug reactions due to various physiological changes that affect the absorption, distribution, metabolism and excretion of drugs.One of these changes is the reduction in liver blood flow, size, drug-metabolizing enzyme content and function.This can result in slower or decreased metabolism of drugs, leading to higher plasma concentrations and increased risk of toxicity.

Choice A is wrong because older adults have decreased renal clearance, not increased.This means that drugs that are eliminated by the kidneys may accumulate in the body and cause adverse effects.

Choice B is wrong because older adults have decreased plasma protein levels, not increased.This means that drugs that are bound to plasma proteins may have higher free fractions and increased pharmacological effects.

Choice D is wrong because older adults have increased permeability of the blood-brain barrier, not decreased.This means that drugs that cross the blood-brain barrier may have enhanced central nervous system effects in older adults.

Normal ranges for liver function tests vary depending on the laboratory and the method used, but some common values are:.

• Alanine aminotransferase (ALT): 7-55 U/L.

• Aspartate aminotransferase (AST): 8-48 U/L.

• Alkaline phosphatase (ALP): 45-115 U/L.

• Total bilirubin: 0.1-1.2 mg/dL.

• Albumin: 3.5-5 g/dL.