A bloody pleural effusion is consistent with a diagnosis of which of the following:

Correct Answer: D

Rationale: A bloody pleural effusion aligns with pulmonary embolus (A) and myocardial infarct (C) thus D (A & C). Embolus causes infarction, leaking RBCs into pleura; post-MI (e.g., Dressler's) involves hemorrhagic inflammation. Acute hemorrhagic pancreatitis (B) causes abdominal effusion, rarely pleural, and not typically bloody unless complicated. All' overextends pancreatitis lacks direct pleural linkage. Bloody effusions (RBC >10,000/mm³) signal vascular or inflammatory breach, distinguishing from transudates, critical in differential diagnosis via thoracentesis, a chest nursing focus.

Correct Answer: B

Rationale: Mediastinal emphysema air in mediastinum stems from tracheal perforation (B), e.g., trauma or barotrauma, leaking air (crunching sound, Hamman's sign). Collaterals (A) fit SVCS. Elderly debilitation (C) is nonspecific. Perforation's air escape is key, needing urgent imaging (e.g., CT), guiding intervention in chest emergencies.

Correct Answer: A

Rationale: Methotrexate, an antimetabolite, causes myelosuppression, hepatitis (A) folate inhibition suppresses marrow, damages liver (e.g., ALT >100 U/L). Protein defects (B) fit asparaginase. Neuropathy (C) is vincristine. Cystitis (D) is cytoxan. Psychosis is prednisone. Methotrexate's toxicity is key in nursing for leucovorin rescue and liver function tests.

Correct Answer: D

Rationale: Idiopathic thrombocytopenic purpura (ITP) immune platelet destruction starts with glucocorticoids (E e.g., prednisone 1 mg/kg), raising counts (e.g., >50,000/μL) by blocking phagocytosis. Transfusion (A) is for bleeding. Testosterone (B) is obsolete. Splenectomy (C) is second-line. 6-MP (D) is leukemia-related. Steroids' efficacy is key in nursing for rapid response and monitoring purpura.

Correct Answer: D

Rationale: Acute leukemia's main complications are infection and bleeding (D) marrow replacement by blasts (e.g., >20%) drops neutrophils (<500/μL) and platelets (<20,000/μL), risking sepsis and hemorrhage (e.g., CNS bleed). Seizures (A) or fractures (B) are secondary. Splenic rupture (C) is rare. None' dismisses. Infection and bleeding dominate, key in nursing for antibiotics, transfusions, and isolation.