A patient has very high plasma uric acid and has high risk of developing acute uric acid nephropathy. Which of the following agent should be avoided?

Correct Answer: D

Rationale: The correct answer is D: Furosemide. Furosemide is a loop diuretic which can increase uric acid levels in the blood, potentially worsening the patient's condition. Ethacrynic acid (A) is also a loop diuretic and can have similar effects. Acetazolamide (B) is a carbonic anhydrase inhibitor and may increase urinary excretion of uric acid, which can be beneficial in this case. Hydrochlorothiazide (C) is a thiazide diuretic that can actually lower uric acid levels by increasing urinary excretion. Therefore, the best choice to avoid in a patient with high plasma uric acid and risk of acute uric acid nephropathy is furosemide.

Correct Answer: C

Rationale: The correct answer is C: limit pH changes caused by metabolic and fixed acids. 1. Phosphate buffer system consists of dihydrogen phosphate (H2PO4-) and hydrogen phosphate (HPO4^2-) ions, which can donate or accept H+ ions to maintain a stable pH. 2. Metabolic and fixed acids produced in the body can lead to pH changes. The phosphate buffer system helps to prevent drastic changes in pH by neutralizing excess H+ ions. 3. Options A, B, and D are incorrect because the phosphate buffer system is not specifically designed to buffer stomach acid, carbonic acid formed by carbon dioxide, or buffer the urine.

Correct Answer: D

Rationale: The correct answer is D because the corpus albicans is the end stage of the corpus luteum, which degenerates if fertilization does not occur. As a result, it no longer secretes hormones. Estrogen and progesterone are secreted by the corpus luteum, not the corpus albicans. Luteinizing hormone is produced by the anterior pituitary gland, not by the corpus albicans.

Correct Answer: A

Rationale: The correct answer is A because after surgery to create an ileal conduit for bladder cancer, monitoring urine output is crucial to assess kidney function and ensure proper drainage. Hourly monitoring helps to detect any complications early. Choice B is incorrect as it does not provide any relevant information. Choice C is incorrect because monitoring urine output is essential postoperatively. Choice D is incorrect as it does not address the immediate postoperative care needs of a patient with an ileal conduit.

Correct Answer: E

Rationale: Step-by-step rationale for the correct answer (E): 1. The prompt mentions a patient with a sacral pressure ulcer. 2. Considering the context, the most relevant issue would be wound care and prevention of pressure ulcers. 3. Option E is the only choice related to wound care and prevention, indicating the correct focus for the nurse. 4. Choices A, B, C, and D are unrelated to the primary concern of managing the sacral pressure ulcer. 5. Therefore, E is the correct answer as it aligns with the patient's immediate care needs.