Cholelithiasis may be due to one of the following:

Correct Answer: D

Rationale: Cholelithiasis gallstones stems from hemolytic anemia (D), where excess bilirubin from RBC breakdown (e.g., sickle cell, Hb 8 g/dL) forms pigment stones. Malignancy (A) or cirrhosis (C) may obstruct, not form stones. High fat diet (B) risks cholesterol stones, less specific here. CHF causes congestion, not lithiasis. Hemolysis's bilirubin overload is key, guiding nursing for ultrasound and monitoring jaundice in anemia patients.

Correct Answer: D

Rationale: Hemolytic anemia RBC destruction occurs in G-6-PD (A drug-induced), thalassemia (B ineffective erythropoiesis), spherocytosis (C spleen lysis), HbC (D mild hemolysis) but not iron deficiency , where low iron reduces RBC production (e.g., Hb <10 g/dL), not lysis. Iron's non-hemolytic nature is key, guiding nursing for iron, not hemolysis workup.

Correct Answer: A

Rationale: Anemia of infection/rheumatoid arthritis chronic disease shows low plasma iron, low TIBC, high stores, low sideroblasts (A), from inflammation (e.g., IL-6) sequestering iron. Erythropoietin (B) fits renal. Normocytic (C) is pattern, not cause. Blood loss (D) is other anemias. Iron block is key, guiding nursing for inflammation control.

Correct Answer: D

Rationale: Juvenile rheumatoid arthritis (JRA) all true : uveitis (A eye inflammation), erythema multiforme (B rash, less common), pericarditis/valvular (C cardiac), lymphadenopathy/hepatosplenomegaly (D systemic JIA). Multisystem involvement is key, guiding nursing for eye exams, steroids, and systemic monitoring.

Correct Answer: C

Rationale: Asthma is an obstructive airway disease characterized by reversible bronchoconstriction, inflammation, and mucus production. During an asthmatic attack, narrowed airways increase resistance, particularly during expiration, when dynamic compression exacerbates airflow limitation, producing wheezing most prominent on expiration, not inspiration. The work of breathing increases significantly as patients struggle against this resistance and reduced airflow, requiring greater effort from respiratory muscles like the diaphragm and intercostals to maintain ventilation. Bronchodilators (e.g., albuterol) are the mainstay of treatment, relaxing bronchial smooth muscle to relieve constriction, so they are not contraindicated. Forced expiratory volume in 1 second (FEV1) decreases during an attack due to obstruction, not increases, as airflow is impeded. The increased work of breathing is a consistent expectation, reflecting the physiological burden of overcoming narrowed airways and trapped air, distinguishing it from the incorrect options that misalign with asthma's acute presentation.