During initial chemotherapy a patient with leukemia develops hyperkalemia and hyperuricemia. The nurse recognizes these symptoms as an oncologic emergency and anticipates that the priority treatment will be to

Correct Answer: A

Rationale: In this scenario, the correct answer is A) increase urine output with hydration therapy. When a patient with leukemia undergoing chemotherapy develops hyperkalemia and hyperuricemia, it indicates tumor lysis syndrome (TLS), which is an oncologic emergency. The priority treatment is to increase urine output through hydration therapy to prevent renal damage from the accumulation of metabolites released during rapid cell destruction. Option B) establish electrocardiographic (ECG) monitoring is incorrect because while ECG monitoring is important in assessing cardiac function, it is not the priority in this situation where renal function is at risk due to TLS. Option C) administer a bisphosphonate such as pamidronate (Aredia) is incorrect as bisphosphonates are used to manage hypercalcemia caused by malignancy or bone metastases, not hyperkalemia and hyperuricemia. Option D) restrict fluids and administer hypertonic sodium chloride solution is incorrect because restricting fluids can exacerbate the renal damage caused by TLS, and hypertonic sodium chloride solution may worsen hyperkalemia. Educationally, understanding the pathophysiology of TLS and its management is crucial for nurses caring for patients undergoing chemotherapy. Recognizing the signs of TLS and knowing the appropriate interventions can help prevent potentially life-threatening complications in oncology patients. Prioritizing interventions based on the patient's condition is essential in providing safe and effective care.

Correct Answer: A

Rationale: The correct answer is A) CO2 is eliminated by the lung. In the carbonic acid-bicarbonate buffer system, carbon dioxide (CO2) is eliminated by the lungs through respiration. This process helps regulate the pH of the blood by controlling the levels of carbonic acid (H2CO3) and bicarbonate ions (HCO3-) in the body. Option B is incorrect because the carbonic acid-bicarbonate buffer system does not neutralize HCl acid to yield carbonic acid and salt. Instead, it primarily acts to maintain the acid-base balance in the body. Option C is incorrect as well. In this buffer system, H2CO3 formed by neutralization does not dissociate into H2O and CO2. Instead, it forms bicarbonate ions and hydrogen ions which help regulate pH. Option D is incorrect because the carbonic acid-bicarbonate buffer system does not shift H+ in and out of cells in exchange for other cations. Its primary function is to maintain the pH balance of the blood by absorbing or releasing hydrogen ions as needed. Understanding the carbonic acid-bicarbonate buffer system is crucial in pharmacology as it plays a vital role in maintaining the acid-base balance in the body. This knowledge is essential for healthcare professionals to understand how the body regulates pH and how certain medications may impact this delicate balance.

Correct Answer: C

Rationale: The correct answer is C because complement proteins bind antibodies attached to cell surfaces and cause cell lysis, enhancing immune response. Choice A is incorrect as complement does not inactivate performs. Choice B is incorrect as complement does not mediate the release of histamine. Choice D is incorrect as phagocytosis is a function of phagocytes, not complement proteins. Therefore, the correct function of complement is to enhance immune response by binding antibodies and causing cell lysis.

Correct Answer: C

Rationale: Step-by-step rationale: 1. The J-chain is a polypeptide involved in the formation of polymeric IgM and IgA. 2. Polymeric forms of IgM and IgA contain the J-chain, aiding in their multimeric structure. 3. The J-chain is not exclusive to T-cells or neutrophils, making choices A and B incorrect. 4. IgE is associated with FcεRI receptors for histamine release, so choice D is incorrect. Summary: The correct answer is C because the J-chain is specifically associated with the multimeric forms of IgM and IgA, helping to form their structure. Choices A, B, and D are incorrect as the J-chain is not solely produced by T-cells, neutrophils, or associated with IgE for histamine release.

Correct Answer: A

Rationale: The correct action is to elevate the foot first. Elevating the foot helps reduce swelling and pain by promoting better circulation. This step is crucial in the initial management of a sprained ankle. Applying ice and administering aspirin can come after elevating the foot. Assisting with ambulation should only be considered after the initial measures are taken to address the sprained ankle.