In chronic emphysema the blood may show the following changes:

Correct Answer: D

Rationale: Chronic emphysema, an obstructive disease, causes CO₂ retention (hypercapnia), lowering pH (acidosis) as HCO₃⁻ rises to compensate respiratory acidosis. Chloride drops (low Cl⁻) via renal compensation, shifting anions, yielding low pH, low chloride, high CO₂ content' (D). High pH (A, E) suggests alkalosis, unfit for chronic CO₂ buildup. Eosinophilia (B) ties to allergy, not emphysema. Low CO₂ (C) fits hyperventilation, not obstruction. This blood gas shift e.g., pH 7.30, PaCO₂ 60 mmHg reflects ventilatory failure, critical in monitoring COPD progression and guiding oxygen or ventilatory support in advanced stages.

Correct Answer: A

Rationale: Pleuritis pleural inflammation produces friction rub (A), a creaking sound from inflamed surfaces (e.g., pneumonia, TB). CHF (B) causes effusion, not rub. Duct rupture (C) yields chylothorax. Pseudomonas (D) links to empyema. Bleb is pneumothorax. Rub's auscultatory hallmark is key, guiding anti-inflammatory therapy in chest assessment.

Correct Answer: C

Rationale: Thrombocytosis (platelets >450,000/μL) occurs in malignancy (A cytokines), myelofibrosis (B marrow dysfunction), splenectomy (D no clearance), and chronic granulomatous disease (E inflammation), but not acute myelocytic leukemia (C) thrombocytopenia dominates from marrow suppression. AML's blast crisis consumes platelets, key in nursing for transfusion readiness, contrasting reactive thrombocytosis.

Correct Answer: C

Rationale: The Schilling test (C) best diagnoses pernicious anemia measures B12 absorption with/without intrinsic factor (IF), confirming gastric IF loss (e.g., <5% excretion). Marrow (A) shows megaloblasts, nonspecific. Neurologic exam (B) detects neuropathy, late. Smear (D) and indices show macrocytosis (MCV >100 fL), not cause. Schilling's specificity is key in nursing for B12 vs. folate differentiation and lifelong therapy.

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.