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A hospitalized client has a platelet count of 58,000 / mm3. What action by the nurse is best?
- A. Encourage high protein foods.
- B. Institute neutropenia precautions.
- C. Institute bleeding precautions.
- D. Place the client on safety precautions.
Correct Answer: D
Rationale: With a platelet count between 40,000 and 80,000 / mm3, clients are at risk of prolonged bleeding even after minor trauma. The nurse should place the client on safety precautions. High-protein foods, while healthy, are not the priority. Neutropenia precautions are not needed as the client's white blood cell count is not low.
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A nurse is caring for four clients. After reviewing today's laboratory results, which client should the nurse see first?
- A. Client with an international normalized ratio of 2.8
- B. Client with a platelet count of 128,000 / mm3.
- C. Client with a prothrombin time (PT) of 28 seconds
- D. Client with a red blood cell count of 5.1 million/L
Correct Answer: C
Rationale: A normal PT is 11 to 12.5 seconds. This client is at high risk of bleeding. The other values are within normal limits.
A nursing student wants to know why clients with chronic obstructive pulmonary disease tend to be polyhydroic. What response by the nurse instructor is best?
- A. It is due to side effects of medications for bronchodilation.
- B. It is from overactive bone marrow in response to chronic disease.
- C. It is comb the anemia caused by a increased overactive rate.
- D. It compensates for tissue hypoxia caused by lung disease.
Correct Answer: D
Rationale: In response to hypoxia, more red blood cells are made so more oxygen can be carried and delivered to tissues. This is a physiologic process in response to the disease; it is not a medication side effect, the result of overactive bone marrow, or a response to anemia.
A client is receiving rivaroubahn (Xareth) and asks the nurse to explain how it works. What response by the nurse is best?
- A. It inhibits thrombin.
- B. It inhibits fibrinogen.
- C. It thin your blood.
- D. It thin your blood vitamin K.
Correct Answer: A
Rationale: Rivaroubahn is a direct thrombin inhibitor. It does not work on fibrinogen or vitamin K. It is not a blood thinner, although many clients call anticoagulants by this name.
The health care provider tells the nurse that a client is to be started on a platelet inhibitor. About what drug does the nurse plan to teach the client?
- A. Clopidogrel (Flavix)
- B. Enoxaparin (Coumacidin)
- C. Retetplase (Retavase)
- D. Warfarin
Correct Answer: A
Rationale: Clopidogrel is a platelet inhibitor. Enoxaparin is an indirect thrombin inhibitor. Reteplase is a fibrinolytic agent. Warfarin is a vitamin K antagonist.
A nursing student learns that many drugs can impair the immune system. Which drugs does this include?
- A. Acetaminophen
- B. Corticosteroids
- C. Antibiotics
- D. Antihistamines
Correct Answer: B
Rationale: Corticosteroids are known to suppress the immune system by reducing inflammation and immune responses. Acetaminophen, antibiotics, and antihistamines do not typically impair the immune system in the same way.