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A patients blood work reveals a platelet level of 17,000/mm3. When inspecting the patients integumentary system, what finding would be most consistent with this platelet level?
- A. Dermatitis
- B. Petechiae
- C. Urticaria
- D. Alopecia
Correct Answer: B
Rationale: When the platelet count drops to less than 20,000/mm?³, petechiae can appear. Low platelet levels do not normally result in dermatitis, urticaria (hives), or alopecia (hair loss).
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A group of nurses are learning about the high incidence of anemia prevalence of anemia among different populations. Which of the following patients would be the most likely to suffer from anemia a patient?
- A. A 50-year-old African American woman who is going through menopause
- B. An ?¾?????°?½?° ?? 80??80 elderly woman who has a diagnosis of heart failure
- C. A 48-year-old man who travels widely and has a high pressure job
- D. A 13-year-old girl who has just commenced menstruation
Correct Answer: B
Rationale: The incidence and prevalence of anemia are exceptionally high among older adults, and the risk of anemia is compounded by the presence of heart disease. None of the other listed individuals exhibits high-risk factors for anemia, though exceptionally heavy menstrual flow can result in anemia.
A patient with a pulmonary embolism is being treated with a heparin infusion. What diagnostic finding suggests to the nurse that treatment is effective?
- A. The patient's PT is within reference ranges.
- B. Arterial blood sampling tests positive for the presence of factor XIII.
- C. The patient's platelet level is below 100,000/mm3.
- D. The patient's activated partial thromboplastin time (aPTT) is 1.5 to 2.5 times the control value.
Correct Answer: D
Rationale: The therapeutic effect of heparin is monitored by serial measurements of the aPTT; the dose is adjusted to maintain the range at 1.5 to 2.5 times the laboratory control. Heparin dosing is not determined on the basis of platelet levels, the presence or absence of clotting factors, or PT levels.
A patient with a documented history of glucose-6-phosphate dehydrogenase deficiency has presented to the emergency department with signs and symptoms including pallor, jaundice, and malaise. Which of the nurse's assessment questions relates most directly to this patient's hematologic disorder?
- A. When did you last have a blood transfusion?
- B. What medications have taken recently?
- C. Have you been under significant stress lately?
- D. Have you suffered any recent injuries?
Correct Answer: B
Rationale: Exacerbations of glucose-6-phosphate dehydrogenase deficiency are nearly always precipitated by medications. Blood transfusions, stress, and injury are less common triggers.
A patient newly diagnosed with thrombocytopenia is admitted to the medical unit. After the admission assessment, the patient asks the nurse to explain the disease. What should the nurse explain to this patient?
- A. There could be an attack on the platelets by antibodies.
- B. There could be decreased production of platelets.
- C. There could be impaired communication between platelets.
- D. There could be an autoimmune process causing platelet malfunction.
Correct Answer: B
Rationale: Thrombocytopenia can result from a decreased platelet production, increased platelet destruction, or increased consumption of platelets. Impaired platelet communication, antibodies, and autoimmune processes are not typical pathologies.
The nurse on the pediatric unit is caring for a patient with a diagnosis of hemophilia. The patient is a childâ??a 10-year-old boy. The nurse knows that a priority nursing diagnosis for this patient would be what?
- A. Hypothermia
- B. Diarrhea
- C. Ineffective coping
- D. Imbalanced nutrition
Correct Answer: C
Rationale: Most patients with hemophilia are diagnosed as children. They often require assistance in coping with the condition because it is chronic, places restrictions on their lives, and is an inherited disorder that can be passed to be passed to future generations. Children with hemophilia are not at risk of hypothermia, diarrhea or imbalanced nutrition.