Nokea
The results of a patient's most recent blood work and physical assessment are suggestive of immune thrombocytopenic purpura (ITP). This patient should undergo testing for which of the following potential causes?
- A. Hepatitis
- B. Acute renal failure
- C. HIV
- D. Malignant melanoma
- E. Cholecystitis
Correct Answer: A,C
Rationale: Viral illnesses have the potential to cause ITP. Renal failure, malignancies, and gall bladder inflammation are not typical causes of ITP.
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An adult human patient has been diagnosed with anemia from iron deficiency anemia. What nursing diagnosis would be the most likely to be applicable to this patient's condition?
- A. Risk for deficient vascular volume related to low red blood cell production
- B. Risk for infection susceptibility related to low oxygen levels in tissue
- C. Anemia-related acute pain
- D. Fatigue from low oxygen transport capacity
Correct Answer: D
Rationale: Fatigue is the major assessment finding common to all forms of anemia. Anemia does not usually result in acute pain or fluid volume deficit. The patient may have an increased risk of infection due to impaired immune function, but fatigue is more likely.
A client with several chronic health problems has been newly diagnosed with a qualitative platelet defect. What component of the patient's previous medication regimen may have contributed to the development of this disorder?
- A. Calcium carbonate
- B. Vitamin B12
- C. Aspirin
- D. Vitamin D
Correct Answer: C
Rationale: Aspirin may induce a platelet disorder. Even small amounts of aspirin reduce normal platelet aggregation, and the prolonged bleeding time lasts for several days after aspirin ingestion. Calcium, vitamin D, and vitamin B12 do not have the potential to induce a platelet defect.
The medical nurse is aware that patients with sickle cell anemia benefit from understanding what situations can precipitate a sickle cell crisis. When teaching a patient with sickle cell anemia about strategies to prevent crises, what measures should the nurse recommend?
- A. Using prophylactic antibiotics and performing meticulous hygiene
- B. Maximizing physical activity and taking OTC iron supplements
- C. Limiting psychosocial stress and eating a high-protein diet
- D. Avoiding cold temperatures and ensuring sufficient hydration
Correct Answer: D
Rationale: Keeping warm and providing adequate hydration can be effective in diminishing the occurrence and severity of attacks. Hygiene, antibiotics, and high protein intake do not prevent crises. Maximizing activity may exacerbate pain and be unrealistic.
A patient is being treated for DIC and the nurse has prioritized the nursing diagnosis of Risk for Deficient Fluid Volume Related to Bleeding. How can the nurse best determine if goals of care relating to this diagnosis are being met?
- A. Assess for edema.
- B. Assess skin integrity frequently.
- C. Assess the patient's level of consciousness frequently.
- D. Closely monitor intake and output.
Correct Answer: D
Rationale: The patient with DIC is at a high risk of deficient fluid volume. The nurse can best gauge the effectiveness of care by closely monitoring the patient's intake and output. Each of the other assessments is a necessary element of care, but none addresses fluid balance as directly as close monitoring of intake and output.
An intensive care nurse is aware of the need to identify patients who may be at risk of developing disseminated intravascular coagulation (DIC). Which of the following ICU patients most likely faces the highest risk of DIC?
- A. A patient with extensive burns
- B. A patient who has a diagnosis of acute respiratory distress syndrome
- C. A patient who suffered multiple trauma in a workplace accident
- D. A patient who is being treated for septic shock
Correct Answer: D
Rationale: Sepsis is a common cause of DIC. A wide variety of acute illnesses can precipitate DIC, but sepsis is specifically identified as a cause.