A client with thrombocytopenia experiences prolonged bleeding even after minor trauma.
What statement by the nurse accurately explains the relationship between platelet count and bleeding risk?
"A platelet count below 100,000/uL is considered normal.”
"A platelet count below 50,000/uL can result in prolonged bleeding.”
"Platelet count has no impact on bleeding risk.”
"Bleeding risk increases with a platelet count above 150,000/uL.”
The Correct Answer is B
Choice A rationale:
"A platelet count below 100,000/uL is considered normal." Rationale: This statement is incorrect.
A normal platelet count typically ranges between 150,000 and 450,000/uL.
A platelet count below 100,000/uL is not considered normal and may indicate thrombocytopenia or another underlying issue.
Choice B rationale:
"A platelet count below 50,000/uL can result in prolonged bleeding." Rationale: This statement is correct.
Platelets are essential for normal blood clotting, and a platelet count below 50,000/uL can lead to an increased risk of bleeding, especially after minor trauma.
Severe bleeding risk typically occurs when the platelet count drops below 20,000/uL.
Choice C rationale:
"Platelet count has no impact on bleeding risk." Rationale: This statement is incorrect.
Platelet count directly affects bleeding risk.
A lower platelet count increases the risk of bleeding, while a higher count can lead to an increased risk of clot formation (thrombosis)
Choice D rationale:
"Bleeding risk increases with a platelet count above 150,000/uL." Rationale: This statement is incorrect.
A platelet count above 150,000/uL is within the normal range and does not increase the risk of bleeding.
Instead, it may increase the risk of thrombosis (excessive clotting)
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
"Increased platelet production due to chemotherapy." Rationale: This statement is not accurate.
Chemotherapy often suppresses bone marrow function, leading to a decrease in platelet production, not an increase.
Thrombocytopenia is a common side effect of chemotherapy due to reduced platelet production.
Choice B rationale:
"Immune-mediated platelet destruction caused by chemotherapy." Rationale: This statement is correct.
Thrombocytopenia in patients undergoing chemotherapy is often due to immune-mediated platelet destruction.
Chemotherapy can trigger an autoimmune response, leading to the destruction of platelets by the immune system.
Choice C rationale:
"Thrombocytopenia in this case is unrelated to chemotherapy." Rationale: This statement is unlikely to be true.
Thrombocytopenia occurring in a patient following chemotherapy is often directly related to the treatment.
While other factors may contribute, chemotherapy is a known cause of decreased platelet counts.
Choice D rationale:
"Thrombocytopenia results from the inhibition of platelet aggregation by chemotherapy." Rationale: This statement is not accurate.
Chemotherapy primarily affects platelet production and can lead to a decrease in platelet count.
It does not typically inhibit platelet aggregation.
Correct Answer is ["A","C","E"]
Explanation
Choice A rationale:
"Administer platelet transfusion." Rationale: This is an appropriate intervention for a patient with thrombocytopenia, especially if they are experiencing severe bleeding or have a very low platelet count.
Platelet transfusion can help increase the platelet count and prevent or stop bleeding.
Choice B rationale:
"Encourage high-intensity physical activity." Rationale: This intervention is not appropriate for a patient with thrombocytopenia.
High-intensity physical activity can increase the risk of bleeding in these patients due to the low platelet count.
Choice C rationale:
"Monitor for signs of bleeding." Rationale: This is an essential intervention for a patient with thrombocytopenia.
Monitoring for signs of bleeding, such as petechiae, ecchymosis, or mucosal bleeding, allows for early detection and intervention.
Choice D rationale:
"Administer heparin therapy." Rationale: This intervention is not appropriate for a patient with thrombocytopenia, especially if the thrombocytopenia is immune-mediated, as heparin can exacerbate the condition.
Choice E rationale:
"Educate the patient on infection prevention." Rationale: This is an appropriate intervention for a patient with thrombocytopenia.
Patients with low platelet counts are at increased risk of infection, so education on infection prevention measures, such as hand hygiene and avoiding sick individuals, is essential.
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