A nurse is assigned to care for a client diagnosed with autoimmune or idiopathic thrombocytopenic purpura (ITP). When reviewing the client's plan of care prior to caring for the client, the nurse should recognize that the priority concern in caring for the client is to monitor for:
Fatigue
Side effects of immunosuppressants
Thrombocytopenia
Infection
The Correct Answer is C
Choice A reason: Fatigue is a common symptom of ITP but is not the primary concern for monitoring, as it does not directly indicate the severity of the condition.
Choice B reason: While monitoring for side effects of immunosuppressants is important, it is not the priority concern. The primary issue in ITP is the low platelet count, which poses a risk of bleeding.
Choice C reason: Thrombocytopenia, or low platelet count, is the hallmark of ITP and the main concern for monitoring, as it increases the risk of bleeding and bruising.
Choice D reason: Infection is a risk due to the potential use of immunosuppressants in treatment; however, the immediate concern in ITP management is the platelet count and associated bleeding risk.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Serum creatinine is a waste product from the normal breakdown of muscle tissue. A level of 1.8 mg/dL is higher than the normal range (0.61.2 mg/dL for females), indicating impaired kidney function and an increased risk of AKI.
Choice B reason: A magnesium level of 2.0 mEq/L is within the normal range (1.72.2 mEq/L) and does not typically indicate an increased risk of AKI.
Choice C reason: A BUN level of 20 mg/dL is within the normal range (720 mg/dL) and does not suggest an increased risk of AKI by itself.
Choice D reason: A serum osmolality of 290 mOsm/kg H2O is within the normal range (275295 mOsm/kg H2O) and does not indicate an increased risk of AKI.
Correct Answer is B
Explanation
Choice A reason: This statement is incorrect. Synthetic casts typically dry much faster than plaster casts. Plaster casts can take 24 to 48 hours to fully harden, while synthetic casts made from materials like fiberglass or plastic can harden within a few hours.
Choice B reason: This is the correct statement. Synthetic casts are indeed lighter than plaster casts. They are made from materials like fiberglass, which is lighter than the traditional plaster of Paris used in plaster casts.
Choice C reason: This statement is incorrect. Plaster casts are generally heavier than synthetic casts. The weight of a cast can be an important consideration, especially for children or for those who may have difficulty managing a heavier cast.
Choice D reason: This statement is incorrect. Both plaster and synthetic casts require specialized equipment for application, but it is not specific to plaster casts. The application involves similar steps for both types, including the use of a stockinette, padding, and then the casting material itself.
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