A nurse is collecting data from a client who has thrombocytopenia. The nurse should identify which of the following findings increases the client's risk for injury.
Wears a face mask around others
Sleeps 8 to 10 hr per night
Uses a firm bristled toothbrush
Increased intake of green, leafy vegetables
The Correct Answer is C
A. Incorrect. Wearing a face mask around others is not directly related to thrombocytopenia and does not impact the risk of injury in this context.
B. Incorrect. Sleep duration is not directly related to thrombocytopenia and does not impact the risk of injury in this context.
C. Correct. Using a firm-bristled toothbrush can increase the risk of bleeding in a client with thrombocytopenia due to potential gum injury. Soft-bristled toothbrushes are recommended to minimize the risk of injury and bleeding.
D. Incorrect. Increased intake of green, leafy vegetables is generally beneficial for health and does not increase the risk of injury in thrombocytopenia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","E","F","G","H"]
Explanation
A. The oxygen saturation is within normal range hence no need to evaluate further
B. Weight: The client has reported a significant weight loss of 2.26 kg (5 lbs.) over the past week. Unintentional weight loss can be a concerning symptom and may require further assessment.
C. Heart rate: The client's heart rate is within range.
D. Blood pressure is within normal range
E. The temperature is slightly elevated and indicates a need for further evaluation.
F. Sputum characteristics: The client reports "blood-tinged sputum." Coughing up blood in the sputum, known as hemoptysis, is a potentially serious symptom that warrants further evaluation to determine its cause.
G. Respiratory complaint: The client presents with a 4-day history of cough, often productive, along with other respiratory symptoms such as fatigue, night sweats, and a low-grade fever. These respiratory complaints require further evaluation to identify the underlying cause.
H. Travel history: The client recently traveled to South Africa and stayed for 3 weeks.
Travel history is important in assessing potential exposure to infectious diseases or other environmental factors that could contribute to the client's symptoms.
Correct Answer is C
Explanation
A. Allowing a family member to stay with the body is a common practice in many cultures, but it is not specific to Islamic practices.
B. Positioning the head northward is not a specific requirement of Islamic postmortem care.
C. Correct. Positioning the client's head toward Mecca is an important aspect of Islamic postmortem care, as Muslims pray facing Mecca.
D. Allowing a family member to stay with the body for a specific duration is not a specific Islamic practice.
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