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

Answer and Explanation

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.

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Correct Answer is D

Explanation

A. Incorrect. The cause of death is an important piece of information but is typically included in the official death certificate rather than in routine postmortem documentation.
B. Incorrect. While vital signs are important during the client's care, the last set of vital signs is not usually a primary focus of postmortem documentation.
C. Incorrect. Advance directives are relevant to the client's care during life but are not typically included in postmortem documentation.
D. Correct. Documentation of the location of the identification tag on the client's body is important for accurate identification and tracking during the postmortem process.

A. "My baby will receive three doses of the meningococcal immunization before kindergarten." B. "My baby will receive the rotavirus immunization orally." C. "I should not feed my baby anything for 2 hours before an immunization." D. "I should expect my baby to have a high fever for 24 hours after an immunization."

Correct Answer is B

Explanation

A. Meningococcal immunization typically includes different schedules and doses; stating three doses before kindergarten is not accurate.
B. Correct. The rotavirus vaccine is administered orally to infants.
C. Feeding restrictions before immunizations are not routinely required for infants.
D. While some mild fever after immunizations is possible, the statement suggests an expectation of a high fever for 24 hours, which is not accurate.

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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.

Nursing Test Bank

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