The nurse provides education regarding daily activities to a patient with thrombocytopenia.
Which activity identified by the patient indicates understanding of the teaching?

Flossing using thick tape floss.

Shaving using an electric razor.

Wearing flip-flops to go walking.

Brushing using a stiff-bristle toothbrush.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Flossing using thick tape floss can cause trauma to the gums and may lead to bleeding in patients with thrombocytopenia. Patients with low platelet counts are at risk of excessive bleeding from minor injuries, and using thick tape floss could potentially harm the gums and exacerbate bleeding.

Choice B rationale:

Shaving using an electric razor is a safe option for patients with thrombocytopenia. Electric razors do not pose a significant risk of cuts or nicks, reducing the likelihood of bleeding, which is crucial for patients with low platelet counts.

Choice C rationale:

Wearing flip-flops to go walking may not be the safest option for a patient with thrombocytopenia. If the patient accidentally stubs their toe or injures their foot while wearing flip-flops, it could lead to bleeding. Closed-toe, comfortable shoes provide better protection against foot injuries.

Choice D rationale:

Brushing using a stiff-bristle toothbrush can be harmful to the gums, especially for patients with thrombocytopenia. Stiff-bristle toothbrushes can cause gum irritation and bleeding. Patients with low platelet counts should use a soft-bristle toothbrush to minimize the risk of gum injury.

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Correct Answer is B

Explanation

Choice A rationale:

0.459% saline is a hypotonic solution with a lower concentration of salt than the normal physiological range (0.9% NaCl) Hypotonic solutions can cause red blood cells to swell and potentially burst due to the osmotic imbalance, making it inappropriate for hypovolemic shock.

Choice B rationale:

0.9% NaCl, also known as normal saline, is an isotonic solution with a salt concentration similar to the body's own fluids. Isotonic solutions are ideal for hypovolemic shock as they help to expand the intravascular volume without causing significant shifts of fluid and electrolytes within the body compartments.

Choice C rationale:

5% dextrose in 0.45% saline is a hypotonic solution with a low salt concentration. While it provides some fluid replacement, it doesn't address the electrolyte imbalance adequately, which is crucial in hypovolemic shock.

Choice D rationale:

Dextran is a plasma volume expander but is not the first-line choice for hypovolemic shock. It might be used in certain situations, but isotonic crystalloids like 0.9% NaCl are preferred for rapid volume expansion and stabilization of the patient.

A. Sodium level of 136 mEq/L, potassium level of 4.5 mEq/L. B. Sodium level of 145 mEq/L, potassium level of 4.8 mEq/L. C. Sodium level of 135 mEq/L, potassium level of 3.6 mEq/L. D. Sodium level of 144 mEq/L, potassium level of 3.7 mEq/L.

Correct Answer is C

Explanation

Choice A rationale:

The sodium level is within the normal range, but the potassium level is slightly elevated. This does not support the rationale for changing the IV prescription to a lower potassium concentration.

Choice B rationale:

The sodium level is slightly elevated, and the potassium level is within the normal range. This does not support the rationale for changing the IV prescription to a lower potassium concentration.

Choice C rationale:

Sodium level of 135 mEq/L, potassium level of 3.6 mEq/L is the correct answer. In this option, both sodium and potassium levels are within normal ranges. Changing the IV prescription to DSNS with 20 mEq KCl/L ensures that the patient receives adequate hydration (from the dextrose and normal saline) without causing hyperkalemia.

Choice D rationale:

The sodium level is slightly elevated, and the potassium level is within the normal range. This does not support the rationale for changing the IV prescription to a lower potassium concentration.

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The nurse provides education regarding daily activities to a patient with thrombocytopenia.Which activity identified by the patient indicates understanding of the teaching?

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Naxlex Comprehensive Predictor Exams

Which fluid replacement therapy would the nurse prepare to administer for a patient who is exhibiting clinical manifestations of hypovolemic shock?

Correct Answer is B

Explanation

The nurse receives a health care provider's prescription to change a patient's IV from D5. half-normal saline with 40 mEq KCl/L to DSNS with 20 mEq KCl/L. Which set of serum laboratory values supports the rationale for this IV prescription change?

Correct Answer is C

Explanation

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The nurse provides education regarding daily activities to a patient with thrombocytopenia.
Which activity identified by the patient indicates understanding of the teaching?