A 55-year-old male patient is admitted to the hospital with a diagnosis of thrombocytopenia. Upon assessment, you note petechiae on his lower extremities, and he reports fatigue and occasional nosebleeds. Which of the following interventions should be prioritized for this patient?

Monitor platelet counts and assess for signs of bleeding.

Administer aspirin to manage pain and prevent clot formation.

Administer a diuretic to reduce fluid retention and swelling.

Encourage the patient to increase physical activity to improve circulation.

Answer and Explanation

The Correct Answer is A

Choice A Reason:

Monitoring platelet counts and assessing for signs of bleeding is crucial for managing thrombocytopenia. Thrombocytopenia is characterized by a low platelet count, which increases the risk of bleeding. Regular monitoring helps in detecting any significant drops in platelet levels, allowing for timely interventions to prevent severe bleeding. Assessing for signs of bleeding, such as petechiae, bruising, or nosebleeds, is essential to manage the condition effectively and prevent complications.

Choice B Reason:

Administering aspirin to manage pain and prevent clot formation is not appropriate for patients with thrombocytopenia. Aspirin is an antiplatelet agent that inhibits platelet function, which can exacerbate bleeding tendencies in patients with low platelet counts. Using aspirin in this context could increase the risk of bleeding and is therefore contraindicated.

Choice C Reason:

Administering a diuretic to reduce fluid retention and swelling is not relevant for managing thrombocytopenia. Diuretics are used to manage conditions like hypertension and edema but do not address the underlying issue of low platelet counts. In fact, diuretics can lead to electrolyte imbalances, which may complicate the patient’s condition further.

Choice D Reason:

Encouraging the patient to increase physical activity to improve circulation is not a priority intervention for thrombocytopenia. While physical activity is generally beneficial for overall health, it can increase the risk of trauma and bleeding in patients with low platelet counts. It is important to avoid activities that could lead to injury and bleeding in these patients.

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Correct Answer is C

Explanation

Choice A Reason:

Adrenal insufficiency, also known as Addison’s disease, is characterized by insufficient production of cortisol and aldosterone by the adrenal glands. Symptoms typically include fatigue, weight loss, low blood pressure, and hyperpigmentation of the skin. High levels of ACTH are not associated with adrenal insufficiency; instead, ACTH levels are usually elevated in response to low cortisol levels.

Choice B Reason:

Pheochromocytoma is a rare tumor of the adrenal gland that produces excess catecholamines, leading to symptoms such as hypertension, palpitations, and headaches. It does not cause high levels of ACTH or the physical manifestations described in the patient, such as facial rounding and purple striae.

Choice C Reason:

Cushing Disease is caused by a pituitary adenoma that secretes excess adrenocorticotropic hormone (ACTH), leading to overproduction of cortisol by the adrenal glands. This results in symptoms such as facial rounding (moon face), central obesity, purple striae on the abdomen, and high levels of ACTH. These clinical features align with the patient’s presentation, making Cushing Disease the most likely underlying cause.

Choice D Reason:

Hyperthyroidism is characterized by excessive production of thyroid hormones, leading to symptoms such as weight loss, heat intolerance, palpitations, and tremors. It does not cause high levels of ACTH or the specific physical changes seen in Cushing Disease.

A. Resume use of contact lenses 48 hours after the procedure. B. Driving will be permitted 12 to 24 hours after the procedure. C. Lie with the face up for 2 weeks following the procedure. D. Refrain from lifting objects that weigh over 15 lb.

Correct Answer is D

Explanation

Choice A Reason:

Resuming the use of contact lenses 48 hours after retinal detachment surgery is not recommended. Postoperative care guidelines typically advise against wearing contact lenses until the eye has sufficiently healed to prevent irritation and infection. The exact duration will depend on the surgeon’s assessment and instructions.

Choice B Reason:

Driving 12 to 24 hours after the procedure is not advisable. Patients are usually instructed to avoid driving until their vision has stabilized and they have received clearance from their eye doctor. This period can vary but often extends beyond the first 24 hours post-surgery to ensure safety.

Choice C Reason:

Lying with the face up for 2 weeks following the procedure is incorrect. In many cases, patients are required to maintain a face-down position to help the retina reattach properly, especially if a gas bubble was used during surgery. The specific positioning instructions will depend on the type of surgery performed and the surgeon’s recommendations.

Choice D Reason:

Refraining from lifting objects that weigh over 15 lb is an appropriate instruction. Heavy lifting can increase intraocular pressure and strain the eye, potentially disrupting the healing process. Patients are generally advised to avoid strenuous activities and heavy lifting during the recovery period to ensure optimal healing.

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A 55-year-old male patient is admitted to the hospital with a diagnosis of thrombocytopenia. Upon assessment, you note petechiae on his lower extremities, and he reports fatigue and occasional nosebleeds. Which of the following interventions should be prioritized for this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 50-year-old male patient presents with facial rounding, central obesity, and purple striae on the abdomen. Laboratory results show high levels of ACTH. What is the most likely underlying cause of his condition?

Correct Answer is C

Explanation

A nurse is preparing a plan of care for a client who is postoperative for retinal detachment. Which of the following instructions should the nurse include in the plan of care?

Correct Answer is D

Explanation

A patient with pheochromocytoma

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