A client on the oncology unit is receiving a chemotherapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. For which symptom should the nurse assess in clients at risk for thrombocytopenia?

Petechiae

Decreased white blood cell count

Increased fatigue

Unexplained bone pain

Answer and Explanation

The Correct Answer is A

A. Petechiae are small, red or purple spots on the skin that indicate bleeding under the skin and are a classic sign of thrombocytopenia, a condition characterized by a low platelet count.
B. A decreased white blood cell count is more indicative of leukopenia, not thrombocytopenia. Thrombocytopenia specifically affects platelet counts.
C. Increased fatigue can be a symptom of many conditions but is not specific to thrombocytopenia. It may occur due to anemia or other side effects of chemotherapy.
D. Unexplained bone pain is not a typical symptom of thrombocytopenia. It might be related to other conditions or side effects but is not specific to low platelet counts.

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Correct Answer is C

Explanation

A. Using a portable electronic thermometer is incorrect as the device must be dedicated to the client to avoid cross-contamination.
B. Wiping the stethoscope with alcohol after use is insufficient because alcohol-based sanitizers are ineffective against C. difficile spores. The stethoscope should be cleaned with bleach-based disinfectant.
C. Removing the protective gown before leaving the client's room is correct as it prevents the spread of C. difficile spores outside the isolation area.
D. Removing the protective gown before removing gloves is incorrect. Gloves should be removed first to prevent contamination when removing the gown.

A. Assess for sources of bleeding and provide pressure on wounds B. Limit contact with infected visitors and place in positive pressure isolation C. Administer antiemetics and assess nutrition and hydration status D. Monitor energy levels and begin energy-conserving techniques

Correct Answer is B

Explanation

A. Assessing for sources of bleeding is important in clients with neutropenia, but the highest priority is preventing infection, as the client’s absolute neutrophil count is zero, indicating an extremely high risk for infection.
B. Limiting contact with infected visitors and placing the client in positive pressure isolation is crucial for preventing infections. With a neutrophil count of zero, the client is highly immunocompromised and at a significant risk of infection, making this the highest priority action.
C. Administering antiemetics and assessing nutrition and hydration are important for managing symptoms, but they do not address the immediate risk of infection associated with severe neutropenia.
D. Monitoring energy levels and implementing energy-conserving techniques are important for overall care but do not address the urgent need to protect the client from infections due to their neutropenic status.

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A client on the oncology unit is receiving a chemotherapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. For which symptom should the nurse assess in clients at risk for thrombocytopenia?

Nursing Test Bank

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