A client with immune thrombocytopenic purpura (ITP) will begin treatment with romiplostim (Nplate) to be administered by subcutaneous injection in the provider's office once per week. Which statement should the nurse plan to include when educating the client about this medication?

This medication increases the production of plasma enzyme ADAMTS-13.

This medication prevents platelets from being destroyed in the spleen.

This medication prevents platelets from binding with heparin.

This medication stimulates the bone marrow to increase platelet production.

Answer and Explanation

The Correct Answer is D

A. Romiplostim does not increase the production of ADAMTS-13; it is used to increase platelet counts.
B. Romiplostim does not prevent platelet destruction in the spleen; it works by stimulating platelet production.
C. Romiplostim does not prevent platelets from binding with heparin; it is not used for heparin-induced thrombocytopenia.
D. Romiplostim is a thrombopoietin receptor agonist that stimulates the bone marrow to increase platelet production, which is its primary mechanism of action in treating ITP.

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Correct Answer is ["B","D"]

Explanation

A. Digoxin improves cardiac output by increasing the force of cardiac contractions, not by increasing the heart rate. In fact, it may slow the heart rate.
B. Holding the dose and calling the doctor if the heart rate is less than 60 beats per minute is correct, as digoxin can cause bradycardia.
C. Doubling the dose is incorrect and dangerous. Missed doses should be handled according to physician instructions, typically by skipping the missed dose and taking the next scheduled dose.
D. Loss of appetite and nausea can be signs of digoxin toxicity and should be reported to the healthcare provider.
E. Frequent urination is not an expected side effect of digoxin; it is more commonly associated with diuretics.

A. A client who had a myocardial infarction two days ago, and complains of soft stools after taking docusate sodium. B. A client being treated for thrombotic thrombocytopenic purpura (TTP) who has had 120 mL of urine output in the last 12 hours. C. A client who was admitted for premature atrial contractions (PACS) and whose most recent blood pressure is 148/89. D. A client receiving furosemide for heart failure whose daily weight shows that he has lost 0.5 kg since yesterday.

Correct Answer is B

Explanation

A. While soft stools after taking docusate sodium is noteworthy, it is not immediately life-threatening and does not require urgent intervention.
B. Oliguria (low urine output) in a client with TTP is concerning because it may indicate acute kidney injury or worsening of the condition, requiring immediate assessment and intervention.
C. An elevated blood pressure in a client with PACs is important but not as critical as potential kidney dysfunction in the TTP patient.
D. A weight loss of 0.5 kg in a client with heart failure on furosemide may be expected and does not require immediate intervention.

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A client with immune thrombocytopenic purpura (ITP) will begin treatment with romiplostim (Nplate) to be administered by subcutaneous injection in the provider's office once per week. Which statement should the nurse plan to include when educating the client about this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing education to a client with heart failure who will begin taking digoxin daily at home. Which of the following statements made by the client indicates an understanding of the teaching? (Select all that apply.)

Correct Answer is ["B","D"]

Explanation

A nurse receives report on four clients at the beginning of the shift. Which of the following clients should the nurse place priority on assessing first?

Correct Answer is B

Explanation

A low-sodium diet is prescribed for a client who has fluid volume overload due to chronic heart failure. The nurse recognizes that additional teaching is necessary when the client makes which statement?

A nurse is providing discharge teaching to a client who has a new diagnosis of heart failure. Which of the following statements made by the client requires the nurse to provide correction and additional teaching?

A nurse is caring for a client who has been diagnosed with thrombotic thrombocytopenic purpura (TTP) and will begin plasmapheresis ment should the nurse plan to include when educating the client about this treatment?

A nurse is caring for a client who has a diagnosis of immune thrombocytopenic purpura (ITP). Despite medication therapy, the client's platelets are low. Which of the following procedures would reduce the destruction of platelets for a client who has ITP?

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