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A client with thrombocytopenia is experiencing spontaneous bleeding.
Which statement best explains the potential cause of this bleeding?

"Spontaneous bleeding in thrombocytopenia is due to excessive clotting.”

"Immune-mediated destruction of platelets leads to spontaneous bleeding.”

"Bleeding occurs in thrombocytopenia due to increased platelet production.”

"Thrombocytopenia-related bleeding is a result of heparin therapy.”

Answer and Explanation

The Correct Answer is B

Choice A rationale:

"Spontaneous bleeding in thrombocytopenia is due to excessive clotting." Rationale: This statement is not accurate.

Thrombocytopenia is characterized by a low platelet count, which impairs the blood's ability to form clots.

Spontaneous bleeding occurs because there are not enough platelets to participate in clot formation.

Choice B rationale:

"Immune-mediated destruction of platelets leads to spontaneous bleeding." Rationale: This is the correct answer.

In thrombocytopenia, especially immune thrombocytopenic purpura (ITP), the immune system destroys platelets, leading to a decreased platelet count.

This makes the patient more prone to spontaneous bleeding.

Choice C rationale:

"Bleeding occurs in thrombocytopenia due to increased platelet production." Rationale: This statement is incorrect.

Thrombocytopenia is characterized by a decreased platelet count, not increased production.

Choice D rationale:

"Thrombocytopenia-related bleeding is a result of heparin therapy." Rationale: This statement is inaccurate.

Thrombocytopenia related to heparin therapy is known as heparin-induced thrombocytopenia (HIT), and it occurs due to an immune response to heparin, not the same mechanism as in thrombocytopenia.

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Correct Answer is ["A","C","E"]

Explanation

Choice A rationale:

"Administer platelet transfusion." Rationale: This is an appropriate intervention for a patient with thrombocytopenia, especially if they are experiencing severe bleeding or have a very low platelet count.

Platelet transfusion can help increase the platelet count and prevent or stop bleeding.

Choice B rationale:

"Encourage high-intensity physical activity." Rationale: This intervention is not appropriate for a patient with thrombocytopenia.

High-intensity physical activity can increase the risk of bleeding in these patients due to the low platelet count.

Choice C rationale:

"Monitor for signs of bleeding." Rationale: This is an essential intervention for a patient with thrombocytopenia.

Monitoring for signs of bleeding, such as petechiae, ecchymosis, or mucosal bleeding, allows for early detection and intervention.

Choice D rationale:

"Administer heparin therapy." Rationale: This intervention is not appropriate for a patient with thrombocytopenia, especially if the thrombocytopenia is immune-mediated, as heparin can exacerbate the condition.

Choice E rationale:

"Educate the patient on infection prevention." Rationale: This is an appropriate intervention for a patient with thrombocytopenia.

Patients with low platelet counts are at increased risk of infection, so education on infection prevention measures, such as hand hygiene and avoiding sick individuals, is essential.

A. The platelet count is likely within the normal range. B. The platelet count may be below 50,000/uL, indicating a risk of prolonged bleeding. C. The platelet count is typically above 100,000/uL in thrombocytopenia. D. The platelet count does not affect bleeding symptoms.

Correct Answer is B

Explanation

Choice A rationale:

"The platelet count is likely within the normal range." Rationale: This statement is unlikely to be true.

Given that the patient is presenting with mucosal bleeding, including petechiae, purpura, and gingival bleeding, it suggests a potential problem with platelet function.

Platelet counts within the normal range do not typically lead to these bleeding symptoms.

Choice B rationale:

"The platelet count may be below 50,000/uL, indicating a risk of prolonged bleeding." Rationale: This statement is accurate.

The symptoms described (petechiae, purpura, and gingival bleeding) are indicative of thrombocytopenia, where the platelet count is typically below 50,000/uL.

This lower count increases the risk of prolonged bleeding and bruising.

Choice C rationale:

"The platelet count is typically above 100,000/uL in thrombocytopenia." Rationale: This statement is not accurate.

Thrombocytopenia is characterized by a decrease in platelet count, often below 100,000/uL, as seen in choice B.

A platelet count above 100,000/uL is not typical in thrombocytopenia.

Choice D rationale:

"The platelet count does not affect bleeding symptoms." Rationale: This statement is incorrect.

Platelet count plays a significant role in the body's ability to form blood clots and prevent bleeding.

Low platelet counts can lead to bleeding symptoms, as described in the patient's presentation of mucosal bleeding.

Platelet count is indeed relevant in assessing and managing bleeding risk in thrombocytopenia.

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A client with thrombocytopenia is experiencing spontaneous bleeding.Which statement best explains the potential cause of this bleeding?

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Naxlex Comprehensive Predictor Exams

(Select all that apply): A nurse is assessing a patient with thrombocytopenia.Which interventions are appropriate for this patient? Select all that apply.

Correct Answer is ["A","C","E"]

Explanation

A nurse is caring for a patient with thrombocytopenia.The patient presents with mucosal bleeding, including petechiae, purpura, and gingival bleeding.What should the nurse anticipate when assessing this patient's platelet count?

Correct Answer is B

Explanation

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A client with thrombocytopenia is experiencing spontaneous bleeding.
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