A client with thrombocytopenia presents with schistocytes on the peripheral blood smear.
What does the presence of schistocytes indicate, and how should the nurse interpret this finding?
Schistocytes suggest normal platelet function.
Schistocytes are associated with thrombocytosis.
Schistocytes indicate hemolysis or microangiopathy.
Schistocytes confirm the absence of bleeding risk.
The Correct Answer is C
Choice A rationale:
Schistocytes suggest normal platelet function.
Rationale: This statement is incorrect.
Schistocytes are not related to platelet function.
Schistocytes are fragmented red blood cells, and their presence on a peripheral blood smear suggests mechanical damage to red blood cells, not platelets.
Choice B rationale:
Schistocytes are associated with thrombocytosis.
Rationale: This statement is incorrect.
Schistocytes are not associated with thrombocytosis, which is an elevated platelet count.
They are more commonly associated with conditions involving red blood cell fragmentation, such as hemolysis or microangiopathy.
Choice C rationale:
Schistocytes indicate hemolysis or microangiopathy.
Rationale: This statement is correct.
Schistocytes are fragmented red blood cells, and their presence on a peripheral blood smear is indicative of hemolysis (destruction of red blood cells) or microangiopathy (damage to small blood vessels)
This finding suggests that the patient may have an underlying condition leading to red blood cell destruction, which can be associated with thrombocytopenia.
Choice D rationale:
Schistocytes confirm the absence of bleeding risk.
Rationale: This statement is incorrect.
Schistocytes do not confirm the absence of bleeding risk.
While they are associated with conditions involving red blood cell damage, they do not provide information about the patient's platelet count, which is a more direct factor in bleeding risk.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
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.
Correct Answer is C
Explanation
Choice A rationale:
The presence of lymphadenopathy Lymphadenopathy refers to the enlargement of lymph nodes and is not a primary assessment finding to identify potential causes and types of thrombocytopenia.
While it may be relevant in some cases, it is not as prioritized as signs of infection or organ dysfunction.
Choice B rationale:
The patient's history of herbal supplements While the patient's history of herbal supplements is important to assess for potential causes of thrombocytopenia, it is not the most immediate assessment finding to prioritize.
Signs of infection or organ dysfunction are more crucial in the initial assessment as they may indicate acute and potentially life-threatening conditions.
Choice D rationale:
The size and shape of platelets on a peripheral blood smear The size and shape of platelets are important for diagnosing specific types of thrombocytopenia but are typically not the initial priority in the assessment.
Identifying signs of infection or organ dysfunction takes precedence because they can guide immediate intervention.
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