A nurse is assigned to care for a client diagnosed with autoimmune or idiopathic thrombocytopenic purpura (ITP). When reviewing the client's plan of care prior to caring for the client, the nurse should recognize that the priority concern in caring for the client is to monitor for:

Fatigue

Side effects of immunosuppressants

Thrombocytopenia

Infection

Answer and Explanation

The Correct Answer is C

Choice A reason: Fatigue is a common symptom of ITP but is not the primary concern for monitoring, as it does not directly indicate the severity of the condition.

Choice B reason: While monitoring for side effects of immunosuppressants is important, it is not the priority concern. The primary issue in ITP is the low platelet count, which poses a risk of bleeding.

Choice C reason: Thrombocytopenia, or low platelet count, is the hallmark of ITP and the main concern for monitoring, as it increases the risk of bleeding and bruising.

Choice D reason: Infection is a risk due to the potential use of immunosuppressants in treatment; however, the immediate concern in ITP management is the platelet count and associated bleeding risk.

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Correct Answer is C

Explanation

Choice A reason: Physical therapy may be prescribed postoperatively to aid in recovery, but it does not directly interfere with the function of a pacemaker.

Choice B reason: Checking serum cardiac enzyme levels is a common practice after heart surgery to assess for any damage to the heart muscle, which would not typically require clarification in the context of pacemaker insertion.

Choice C reason: An MRI of the chest should be clarified with the healthcare provider because MRI can interfere with pacemaker function. Patients with pacemakers are generally advised to avoid MRI unless the pacemaker is Incompatible, due to the risk of the magnetic field affecting the device's operation.

Choice D reason: A low sodium diet may be recommended for patients with heart conditions to manage blood pressure and fluid retention, but it is not directly related to the care of a pacemaker.

A. "The normal range for serum creatinine is 0.6 to 1.2 mg/dL for males and 0.5 to 1.1 mg/dL for females." B. "A GFR below 60 mL/min/1.73 m for three months or more suggests chronic kidney disease." C. "Blood urea nitrogen (BUN) levels should be between 7 and 20 mg/dL." D. "An increase in serum potassium can indicate hyperkalemia, which may be a sign of acute kidney injury."

Correct Answer is B

Explanation

Choice A reason: The normal range for serum creatinine is indeed 0.6 to 1.2 mg/dL for males and 0.5 to 1.1 mg/dL for females. Serum creatinine is a waste product from the normal breakdown of muscle tissue. As kidneys become impaired for any reason, the serum creatinine level rises due to poor clearance by the kidneys.

Choice B reason: A GFR below 60 mL/min/1.73 m for three months or more is one of the criteria for the diagnosis of chronic kidney disease. GFR is a measure of how well the kidneys filter blood, and a lower GFR indicates poorer kidney function.

Choice C reason: Blood urea nitrogen (BUN) levels should indeed be between 7 and 20 mg/dL. BUN measures the amount of nitrogen in your blood that comes from the waste product urea. Urea is made when protein is broken down in your body. BUN levels can rise with the level of protein in your diet and your kidney function[^10^].

Choice D reason: An increase in serum potassium can indicate hyperkalemia, which may be a sign of acute kidney injury. Potassium is a critical electrolyte, and its levels are tightly regulated by the kidneys. High levels can lead to dangerous heart rhythms.

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A nurse is assigned to care for a client diagnosed with autoimmune or idiopathic thrombocytopenic purpura (ITP). When reviewing the client's plan of care prior to caring for the client, the nurse should recognize that the priority concern in caring for the client is to monitor for:

Nursing Test Bank

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Explanation

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