A nurse is caring for a patient with thrombocytopenia.
Which statement accurately describes the pathophysiology of immune thrombocytopenic purpura (ITP)?
"ITP results from decreased platelet production in the bone marrow.”
"In ITP, autoantibodies mark platelets for destruction by macrophages.”
"ITP is characterized by impaired cleavage of von Willebrand factor.”
"Thrombocytopenia in ITP is triggered by heparin-platelet factor 4 complexes.”
The Correct Answer is B
Choice A rationale:
"ITP results from decreased platelet production in the bone marrow." Rationale: This statement is not accurate.
Immune Thrombocytopenic Purpura (ITP) is primarily a disorder of platelet destruction, not decreased production in the bone marrow.
In ITP, autoantibodies target platelets, leading to their destruction by macrophages.
Choice B rationale:
"In ITP, autoantibodies mark platelets for destruction by macrophages." Rationale: This is the correct answer.
ITP is an autoimmune disorder where the immune system produces autoantibodies that attach to platelets, tagging them for destruction by macrophages in the spleen and liver.
Choice C rationale:
"ITP is characterized by impaired cleavage of von Willebrand factor." Rationale: This statement is not accurate.
Impaired cleavage of von Willebrand factor is a characteristic of von Willebrand disease, a different bleeding disorder, not ITP.
Choice D rationale:
"Thrombocytopenia in ITP is triggered by heparin-platelet factor 4 complexes." Rationale: This statement is incorrect.
Heparin-induced thrombocytopenia (HIT) involves the formation of antibodies against heparin-platelet factor 4 complexes, leading to platelet activation and a decrease in platelet count.
This is a different condition than ITP.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
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.
Correct Answer is B
Explanation
Choice A rationale:
"Increased platelet production due to chemotherapy." Rationale: This statement is not accurate.
Chemotherapy often suppresses bone marrow function, leading to a decrease in platelet production, not an increase.
Thrombocytopenia is a common side effect of chemotherapy due to reduced platelet production.
Choice B rationale:
"Immune-mediated platelet destruction caused by chemotherapy." Rationale: This statement is correct.
Thrombocytopenia in patients undergoing chemotherapy is often due to immune-mediated platelet destruction.
Chemotherapy can trigger an autoimmune response, leading to the destruction of platelets by the immune system.
Choice C rationale:
"Thrombocytopenia in this case is unrelated to chemotherapy." Rationale: This statement is unlikely to be true.
Thrombocytopenia occurring in a patient following chemotherapy is often directly related to the treatment.
While other factors may contribute, chemotherapy is a known cause of decreased platelet counts.
Choice D rationale:
"Thrombocytopenia results from the inhibition of platelet aggregation by chemotherapy." Rationale: This statement is not accurate.
Chemotherapy primarily affects platelet production and can lead to a decrease in platelet count.
It does not typically inhibit platelet aggregation.
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