A nurse is collecting data from a client who has thrombocytopenia. The nurse should identify which of the following findings increases the client's risk for injury.

Wears a face mask around others

Sleeps 8 to 10 hr per night

Uses a firm bristled toothbrush

Increased intake of green, leafy vegetables

Answer and Explanation

The Correct Answer is C

A.   Incorrect. Wearing a face mask around others is not directly related to thrombocytopenia and does not impact the risk of injury in this context.
B.   Incorrect. Sleep duration is not directly related to thrombocytopenia and does not impact the risk of injury in this context.
C.   Correct. Using a firm-bristled toothbrush can increase the risk of bleeding in a client with thrombocytopenia due to potential gum injury. Soft-bristled toothbrushes are recommended to minimize the risk of injury and bleeding.
D.   Incorrect. Increased intake of green, leafy vegetables is generally beneficial for health and does not increase the risk of injury in thrombocytopenia.

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

Explanation

The nurse should write an incident report for the following events:
1. An approximate amount of urine was recorded after the urine leaked from the client's catheter bag. This indicates a potential issue with the catheter or its proper functioning, which needs to be documented and addressed.
2. A client received an 0900 daily medication at 1000. This is a medication administration error as the medication was given later than the prescribed time. Medication errors should be reported and documented to ensure proper follow-up and prevent future occurrences.
3. A client fell when ambulating to the bathroom alone. Falls are considered significant incidents and should always be documented and reported to ensure appropriate evaluation, intervention, and prevention of future falls.
The following events do not require an incident report:
A client who has an infection refused the evening meal. While it is important to document a client's refusal of meals, it does not typically warrant an incident report unless there are specific concerns related to the client's health or safety.

A client received the first dose of an antibiotic 1 hr before the collection of blood for culture and sensitivity testing. This may not require an incident report unless there are specific

circumstances or contraindications related to the timing of the antibiotic administration and blood collection, which need to be documented and reviewed.

A. Nutritionist B. Pediatric nurse practitioner C. Case manager D. Primary care provider

Correct Answer is C

Explanation

A. A nutritionist might provide information about feeding options, but a case manager can assist with financial concerns.
B. While a pediatric nurse practitioner can provide health guidance, a case manager is better suited for addressing financial matters.
C. Correct. A case manager can help the client access resources and assistance programs to afford necessary items like baby formula.
D. The primary care provider's role is more focused on medical care, not financial assistance.

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A nurse is collecting data from a client who has thrombocytopenia. The nurse should identify which of the following findings increases the client's risk for injury.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medical records of five clients. For which of the following events should the nurse write an incident report? (Select all that apply.)

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

Explanation

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Correct Answer is C

Explanation

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