An 82-year-old client who sustained a head injury in a motor vehicle crash while on warfarin therapy is admitted for observation. The nurse is providing teaching regarding the client's diagnosis of a subdural hematoma. Which of the following statements by the client indicates an understanding of teaching?

"I developed a hematoma because an artery burst in my brain when my head hit the windshield."

"I developed a bleed in my brain because my platelets were too high."

"I developed a hematoma because I take a blood thinner and my head hit the windshield."

"I developed a hematoma because my bleeding times were too low and I hit my head."

Answer and Explanation

The Correct Answer is C

A. A subdural hematoma is typically caused by venous bleeding, not arterial bleeding. An arterial rupture would more likely cause an epidural hematoma, which is not the case here.
B. High platelet counts are not commonly associated with the formation of subdural hematomas. Subdural hematomas are usually due to bleeding related to anticoagulant use or trauma.
C. Taking a blood thinner like warfarin increases the risk of bleeding and hematoma formation, particularly when combined with head trauma. This statement correctly links the anticoagulant therapy and head injury as contributing factors to the subdural hematoma.
D. Low bleeding times are not a cause of hematomas. In fact, elevated bleeding times due to anticoagulant therapy would increase the risk of bleeding, not low bleeding times.

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Correct Answer is C

Explanation

A. Increasing fluid intake is not recommended, as clients with Cushing disease often have fluid retention.
B. Decreasing protein intake is not recommended because muscle wasting is a concern in Cushing disease, and adequate protein is necessary to maintain muscle mass.
C. Decreasing carbohydrate intake is recommended because Cushing disease can cause hyperglycemia, and reducing carbohydrates can help manage blood glucose levels.
D. Limiting potassium-rich foods is not advisable as Cushing disease can lead to hypokalemia, and clients may need to increase their potassium intake.

A. Place the client on protective isolation. B. Initiate measures to prevent venous thromboembolism. C. Initiate droplet precautions. D. Check the client's most recent platelet level.

Correct Answer is D

Explanation

A. Protective isolation is not directly related to the symptoms of ecchymoses and petechiae but is more relevant for preventing infections in immunocompromised clients.
B. Measures to prevent venous thromboembolism are not the immediate concern given the bleeding symptoms; instead, managing platelet levels and bleeding risks is more critical.
C. Droplet precautions are not indicated based on the described symptoms, which are more related to bleeding disorders rather than infectious conditions requiring droplet precautions.
D. Checking the client's most recent platelet level is the most appropriate action because ecchymoses and petechiae are signs of potential thrombocytopenia (low platelet count), which is common in leukemia. Monitoring platelet levels will help determine if there is a need for interventions to address bleeding risks.

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Naxlex Comprehensive Predictor Exams

A nurse is providing dietary teaching for a client who has Cushing disease. Which of the following recommendations should the nurse include in the teaching?

Correct Answer is C

Explanation

A nurse is caring for a client who has been diagnosed with leukemia. The nurse's most recent assessment reveals the presence of ecchymoses on the client's sacral area and petechiae on the forearms. Based on the most recent assessment findings, the nurse should perform which action?

Correct Answer is D

Explanation

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