The nurse is caring for a client diagnosed with secondary immune thrombocytopenic purpura (ITP). The nurse should expect the client to be tested for which of the following possible causes?
Thrombopoiesis.
Human immunodeficiency virus (HIV).
Hepatitis C virus (HCV).
Von Willebrand disease (vWD).
Hemophilia B.
Correct Answer : B,C
Choice A rationale
Thrombopoiesis, the process of platelet production, is not typically a direct cause of secondary immune thrombocytopenic purpura. This condition often stems from an underlying immune or viral trigger rather than bone marrow dysfunction.
Choice B rationale
HIV is a recognized cause of secondary ITP due to immune dysregulation and increased platelet destruction. It is essential to test for HIV in clients with newly diagnosed ITP to identify and manage the underlying condition effectively.
Choice C rationale
Hepatitis C virus is a common trigger for secondary ITP due to immune complex formation and platelet destruction. Testing for HCV is crucial for clients with thrombocytopenia to establish a precise etiology and guide treatment.
Choice D rationale
Von Willebrand disease primarily affects von Willebrand factor and is associated with qualitative or quantitative clotting issues rather than platelet destruction or secondary ITP. It is not routinely tested in this context.
Choice E rationale
Hemophilia B involves Factor IX deficiency leading to bleeding disorders but does not relate to immune-mediated platelet destruction. Testing for hemophilia B is irrelevant in clients suspected of secondary ITP.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Amlodipine, a calcium channel blocker, primarily acts on vascular smooth muscles to reduce blood pressure. It does not directly affect renal function or significantly increase urine output. This statement reflects a misunderstanding of the drug's mechanism of action.
Choice B rationale
Edema, a common side effect of amlodipine, is due to vasodilation and capillary leakage, particularly in lower extremities. However, sudden discontinuation of the medication may lead to rebound hypertension and should be avoided. Reporting side effects is crucial for alternative management.
Choice C rationale
Amlodipine does not necessitate routine potassium monitoring as it does not significantly affect potassium homeostasis. This requirement is more commonly associated with potassium-wasting diuretics or renin-angiotensin-aldosterone system modulators.
Choice D rationale
Constipation and abdominal pain, although less common, may occur due to gastrointestinal motility changes caused by smooth muscle relaxation. Prompt reporting ensures timely assessment and potential treatment modifications to enhance adherence.
Correct Answer is A
Explanation
Choice A rationale
Phosphodiesterase type 5 inhibitors, such as sildenafil, are the next step in treating erectile dysfunction after lifestyle changes fail. These medications enhance nitric oxide-mediated vasodilation in the penile tissues, improving erectile function. Their efficacy, safety, and widespread availability make them the first-line pharmacological option.
Choice B rationale
Negative-pressure devices, like vacuum erection devices, mechanically increase blood flow to the penis to maintain an erection. While effective for some, they are typically considered after the failure of oral pharmacological agents, as they require significant user compliance and may cause discomfort.
Choice C rationale
Penile injections of vasodilatory agents, such as alprostadil, are effective for managing erectile dysfunction. However, these are invasive and often reserved for cases unresponsive to oral medications or mechanical devices. They are not typically the first choice after lifestyle modification.
Choice D rationale
Penis transplantation is an experimental treatment and not a standard approach to managing erectile dysfunction. Its application is limited to cases of significant penile trauma or congenital abnormalities and is not relevant for individuals without such conditions.
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