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.

Answer and Explanation

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.

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Correct Answer is A

Explanation

Choice A rationale

Ureteral stones cause severe, colicky pain that radiates to the groin or genital area. The ureter’s narrow anatomy can trap stones, causing obstruction. This obstruction triggers increased intrarenal pressure and ureteral spasms, producing waves of intense pain. Hematuria and urinary urgency with minimal voiding are common due to mucosal irritation or obstruction.

Choice B rationale

While small stones may pass spontaneously, predicting exact timelines is speculative. Passage depends on factors like stone size, location, and hydration. For stones larger than 5 mm, spontaneous passage rates decrease, often requiring intervention. Therefore, giving definite timeframes may misinform patients and delay appropriate care.

Choice C rationale

Bladder stones typically cause suprapubic pain, urinary frequency, and hematuria rather than radiating pain to the thigh or genital area. Bladder irritation may lead to dysuria or cloudy urine, but the described symptoms are more consistent with ureteral obstruction rather than bladder involvement.

Choice D rationale

Some stones do require procedural removal, especially those causing recurrent infections or obstruction. However, initial management includes conservative measures like hydration and pain control, reserving procedures for unresolvable cases. Early procedural focus may unnecessarily alarm the client or overlook noninvasive options.

A. Ask if the client took any medication to treat the headache. B. Refer the client to see an eye specialist. C. Obtain a full history and physical. D. Obtain the client's blood pressure.

Correct Answer is D

Explanation

Choice A rationale

Asking about medication use may provide helpful information but does not address the primary concern. The symptoms of visual changes and headaches can indicate serious conditions such as increased intracranial pressure or hypertensive crisis. Immediate assessment is necessary to determine severity and prevent complications. Identifying a potential trigger does not replace the need for prompt diagnostic evaluation.

Choice B rationale

Referring the client to an eye specialist might be appropriate in cases of persistent vision issues without urgent symptoms. However, when combined with headaches, these symptoms could indicate systemic or neurological issues, such as hypertension or a brain lesion. Immediate action is required, as delayed assessment might allow for worsening of an acute condition.

Choice C rationale

Obtaining a full history and physical would provide valuable data for diagnosis. However, this approach is time-intensive and may not address the urgency of the situation. Rapid assessment, such as blood pressure measurement, takes precedence to identify conditions that could be immediately life-threatening, such as hypertensive emergencies.

Choice D rationale

Measuring blood pressure promptly assesses for hypertensive crises, a common cause of vision changes and headaches. Hypertensive crises require immediate treatment to prevent end-organ damage. Normal blood pressure ranges are typically 120/80 mmHg, and values exceeding 180/120 mmHg indicate a crisis. This action provides quick, actionable information critical for patient safety.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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