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 C

Explanation

Choice A rationale

Constant erythema and warmth are more characteristic of venous insufficiency or inflammation, rather than peripheral artery disease. PAD is associated with reduced blood flow and tissue perfusion, leading to symptoms like pallor, coolness, and pain rather than persistent redness and warmth in affected areas.

Choice B rationale

Elevating the legs worsens ischemic pain in PAD by further reducing blood flow. Symptoms typically improve when the legs are in a dependent position due to gravity aiding perfusion. This is a key distinguishing feature in PAD compared to other vascular conditions like venous insufficiency.

Choice C rationale

Discomfort in the legs during exercise relieved by rest, known as intermittent claudication, is a hallmark of PAD. It occurs due to inadequate blood supply during increased activity. Rest restores perfusion and alleviates ischemic pain. This symptom reflects underlying arterial obstruction, a core pathophysiological feature of PAD.

Choice D rationale

Peripheral pulses in PAD are diminished or absent due to arterial obstruction. Bounding pulses in dependent positions suggest venous issues or high cardiac output, not arterial insufficiency. Accurate pulse assessment helps differentiate PAD from other vascular conditions. Normal pulse documentation is critical to diagnosis.

A. Magnesium and bilateral lower extremity ultrasounds. B. Urinalysis, blood chemistry, and 12-lead electrocardiogram. C. Complete blood count and electroencephalogram. D. Troponin, calcium, and partial thromboplastin time.

Correct Answer is B

Explanation

Choice A rationale

Magnesium levels and bilateral lower extremity ultrasounds are not specific for assessing target organ damage in hypertension. While magnesium may influence cardiovascular health, it is not a primary indicator of organ damage. Ultrasounds evaluate arterial or venous abnormalities, not hypertension’s systemic effects.

Choice B rationale

Urinalysis, blood chemistry, and a 12-lead electrocardiogram assess renal, metabolic, and cardiac effects of hypertension. Proteinuria in urinalysis indicates kidney damage. Electrolyte imbalances or creatinine elevations suggest renal impairment. An ECG reveals left ventricular hypertrophy or ischemia. These tests comprehensively evaluate hypertension-related complications.

Choice C rationale

A complete blood count evaluates blood cell counts but does not directly assess target organ damage from hypertension. An electroencephalogram assesses brain activity, not hypertension-induced injury. These tests are inappropriate for this diagnostic goal.

Choice D rationale

Troponin, calcium, and partial thromboplastin time evaluate myocardial infarction, bone health, and coagulation, respectively. They do not provide information about hypertension’s systemic organ effects. Accurate test selection ensures appropriate diagnostic focus.

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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 C

Explanation

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Correct Answer is B

Explanation

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