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

Referring the client to see an optometrist is inappropriate because visual disturbances can be a sign of digoxin toxicity, which requires immediate medical attention rather than routine visual examination. Toxicity manifests due to elevated serum digoxin levels, with symptoms including blurred vision and yellow-green halos. Normal digoxin range is 0.5-2.0 ng/mL.

Choice B rationale

Asking if the client wears glasses or contact lenses does not address the root cause of visual disturbances, which is likely linked to digoxin toxicity. Such queries delay prompt medical intervention needed to evaluate and manage the client’s condition. Ocular aids are unrelated to pharmacological adverse effects.

Choice C rationale

Obtaining a prescription for stat laboratory tests is essential for assessing serum digoxin levels and electrolytes, particularly potassium, as hypokalemia increases sensitivity to digoxin toxicity. Prompt identification of toxicity allows timely interventions, including discontinuation of digoxin or administration of antidotes like Digibind.

Choice D rationale

Obtaining the client’s blood pressure is irrelevant in this scenario, as visual disturbances are not indicative of blood pressure abnormalities but rather digoxin toxicity. Immediate focus should be on confirming and managing toxicity through laboratory evaluation and clinical assessment.

Correct Answer is ["12"]

Explanation

Step 1 is (176 pounds ÷ 2.2 pounds/kg) × 10 mcg/kg/min = 800 mcg/min.

Step 2 is (800 mcg ÷ 1000 mcg/mg) × 250 mL = 0.2 mL/min.

Step 3 is 0.2 mL/min × 60 min = 12 mL/hour. Final answer: 12 mL/hour.

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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

The nurse is assessing a client taking prescribed digoxin (Lanoxin) for heart failure, and the client reports visual disturbances.Which of the following actions should the nurse take?

Correct Answer is C

Explanation

The nurse is caring for a client who is in heart failure and weighs 176 pounds. The client is to receive prescribed dobutamine 10 mcg/kg/minute. The nurse has available 1,000 mg in 250 mL of 0.9% normal saline. How many mL per hour should the nurse administer to the client?

Correct Answer is ["12"]

Explanation

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