The nurse is caring for a client who has thrombocytopenia.
Which of the following will the nurse administer for this disorder?
Corticosteroid.
Diphenhydramine.
Desmopressin (DDAVP).
Hydrochlorothiazide (HCTZ).
The Correct Answer is A
Choice A rationale
Corticosteroids are used in thrombocytopenia because they suppress the immune response, particularly in immune thrombocytopenic purpura (ITP). They reduce platelet destruction by inhibiting autoantibody formation and increasing platelet lifespan. Normal platelet count ranges from 150,000 to 400,000/µL. Thrombocytopenia occurs when platelets drop below 150,000/µL, increasing bleeding risk. Corticosteroids can also decrease capillary permeability, minimizing petechiae and ecchymoses.
Choice B rationale
Diphenhydramine, an antihistamine, is used for allergic reactions but has no role in treating thrombocytopenia. It does not address the underlying immune or hematologic causes of low platelet counts. Its primary actions include H1 receptor antagonism, reducing histamine-mediated symptoms like itching and swelling. However, it lacks immunosuppressive or hematologic-stimulating effects essential for managing thrombocytopenia.
Choice C rationale
Desmopressin (DDAVP) is a synthetic antidiuretic hormone analog used for certain bleeding disorders like von Willebrand disease or mild hemophilia A. It increases factor VIII and von Willebrand factor levels, improving clotting. However, it is not indicated for thrombocytopenia as it does not address platelet count deficiencies or immune-mediated platelet destruction.
Choice D rationale
Hydrochlorothiazide (HCTZ) is a thiazide diuretic used for hypertension and edema. Its mechanism of action involves inhibiting sodium reabsorption in the distal tubule, promoting diuresis. HCTZ has no effect on platelet counts or immune mechanisms and is not used in thrombocytopenia. Its side effects, like electrolyte imbalances, may complicate patient management.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Serum electrolyte analysis provides insights into fluid and electrolyte balance but does not specifically diagnose heart failure. Electrolyte changes may occur secondary to heart failure but are not definitive markers for the condition.
Choice B rationale
Complete blood count evaluates for anemia or infection, which may contribute to symptomatology but is not diagnostic for heart failure. Heart failure diagnosis focuses on cardiac-specific markers rather than hematologic parameters.
Choice C rationale
Blood urea nitrogen assesses renal function and reflects perfusion status but lacks specificity for heart failure. Although renal dysfunction may occur in advanced heart failure, BNP measurement is more definitive for cardiac assessment.
Choice D rationale
Brain natriuretic peptide (BNP) is a key diagnostic marker for heart failure. Elevated BNP levels occur due to ventricular stretch and strain associated with fluid overload, a hallmark of heart failure. Normal BNP levels are typically <100 pg/mL, with elevated levels strongly suggesting cardiac dysfunction. .
Correct Answer is B
Explanation
Choice A rationale
Assessing energy levels provides indirect information about cardiac output but lacks specificity regarding fluid overload or pulmonary congestion, which are key indicators of heart failure exacerbation. It is a relevant question but not the best for evaluating treatment outcomes.
Choice B rationale
Asking about pillow use evaluates orthopnea, a common symptom of heart failure due to fluid buildup in the lungs when lying flat. It provides a direct assessment of fluid status and the effectiveness of heart failure management, making it the best question.
Choice C rationale
Exercising regularly is an important lifestyle aspect for heart failure patients but does not directly assess the status of symptoms such as fluid overload or cardiac function. Thus, it is not the most critical outcome measure.
Choice D rationale
Chest pain can indicate ischemia or worsening cardiac function but is not specific to fluid status or pulmonary congestion in heart failure. Therefore, it is a relevant but less optimal question for evaluating treatment goals.
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