The nurse is reviewing laboratory values for a patient with thrombocytopenia associated with ITP. Which result would concern the nurse the most?

Red blood cells (RBCs) 5.0 million/mm3 (F 4.2-5.4; M 4.7-6.1)

Hemoglobin 14.5 g/100 mL (F 12-16: M 14-18)

Platelets 50,000/mm3 (150.000-400,000)

White blood cells (WBCs) 7,400/mm3 (5,000-10,000)

Answer and Explanation

The Correct Answer is C

A. Red blood cells (RBCs) 5.0 million/mm³ (F 4.2–5.4; M 4.7–6.1): This RBC count is within normal limits and does not indicate a concern related to thrombocytopenia.

B. Hemoglobin 14.5 g/100 mL (F 12–16; M 14–18): Hemoglobin is within normal limits and is not an immediate concern for a patient with ITP, as thrombocytopenia primarily affects platelets, not hemoglobin levels.

C. Platelets 50,000/mm³ (150,000–400,000): A platelet count of 50,000/mm³ is significantly below the normal range and poses a risk for bleeding, which is the primary concern in ITP (immune thrombocytopenic purpura).

D. White blood cells (WBCs) 7,400/mm³ (5,000–10,000): The WBC count is normal and not directly related to thrombocytopenia in ITP, which specifically affects platelets.

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Correct Answer is C

Explanation

A. Hip: While “hip” can sometimes colloquially refer to the iliac crest, it is not commonly used to describe the specific site for aspiration outside of the iliac crest.

B. Cervical spine: The cervical spine is not a site used for bone marrow aspiration due to its inaccessibility and proximity to critical structures.

C. Sternum: The sternum is a common site for bone marrow aspiration in adults as it provides direct access to the marrow.

D. Humerus: The humerus is generally not used for bone marrow aspirations as it does not provide as accessible or large an area for aspiration.

A. Results indicate the presence of Reed Sternberg cells B. The patient is cyanotic C. The patient is complaining of excessive thirst and hunger D. Results indicate the presence of the Philadelphia chromosome

Correct Answer is A

Explanation

A. Results indicate the presence of Reed Sternberg cells: Reed-Sternberg cells are a defining characteristic of Hodgkin disease, a type of lymphoma. Their presence in biopsy samples confirms the diagnosis, distinguishing Hodgkin disease from other types of lymphomas and leukemias.

B. The patient is cyanotic: Cyanosis, or bluish skin discoloration due to low oxygen levels, is not a common sign of Hodgkin disease. It may occur in advanced disease due to respiratory compromise but is not a defining characteristic.

C. The patient is complaining of excessive thirst and hunger: Excessive thirst and hunger are more characteristic of diabetes mellitus, not Hodgkin disease. These symptoms are unrelated to the lymphatic involvement seen in Hodgkin disease.

D. Results indicate the presence of the Philadelphia chromosome: The Philadelphia chromosome is a genetic abnormality associated with chronic myelogenous leukemia (CML), not Hodgkin disease. Its presence suggests a different hematologic malignancy.

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The nurse is reviewing laboratory values for a patient with thrombocytopenia associated with ITP. Which result would concern the nurse the most?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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