Which of the following assessments are critical to monitor for improvement in a patient diagnosed with idiopathic thrombocytopenic purpura (ITP)? Select All that Apply

Some epistaxis

Reduction in iron levels

Platelet count greater than 150,000/mm3

Decrease in petechiae

Continued bruising with no signs of improvement

Answer and Explanation

Correct Answer : C,D

Rationale:

A. Epistaxis, or nosebleeds, is a manifestation of ongoing bleeding due to low platelet counts. While mild bleeding may be expected in ITP, its presence does not indicate improvement. Clinicians monitor for a reduction or cessation of bleeding episodes as a sign of recovery.

B. Iron levels are not a primary measure of ITP improvement. Although chronic bleeding in ITP can eventually lead to iron deficiency, a change in iron does not reflect platelet recovery or improved hemostasis. Monitoring iron may be part of supportive care but is not an indicator of treatment success.

C. Platelet count is the most objective measure of recovery in ITP. Normal platelet levels indicate that the immune-mediated destruction of platelets has diminished or that treatment has successfully stimulated platelet production. Achieving a count above 150,000/mm³ signifies a return to effective hemostasis, reducing the risk of spontaneous bleeding.

D. Petechiae are small, pinpoint hemorrhages on the skin caused by low platelet counts. A decrease in petechiae is a visible, clinical sign that bleeding tendencies are resolving and indicates improved platelet function. This complements laboratory monitoring by providing a real-time, observable measure of patient improvement.

E. Persistent bruising reflects ongoing thrombocytopenia and bleeding risk. If bruising does not improve, it suggests that treatment has not yet been effective, and further evaluation or therapy adjustments may be necessary.

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Correct Answer is ["C","E"]

Explanation

Rationale:

A. AB- blood contains both A and B antigens on the red blood cells. A recipient with blood type A- has anti-B antibodies in their plasma. If AB- blood is transfused, the recipient’s immune system will recognize the B antigens as foreign, leading to a potentially dangerous hemolytic reaction.

B. While A+ blood has the A antigen that matches the recipient’s ABO type, it is Rh-positive, and the recipient is Rh-negative (A-). Transfusing Rh-positive blood to an Rh-negative individual can trigger alloimmunization, where the immune system develops antibodies against the Rh factor. This is especially concerning in women of childbearing age, as it may affect future pregnancies, and it can also cause hemolytic transfusion reactions.

C. O- blood has no A or B antigens and is Rh-negative, making it the universal donor for red blood cells. An A- recipient will not react immunologically to O- red blood cells because there are no antigens to trigger an antibody response. O- blood is safe for emergency transfusions when a perfectly matched unit is unavailable.

D. AB+ blood contains A and B antigens as well as Rh-positive antigen. Transfusing AB+ to an A- recipient is incompatible because the B antigens would trigger anti-B antibodies and the Rh-positive factor could cause alloimmunization, making this combination unsafe.

E. A- blood is both ABO compatible (A antigen matches) and Rh compatible (negative). This is the ideal match for an A- recipient because it eliminates the risk of immune-mediated hemolysis and ensures safe transfusion.

F. Although O blood lacks A and B antigens, O+ blood contains the Rh D antigen, which is incompatible with an Rh-negative recipient. Transfusing O+ blood to an A- recipient could trigger alloimmunization or hemolytic reaction, so it is unsafe.

A. Silke should not take ibuprofen over the counter for pain or fever. B. As Silke gets older, she may grow out of the disease and no longer require treatment. C. I should apply pressure to the bleeding site, and if it doesn't stop after 10 minutes, she may need clotting factor replacement. D. Silke should have activity restrictions and should not play sports as she gets older.

Correct Answer is B

Explanation

Rationale:

A. This is correct guidance. Ibuprofen and other NSAIDs are contraindicated in hemophilia because they inhibit platelet function, increasing the risk of bleeding and complicating hemostasis. For pain or fever, acetaminophen is preferred, as it does not affect platelet function or clotting. Educating caregivers on safe medication choices is a key aspect of hemophilia management.

B. Hemophilia is a genetic, lifelong condition caused by a deficiency in clotting factors (usually factor VIII or IX). There is no natural cure or resolution with age, and affected individuals will require ongoing prophylactic factor replacement, bleeding management, and careful monitoring throughout life. Believing a child can outgrow hemophilia can lead to dangerous gaps in care, delayed treatment during bleeding episodes, and increased risk of joint damage or life-threatening hemorrhage. This statement reflects a critical misunderstanding of the disease process.

C. This is appropriate guidance. Immediate first aid for bleeding includes direct pressure, immobilization, and elevation of the affected area. If bleeding persists beyond 10–15 minutes, administration of clotting factor replacement is indicated. Prompt recognition and intervention prevent complications such as hemarthrosis, soft tissue damage, and anemia.

D. This statement is partially correct in that children with hemophilia should avoid high-risk contact sports (e.g., football, hockey) that increase the risk of trauma. However, participation in safe, low-impact activities such as swimming, cycling, or walking is encouraged to promote muscle strength, joint stability, and overall physical health. Activity recommendations should be individualized and balanced with safety precautions.

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Which of the following assessments are critical to monitor for improvement in a patient diagnosed with idiopathic thrombocytopenic purpura (ITP)? Select All that Apply

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Naxlex Comprehensive Predictor Exams

Which of the following blood types can at scan a type A-(A negative) recipient safely receive during a transfusion? Select All that Apply

Correct Answer is ["C","E"]

Explanation

In the case of managing Silke, a child with hemophilia, which statement indicates a misunderstanding of his care during a bleeding episode?

Correct Answer is B

Explanation

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