With which term will the nurse document the finding after noting multiple 1-mm red macules when assessing the skin of a patient with leukemia and thrombocytopenia?
Purpura.
Bruising.
Petechiae.
Ecchymosis.
The Correct Answer is C
Choice A rationale:
Purpura refers to purple or red discolorations on the skin caused by bleeding underneath the skin. It is larger than petechiae and ecchymosis and could be a sign of a more serious underlying condition. Petechiae are small, red or purple dots that appear on the skin due to minor bleeding from broken capillaries. In the context of leukemia and thrombocytopenia (low platelet count), petechiae are common due to impaired clotting mechanisms.
Choice B rationale:
Bruising occurs due to damage to blood vessels underneath the skin, resulting in the leakage of blood into the surrounding tissues. Bruises are typically larger than petechiae and can occur with various conditions, including trauma. In this case, the small 1-mm red macules are more indicative of petechiae.
Choice D rationale:
Ecchymosis refers to a larger area of subcutaneous bleeding or bruising. It is larger than both petechiae and purpura and often results from more significant trauma or bleeding disorders. The description of multiple 1-mm red macules is characteristic of petechiae rather than ecchymosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Taking a daily walk is a beneficial activity for patients with venous leg ulcers. Walking promotes blood circulation, which can aid in wound healing. This statement indicates that the patient understands the importance of physical activity for their condition.
Choice B rationale:
Trying to lose weight is another positive step for a patient with venous leg ulcers, especially if the patient is overweight. Excess body weight can put additional pressure on the veins in the legs, worsening venous insufficiency. Losing weight can alleviate this pressure and improve venous circulation, supporting the healing process of leg ulcers.
Choice C rationale:
Wearing stockings after getting out of bed is a proper technique for managing venous leg ulcers. Compression stockings help improve blood flow in the legs and reduce swelling, which is beneficial for patients with venous insufficiency and leg ulcers. This statement indicates that the patient understands the importance of wearing compression stockings consistently.
Choice D rationale:
Not wearing knee-high socks that are tight around the calf is essential advice for patients with venous leg ulcers. Tight clothing, including socks or stockings, can impede blood circulation in the legs, worsening venous insufficiency and delaying wound healing. This statement indicates the need for further education because the patient should avoid any tight clothing around the affected area to promote optimal blood flow and wound healing.
Correct Answer is C
Explanation
Choice A rationale:
Metabolic acidosis is characterized by low blood pH and low bicarbonate ion levels. The patient's bicarbonate ion level (24 mEq/L) is within the normal range, and the low pH (7.32) and elevated PaCO2 (56 mm Hg) indicate respiratory acidosis, not metabolic acidosis.
Choice B rationale:
Metabolic alkalosis is characterized by high blood pH and high bicarbonate ion levels. The patient's pH is low (7.32), and the bicarbonate ion level (24 mEq/L) is within the normal range, indicating respiratory acidosis rather than metabolic alkalosis.
Choice C rationale:
Respiratory acidosis is characterized by low blood pH and high PaCO2 levels. In this case, the patient has a low pH (7.32) and elevated PaCO2 (56 mm Hg), indicating respiratory acidosis. The bicarbonate ion level (24 mEq/L) is a compensatory response. Respiratory alkalosis would present with high pH and low PaCO2 levels.
Choice D rationale:
Respiratory alkalosis is characterized by high blood pH and low PaCO2 levels. The patient's PaCO2 level is elevated (56 mm Hg), indicating respiratory acidosis, not alkalosis. The low pH (7.32) further supports the diagnosis of respiratory acidosis.
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