ATI LPN
Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017)
Chapter 33 : Management of Patients With Nonmalignant Hematologic Disorders Questions
Question 1 of 5
The results of a patient's most recent blood work and physical assessment are suggestive of immune thrombocytopenic purpura (ITP). This patient should undergo testing for which of the following potential causes?
Correct Answer: A,C
Rationale: Viral illnesses have the potential to cause ITP. Renal failure, malignancies, and gall bladder inflammation are not typical causes of ITP.
Question 2 of 5
A patient with a recent diagnosis of ITP has asked the nurse why the care team has not chosen to administer platelets, stating, â??I have low platelets, so why not give me a transfusion of exactly what I'm missing?â?? How should the nurse best respond?
Correct Answer: A
Rationale: Despite extremely low platelet counts, platelet transfusions are usually avoided. Transfusions tend to be ineffective not because the platelets are nonfunctional but because the patient's antiplatelet antibodies bind with the transfused platelets, causing them to be destroyed. Matching the patient's blood type is not usually necessary for a platelet transfusion. Platelet transfusions do not exacerbate low platelet production.
Question 3 of 5
A client with several chronic health problems has been newly diagnosed with a qualitative platelet defect. What component of the patient's previous medication regimen may have contributed to the development of this disorder?
Correct Answer: C
Rationale: Aspirin may induce a platelet disorder. Even small amounts of aspirin reduce normal platelet aggregation, and the prolonged bleeding time lasts for several days after aspirin ingestion. Calcium, vitamin D, and vitamin B12 do not have the potential to induce a platelet defect.
Question 4 of 5
A young man with a diagnosis of hemophilia A has been brought to emergency department after suffering a workplace accident resulting in bleeding. Rapid assessment has revealed the source of the patient's bleeding and established that his vital signs are stable. What should be the nurse's next action?
Correct Answer: C
Rationale: Injuries in patients with hemophilia necessitate prompt administration of clotting factors. Vitamin K is not a treatment modality and a prone position will not be appropriate for all types and locations of wounds. A normal saline bolus is not indicated.
Question 5 of 5
A nurse is planning the care of a patient who has a diagnosis of hemophilia A. When addressing the nursing diagnosis of Acute Pain Related to Joint Hemorrhage, what principle should guide the nurse's choice of interventions?
Correct Answer: D
Rationale: NSAIDs may be contraindicated in patients with hemophilia due to the associated risk of bleeding. Opioids do not have a similar effect and they do not inhibit platelet synthesis. The pain associated with hemophilia is not neuropathic.