A hospitalized client has a platelet count of 58,000/mm3 (58 × 109/L). What action by the nurse is most appropriate?

Correct Answer: D

Rationale: The correct answer is D: Place the client on safety precautions. A platelet count of 58,000/mm3 is considered low (normal range is 150,000-450,000/mm3). This places the client at risk for bleeding. Safety precautions involve preventing injuries that could lead to bleeding, such as falls, bumps, or cuts. This is crucial to prevent complications like spontaneous bleeding. Encouraging high-protein foods (choice A) is important for overall health but not directly related to managing low platelet count. Neutropenic precautions (choice B) are for clients with low white blood cell counts, not low platelet counts. Limiting visitors (choice C) to healthy adults is important for infection control but not directly related to preventing bleeding in a client with low platelet count.

Correct Answer: A

Rationale: The correct answer is A. Subcutaneous injection of heparin is avoided because it can lead to hematomas due to its anticoagulant properties. Heparin is not stored in mast cells (B), but it is synthesized in mast cells. Heparin binds to plasma antithrombin III and inhibits activated thrombin (C). Protamine sulfate can be used to counteract heparin overdose by binding to heparin and neutralizing its anticoagulant effects (D). Therefore, the statement that subcutaneous injection of heparin is avoided due to hematoma formation is the false statement among the options provided.

Correct Answer: C

Rationale: The correct answer is C: Trypanosoma brucei gambiense. This is the most likely causative organism because the patient's presentation of fever and posterior cervical lymphadenopathy is consistent with African trypanosomiasis, also known as sleeping sickness, which is caused by T. brucei gambiense. This parasite is transmitted by the tsetse fly in sub-Saharan Africa. The other choices (A, B, D) are not the correct causative organism for African trypanosomiasis and do not match the clinical presentation described in the question. Trypanosoma cruzi causes Chagas disease, Trypanosoma brucei rhodesiense causes a more acute form of African trypanosomiasis, and Leishmania donovani causes visceral leishmaniasis, which typically presents with splenomegaly and hepatomegaly rather than posterior cervical lymphadenopathy.

Correct Answer: C

Rationale: The correct answer is C: Quinine and clindamycin. Quinine is recommended for pregnant women due to its safety profile in pregnancy. Clindamycin is often used in combination with quinine to treat malaria during pregnancy. A: Atovaquone and proguanil are not recommended for pregnant women due to limited safety data. B: Quinine and doxycycline should be avoided in pregnancy as doxycycline can harm the fetus. D: Primaquine is not recommended during pregnancy due to potential risks to the fetus. In summary, the combination of quinine and clindamycin is the most suitable anti-malarial drug for pregnant women due to their safety profiles and efficacy in treating malaria without harming the fetus.

Correct Answer: B

Rationale: The correct answer is B: Reduction of glutathione. In the hexose monophosphate pathway (HMP), NADPH is generated, which serves as a reducing agent. This NADPH is crucial for reducing oxidized glutathione back to its reduced form, maintaining cellular antioxidant defense. This process helps to protect cells from oxidative damage and maintain redox balance. Now, let's summarize why the other choices are incorrect: A: Synthesis of fatty acids - NADPH is indeed involved in fatty acid synthesis, but in the context of red blood cells, the primary role of NADPH is in reducing glutathione. C: Formation of ATP - NADPH is not directly involved in ATP synthesis. ATP is primarily produced through processes like glycolysis and oxidative phosphorylation. D: Removal of oxygen radicals - While NADPH indirectly contributes to the removal of oxygen radicals through its role in reducing glutathione, it is not the primary function of NAD