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. With a platelet count of 58,000/mm3, the client is at risk for bleeding due to thrombocytopenia. Placing the client on safety precautions will help prevent injuries and minimize bleeding risks. This includes using a soft-bristled toothbrush, avoiding IM injections, and using caution with activities that may cause trauma. A: Encouraging high-protein foods is not directly related to managing the client's thrombocytopenia. B: Neutropenic precautions are for clients with low white blood cell counts, not low platelet counts. C: Limiting visitors to healthy adults is important for clients with compromised immune systems, not specifically for thrombocytopenia.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Subcutaneous injection of heparin is avoided due to the risk of hematoma formation at the injection site. 2. This statement is false because heparin is commonly administered subcutaneously for prophylaxis of thromboembolic events. 3. The preferred route for heparin administration is subcutaneous or intravenous. 4. Therefore, choice A is the false statement. Summary: - Choice A is incorrect as heparin is commonly given subcutaneously. - Choice B is incorrect as heparin is not stored in mast cells but in specialized granules in mast cells. - Choice C is correct as heparin binds to plasma antithrombin III to inhibit thrombin. - Choice D is correct as protamine sulfate can reverse heparin's anticoagulant effects in case of overdose.

Correct Answer: C

Rationale: The correct answer is C: Trypanosoma brucei gambiense. This is the most probable causative organism because the patient's presentation of fever and posterior cervical lymphadenopathy over a prolonged period aligns with the chronic infection caused by Trypanosoma brucei gambiense, which leads to African Trypanosomiasis (sleeping sickness). Trypanosoma cruzi (choice A) causes Chagas disease, which typically presents with acute symptoms such as fever and swelling at the site of infection. Trypanosoma brucei rhodesiense (choice B) causes acute African Trypanosomiasis with a more rapid progression compared to gambiense. Leishmania donovani (choice D) causes visceral leishmaniasis, which presents with prolonged fever, splenomegaly, and pancytopenia, but not typically with cervical lymphadenopathy.

Correct Answer: C

Rationale: The correct answer is C: Quinine and clindamycin. Quinine is considered safe for use in pregnancy to treat malaria, as it has been used for many years without significant adverse effects. Clindamycin is also safe for use in pregnancy and can be used in combination with quinine to treat malaria. Atovaquone and proguanil (choice A) are not recommended for use in pregnancy due to limited safety data. Quinine and doxycycline (choice B) is not suitable for pregnant women as doxycycline is contraindicated during pregnancy. Primaquine (choice D) is not recommended for use during pregnancy as it can cause harm to the fetus.

Correct Answer: B

Rationale: The correct answer is B: Reduction of glutathione. In the HMP pathway, glucose-6-phosphate is converted to ribulose-5-phosphate, generating NADPH. NADPH is essential for the reduction of glutathione, which helps in detoxifying reactive oxygen species and protecting red blood cells from oxidative damage. Fatty acid synthesis (choice A) primarily requires NADPH from the pentose phosphate pathway. ATP formation (choice C) is not a direct function of NADPH production in the HMP pathway. NADPH is not directly involved in the removal of oxygen radicals (choice D), as it is the reduced form of NADP+ that participates in antioxidant defense mechanisms.