During physical assessment of a patient with thrombocytopenia, what would the nurse expect to find?

Correct Answer: B

Rationale: In a patient with thrombocytopenia, the nurse would expect to find petechiae and purpura during physical assessment. This is because thrombocytopenia is a condition characterized by a low platelet count, leading to easy bruising and small red or purple spots on the skin. Petechiae are pinpoint, round spots that appear on the skin as a result of bleeding under the skin. Purpura refers to larger areas of bleeding under the skin that appear as purple or red-colored patches. Option A, sternal tenderness, is not typically associated with thrombocytopenia. Stiffness or tenderness in the sternum may be indicative of other conditions such as costochondritis. Option C, jaundiced sclera and skin, is more commonly associated with liver dysfunction or hemolytic anemia where there is an excess breakdown of red blood cells leading to elevated bilirubin levels. Option D, tender, enlarged lymph nodes, is not a typical finding in thrombocytopenia. Enlarged lymph nodes may be seen in conditions such as lymphadenopathy or infections. Understanding the physical manifestations of thrombocytopenia is crucial for nurses to provide appropriate care, monitor for complications like excessive bleeding, and educate patients on signs to report to their healthcare provider. It also highlights the importance of a thorough physical assessment in identifying and managing hematological conditions effectively.

Correct Answer: A

Rationale: The correct answer is A) Iodine sensitivity. When a patient is undergoing a contrast CT scan of the spleen, the contrast dye used typically contains iodine. It is crucial for the nurse to ask about iodine sensitivity to prevent an allergic reaction, which can range from mild itching to severe anaphylaxis. Option B) Prior blood transfusions is not the most important consideration before a contrast CT of the spleen. While knowing the patient's transfusion history is important for overall medical care, it is not directly related to the contrast CT procedure. Option C) Phobia of confined spaces, and Option D) Internal metal implants or appliances are not the priority considerations before a contrast CT of the spleen. While these factors may be relevant in other medical contexts, they do not directly impact the safety and success of the CT procedure in this case. Educationally, this question highlights the importance of assessing patient allergies and sensitivities before procedures involving contrast agents. It underscores the nurse's role in ensuring patient safety by identifying and addressing potential risks associated with the procedure. This knowledge is crucial for providing quality patient care and preventing adverse events in clinical practice.

Correct Answer: D

Rationale: Performing a lymph node biopsy is crucial in diagnosing neoplastic conditions such as lymphomas or metastatic cancer. Neoplastic cells can infiltrate lymph nodes, causing changes in size, consistency, and tenderness. Biopsy helps identify the type of cancer, its stage, and guides treatment decisions. Option A, Leukemia, is a systemic blood cancer that primarily affects the bone marrow and blood, not the lymph nodes. Option B, Cause of lymphedema, involves the accumulation of lymphatic fluid, not cellular changes in lymph nodes. Option C, Hemorrhagic tendencies, are related to clotting disorders or platelet abnormalities, not typically diagnosed through lymph node biopsies. In an educational context, understanding the rationale behind a lymph node biopsy emphasizes the importance of diagnostic procedures in oncology and hematology. This knowledge aids healthcare professionals in interpreting test results accurately, formulating appropriate treatment plans, and providing optimal care for patients with hematologic or oncologic conditions.

Correct Answer: B

Rationale: In patients with anemia, the correct answer to why they often feel fatigued is option B) Lack of oxygen getting to the cells in her body. Anemia is a condition characterized by a decreased number of red blood cells or hemoglobin in the blood, leading to reduced oxygen-carrying capacity. This lack of oxygen impairs the body's ability to generate energy through aerobic metabolism, resulting in fatigue. Option A) Destruction (hemolysis) of the RBCs, while a cause of anemia in conditions like hemolytic anemia, does not directly explain the fatigue experienced by patients. Option C) Paleness (pallor) of the skin is a symptom of anemia but does not address the underlying reason for fatigue. Option D) Lack of nutritional intake of essential nutrients like iron or B12 can lead to specific types of anemia but does not directly relate to the fatigue mechanism in anemia. Educationally, it is essential for healthcare professionals to understand the physiological basis of symptoms in anemia to provide appropriate care and support for patients. By knowing that fatigue in anemia is primarily due to the lack of oxygen delivery to tissues, healthcare providers can tailor interventions to address this root cause, such as managing the underlying condition causing the anemia or providing supplemental oxygen or blood transfusions when necessary.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Disseminated intravascular coagulation (DIC). DIC is a serious condition characterized by both excessive clotting and bleeding. It occurs as a result of widespread activation of the clotting cascade, leading to the formation of microthrombi throughout the body, which can consume clotting factors and platelets, resulting in bleeding. Option B) Hemophilia is incorrect because hemophilia is a bleeding disorder where the blood does not clot properly. Patients with hemophilia typically do not experience clotting and bleeding simultaneously. Option C) Multiple myeloma is incorrect as it is a type of cancer that affects plasma cells in the bone marrow, leading to symptoms like bone pain, anemia, and kidney problems. It is not typically associated with clotting and bleeding at the same time. Option D) Polycythemia vera is incorrect because it is a disorder characterized by an overproduction of red blood cells, leading to an increased risk of blood clots. However, it does not typically present with both clotting and bleeding manifestations simultaneously. Educationally, understanding the pathophysiology of DIC is crucial in clinical practice, especially in hematology and oncology settings. Recognizing the signs and symptoms of DIC is essential for prompt diagnosis and management to prevent serious complications. This question highlights the importance of differentiating between various hematological conditions based on their unique presentations and underlying mechanisms.