Lippincott Certification Review Medical-Surgical Nursing

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Thrombocytopenia

Question 9. A nurse is caring for a patient admitted to the medical–surgical unit for pneumonia-related sepsis. On initial assessment, the nurse finds that the patient has increasing bloody drainage around both IV sites and petechiae on their face, arms, and legs. Based on these findings, what disease process might the nurse suspect? A. Pernicious anemia B. Disseminated intravascular coagulation (DIC) C. Polycythemia vera D. Thalassemia Answers and Rationales Question 1. Correct answer: C Patients who have gastric surgery, including gastric bypass, are at higher risk of megaloblastic anemia due to malabsorption of vitamin B 12 , a building block of healthy red blood cells. Iron deficiency anemia (Option A) is not the anemia the patient is at the highest risk for, though iron deficiency may occur in some gastric bypass patients. Aplastic anemia (Option B) is caused by bone marrow suppression due to exposures including drugs, toxins, or viruses. Thalassemia (Option C) is a congenital anemia that is inherited. Question 2. Correct answers: A, B, C, and D Each of these findings could be expected for a patient newly diagnosed with acute lymphocytic leukemia (ALL). Leukemia is characterized by an overabundance of immature (blast) WBCs produced by the bone marrow. This overproduction interferes with the production of other cells, including red blood cells (RBCs) and platelets, decreasing production and circulating levels. Question 3. Correct answer: When prioritizing nursing care, the nurse should address actual assessment findings first (pain). Patient safety is the next priority because of the risk of injury for the patient, and finally, patient and family education can be addressed once priority patient needs are addressed. See below for prioritization:

Question 10. When educating patients with iron deficiency anemia about oral iron supplementation, which essential points should be included? Select all that apply. A. Black stools should be reported immediately. B. Constipation is a common side effect of oral iron. C. Oral iron should be taken on an empty stomach. D. Foods containing vitamin C aid in iron absorption. E. Provide a list of foods high in iron.

Question 4. Correct answer: A Stage III Hodgkin lymphoma is described as a disease involving lymph node regions on both sides of the diaphragm. Options B, C, and D describe stages I, IV, and II of Hodgkin lymphoma, respectively. Question 5. Correct answer: A Initial treatment for newly diagnosed CML patients includes treatment with oral imatinib (Gleevec) or similar tyrosine kinase inhibitors. Option B is incorrect because it describes the type of treatment used if the patient does not respond oral tyrosine kinase inhibitors. There are many treatment options for CML (Option C). Radiation (Option D) is not typically used to treat CML. Question 6. Correct answer: D Type O Rh− blood is only compatible with O Rh− blood due to the presence of A, B, and Rh antibodies. Options A, B, and C are incorrect because each answer contains blood types with either A, B, or Rh antigens. Question 7. Correct answer: C Transfusion-associated circulatory overload (TACO) is likely because the patient’s symptoms indicate fluid overload. Also, the patient’s age puts them at higher risk for this complication. Options A, B, and D are other types of transfusion reactions but do not fit this patient’s constellation of exhibited symptoms.

Answer Question 8. Correct answer: B Hemarthrosis is a common complication of hemophilia and can cause joint pain, swelling, and warmth. Epistaxis (Option A), also known as a bloody nose, is a complication of hemophilia but is not described here. Petechiae (Option C) are round spots on the skin due to blood under the skin. This is also a complication of hemophilia but is not described here. Ecchymosis (Option D), also known as bruising, is a complication of hemophilia but does not fully describe this patient’s issue. Copyright © 2025 Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited. Priority 1 Priority 2 Priority 3 Educate the family regarding patient home care. Implement safety measures to prevent fractures. Assess the patient for pain regularly. X X X