NCLEX-PN

Category - Reduction of Risk

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The nurse is caring for a client undergoing chemotherapy who develops thrombocytopenia. Which of the following interventions should the nurse give the highest priority?

Maintaining reverse isolation at all times
Encourage the client to ambulate at least 3 times a day
Monitor for bleeding in the gums
Provide list of foods high in iron

Explanation

Answer: C - Thrombocytopenia indicates a decrease in the number of platelets, leading to high risk of bleeding. The nursing intervention should focus on preventing and monitoring for bleeding. Option A is an intervention for leukopenia, or a decrease in white blood cells. Options B and D are not related to thrombocytopenia.

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