Deck 14: Disorders of Platelets, Hemostasis, and Coagulation

Question 1

A client reports a sensation of stomach fullness, fatigue, nausea, vomiting, and abdominal bloating. The client is diagnosed with stomach cancer. Which prescribed medication requires the nurse to closely monitor the client for clotting issues?
1)Cisplatin
2)Ticlopidine
3)Cyclosporine
4)Tacrolimus

Answer 1

1

Question 2

A client with hemolytic-uremic syndrome reports fever, abdominal pain, pale skin, bruising, and bleeding of the skin. Which medication or treatment will be beneficial for the client?
1)Supportive treatment with dialysis and plasma exchange
2)Aspirin and antiplatelet drugs
3)Desmopressin acetate
4)Immunomodulatory drugs

Answer 2

1

Question 3

A school-age client is brought to an acute care facility because of bloody diarrhea. The vital signs of the client show a body temperature of 101°F and blood pressure of 125/85 mm Hg. Recent activity involved camping and swimming in a local lake. With which condition does the nurse expect the client be diagnosed?
1)Hemolytic-uremic syndrome
2)Von Willebrand disease
3)Essential thrombocytosis
4)Hemophilia

Answer 3

1

Question 4

A client reports shortness of breath and severe pain in the back, chest, and muscles. Which condition does the nurse recognize as a possible diagnosis for the client?
1)Hemophilia B
2)Hemophilia A
3)Disseminated intravascular coagulation
4)Von Willebrand disease

Question 5

Which statement made by an attending nursing staff member indicates effective learning about the coagulation factors and intrinsic pathway?
1)"The clotting time is measured by prothrombin time."
2)"The clotting time is measured by activated partial thromboplastin time (aPTT)."
3)"TF-factor VII is formed by factor VII and tissue factor."
4)"Fibroblasts and leukocytes are stimulated with injury."

Question 6

While reviewing a client's medical history, the nurse understands that the client is at risk of bleeding because the client's platelet count is 80,000/uL. Which condition is this?
1)Thrombocytosis
2)Thrombocytopenia
3)Thrombus
4)Thrombosis

Question 7

A client reports unsteadiness, vertigo, dizziness, and seizures. On assessment, the client is diagnosed with essential thrombocytosis. Which is the abnormal manifestation found during the diagnosis?
1)Decreased bleeding
2)Decreased number of white blood cells (WBCs)
3)Decreased number of platelets
4)Increased number of red blood cells (RBCs)

Question 8

A client in a health-care unit has acute immune thrombocytopenic purpura. Which is a unique feature of acute immune thrombocytopenic purpura?
1)Occurs in children
2)Occurs in adults
3)Occurs in persons aged 20 to 50 years
4)Occurs twice as often in men than in women

Question 9

A client reports abdominal pain, fever, and fatigue. On assessment, the client is diagnosed with hemolytic-uremic syndrome. Which abnormal diagnostic test result could further confirm the diagnosis?
1)High proteinuria and hematuria
2)High blood urea nitrogen
3)Low serum creatinine
4)Low bilirubin

Question 10

The nurse educator is preparing material for a nursing staff program about coagulation processes. Which material does the nurse include with regard to platelets?
1)Formation is inhibited by the hormone thrombopoietin
2)Normal platelet life span is 14 to 21 days
3)Almost one-third of platelets reside in the spleen
4)Megakaryocytes have a nucleus with RNA present

Question 11

The nurse is providing care for a client receiving emergency care for a condition presenting with the symptoms of a stroke. Which characteristic of the involved clotting pathway does the nurse recognize?
1)The extrinsic pathway is stimulated because of trauma
2)Diagnostic testing will involve both the prothrombin time (PT) and international normalized ratio (INR)
3)Injury has occurred to the endothelial lining of a vessel
4)The intrinsic pathway does not convert fibrinogen to fibrin

Question 12

An adult client who presents with symptoms of redness, heat, and pain in the joints undergoes a complete blood count test. The blood report shows an increased white blood cell count. Which condition does this indicate?
1)Inflammation
2)Anemia
3)Increased bleeding tendency
4)Pulmonary embolism

Question 13

Which statement is true regarding megakaryocytes?
1)They are invisible in bone marrow.
2)They have a nucleus.
3)They can synthesize proteins.
4)They mature into platelets.

Question 14

Two clients are admitted into an acute care unit for clotting-related conditions. One of the clients is prescribed the drug fondaparinux, whereas the other client is prescribed dabigatran. In which way is fondaparinux different from dabigatran?
1)Fondaparinux is administered by subcutaneous injection.
2)Fondaparinux is an oral form of anticoagulant.
3)Fondaparinux is used to prevent stroke in clients with atrial fibrillation.
4)Fondaparinux is also called factor IIa.

Question 15

The nurse is caring for a client who feels tired and weak and reports shortness of breath and pink or purple spots on the skin. Which treatment does the nurse recognize as the most effective intervention for this client?
1)Performing plasmapheresis
2)Administering corticosteroid drugs
3)Providing direct thrombin inhibitors
4)Performing factor VIII replacement therapy

Question 16

Low-molecular-weight heparin (LMWH) is a class of anticoagulant medications. Which is a characteristic of LMWH?
1)It consists of large fragments of heparin.
2)It binds to plasma proteins as strongly as standard heparin.
3)It can be administered subcutaneously.
4)It has more side effects than standard heparin.

Question 17

Which does the nurse recognize as the best intervention for immediately lowering the platelet count to safer levels in a client diagnosed with severe life-threatening thrombocytosis?
1)Administering aspirin in a small dose
2)Providing clopidogrel to inhibit blood clotting
3)Administering hydroxyurea to lower the platelet count
4)Performing pheresis to remove whole blood from the donor

Question 18

The nurse is caring for a client who reports with severe bleeding. The primary health-care provider prescribes a diagnostic test that would measure the time taken for the blood to clot and examine the extrinsic pathway of coagulation cascade. Which diagnostic test does the nurse expect to be performed?
1)Fibrinogen test
2)Activated partial thromboplastin time test
3)Platelet aggregation test
4)Prothrombin time test

Question 19

Which is a supportive treatment for a client with disseminated intravascular coagulation?
1)Transfuse fresh frozen plasma.
2)Maintain fluid and electrolyte balance.
3)Start prophylactic treatment with phenytoin.
4)Transfuse with whole blood products.

Question 20

The nurse is providing care for a client diagnosed with heart failure, which inhibits ambulatory activities. Which factor does the nurse recognize as the greatest risk for enhanced platelet activity with this client?
1)Disturbances in blood flow
2)Stasis of blood flow
3)Increase in procoagulation factors
4)Decrease in anticoagulation factors

Question 21

A registered nurse is teaching a student nurse about the features of the extrinsic pathway of the coagulation cascade. Assess the statements made by the student nurse and choose the ones that indicate effective learning. Select all that apply.
1)"It is measured by the activated partial thromboplastin time (aPTT)."
2)"It is stimulated by tissue damage incurred by injury to the endothelial lining."
3)"It is also known as tissue factor pathway."
4)"It leads to the ultimate conversion of fibrinogen into fibrin."
5)"It leads to the conversion of prothrombin to thrombin."

Question 22

Which statements are correct regarding platelets? Select all that apply.
1)Platelet formation is stimulated by the hormone thrombopoietin.
2)Platelets increase in the bone marrow.
3)Platelets have a life span of less than 7 days.
4)Platelets spend one-third of their lives in the spleen.
5)Platelet adhesion results in the activation of the glycoprotein.

Question 23

In which ways does the drug heparin compare to the drug warfarin? Select all that apply.
1)Both heparin and warfarin are based on an activated partial thromboplastin time (aPTT) value, which requires 30 to 45 seconds.
2)Both heparin and warfarin are administered intravenously or subcutaneously.
3)Both heparin and warfarin are anticoagulant drugs.
4)Both heparin and warfarin take the same amount of time to reach therapeutic levels.
5)Both heparin and warfarin have bleeding as a side effect.

Question 24

Which statements are true regarding the final pathway in the coagulation cascade? Select all that apply.
1)It converts fibrinogen to fibrin.
2)It requires minerals and vitamins.
3)It stores vitamin K in fatty tissue.
4)It increases the absorption of vitamin K.
5)It converts thrombin into prothrombin.

Question 25

A nurse is caring for an adult client who is exhibiting trouble with speaking, sudden numbness, and weakness of the face. The client is diagnosed with a stroke. A physician orders thrombolytic therapy. Which condition is effectively treated with thrombolytic therapy? Select all that apply.
1)It is used to dissolve the clot.
2)It is used to reestablish blood flow.
3)It is used after 8 hours from the time of the acute event.
4)It is used to treat a myocardial infarction (MI) within 24 hours of the onset of symptoms.
5)It is used to convert plasminogen to plasmin.