Deck 14: Disorders of Platelets, Hemostasis, and Coagulation

Question 1

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.

Answer 1

4

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 client reports unsteadiness, vertigo, dizziness, and seizures. On assessment, the client is diagnosed with essential thrombocytosis. What is the abnormal result 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)

Answer 3

2

Question 4

A client reports fullness of the stomach, fatigue, nausea, vomiting, and abdominal bloating. The client is diagnosed with stomach cancer. Which medication does the nurse expect the primary health-care provider to prescribe?
1) Cisplatin
2) Ticlopidine
3) Cyclosporine
4) Tacrolimus

Question 5

Two clients are admitted into a health-care unit for clotting-related conditions. One of the clients is prescribed with the drug fondaparinux; whereas, the other client is prescribed dabigatran. How is fondaparinux different from dabigatran?
1) Fondaparinux is a parenteral form of anticoagulant.
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 6

While reviewing a client's medical history, a 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

What 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) None of the above

Question 8

A 35-year-old male client with severe bleeding from an accident is brought to a hospital. The result of the complete blood count report shows red blood cells (RBCs) at 4.9 millions/microliter, white blood cells (WBCs) at 5,000/microliter, platelets at 80,000/microliter, and hemoglobin at 12 grams/deciliter. Which condition has the client developed?
1) Leukopenia
2) Leukocytosis
3) Thrombocytopenia
4) Neutropenia

Question 9

Low molecular weight heparin (LMWH) is a class of anticoagulant medications. Which is a characteristic of low molecular weight heparin?
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 10

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 11

A nurse is caring for a client who feels tired and weak and reports shortness of breath and pink or purple spots on the skin. The client is diagnosed with thrombotic thrombocytopenic purpura. Which is 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 12

A 30-year-old 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

A client reports shortness of breath and severe pain in the back, chest, and muscles. Which condition could the client possibly be diagnosed with?
1) Hemophilia B
2) Hemophilia A
3) Disseminated intravascular coagulation
4) Von Willebrand disease

Question 14

Which factor leads to enhanced platelet activity?
1) Disturbances in blood flow
2) Stasis of blood flow
3) Increase in procoagulation factors
4) Decrease in anticoagulation factors

Question 15

What is 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 16

A 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 17

How does primary thrombocytosis differ from secondary thrombocytosis?
1) It occurs in the bone marrow.
2) It has an elevated platelet count.
3) It is a development of thrombosis, which is unclear.
4) It occurs as a result of an excessive number of platelets.

Question 18

A 10-year-old client is brought to the hospital with complaints of bloody diarrhea. The client was learning to swim. The vital signs of the client show a body temperature of 101°F and blood pressure of 125/85 mm Hg. With which condition might the client be diagnosed?
1) Hemolytic-uremic syndrome
2) Von Willebrand disease
3) Essential thrombocytosis
4) Hemophilia

Question 19

A client visits a health-care unit with 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 between 20 to 50 years
4) Occurs twice as often in men than in women

Question 20

Which statement made by the student nurse 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) All of the above

Question 21

A nurse is caring for a 50-year-old client with symptoms of trouble in speaking, sudden numbness, and weakness of the face. The client is diagnosed with a stroke. A physician orders thrombolytic therapy. How is thrombolytic therapy effective to treat the condition?
1) It is used to dissolve the clot.
2) It is used to reestablish blood flow.
3) It is used to treat the client with more than 3 to 4 hours from the time of the acute event.
4) It is used to treat the client within 24 hours of the onset of symptoms.
5) It is used to convert plasminogen to plasmin.

Question 22

Which statements are correct regarding platelets?
1) Platelet formation is stimulated by the hormone thrombopoietin.
2) Platelets increase in the bone marrow.
3) Platelets have a lifespan 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

How does the drug heparin compare to the drug warfarin?
1) Both heparin and warfarin are based on a 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 same amount of time to reach therapeutic levels.
5) Both heparin and warfarin have bleeding as side effect.

Question 24

A registered nurse is teaching a student nurse about the features of the extrinsic pathway of the coagulation cascade. Asses the statements made by the student nurse and choose the ones that indicate effective learning.
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 25

Which statements are true regarding the final pathway in the coagulation cascade?
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.