Deck 22: Alterations of Hemostasis

Question 1

Which statement by a patient at risk for excessive bleeding indicates that more teaching is needed?

A) "I will brush my teeth with a soft toothbrush."
B) "I need to avoid playing football with my children."
C) "Stool softeners will help me avoid straining."
D) "I have a new pair of sandals that I bought to wear this summer."

Answer 1

"I have a new pair of sandals that I bought to wear this summer."

Question 2

Which vitamin does the nurse teach is essential to the function of clotting factors?

A) Vitamin D
B) Vitamin E
C) Vitamin C
D) Vitamin K

Answer 2

Vitamin K

Question 3

Which of the following would the nurse explain to a patient with type 3 von Willebrand disease?

A) The binding ability of von Willebrand factor is delayed.
B) There is no production of von Willebrand factor.
C) The binding ability of von Willebrand factor is enhanced.
D) There is increased clearance of von Willebrand factor.

Answer 3

There is no production of von Willebrand factor.

Question 4

When assessing the laboratory values for patient with von Willebrand disease who is taking desmopressin (DDAVP), the nurse should be alert for:

A) hypernatremia.
B) hyponatremia.
C) hypokalemia.
D) hyperkalemia.

Question 5

Which platelet value should the nurse report immediately to the physician?

A) 9,000 uL
B) 150,000/uL
C) 200,000/uL
D) 300,000/uL

Question 6

Which sign would alert the nurse that a patient receiving low-molecular-weight heparin has developed type 1 heparin-induced thrombocytopenia (HIT)?

A) Platelet clots develop upon initiation of heparin therapy.
B) Platelet clots develop 2 weeks after initiating heparin therapy.
C) Platelet count decreases modestly 2 days after beginning heparin therapy.
D) Platelet count decreases significantly 2 days after beginning heparin therapy.

Question 7

Which manifestations is the nurse most likely to assess in a patient with thrombocytopenia?

A) Purpura and ecchymosis
B) Nausea and vomiting
C) Weakness and lethargy
D) Malaise and chills

Question 8

Which laboratory value will most likely be abnormal in the patient undergoing diagnostic testing for hemophilia?

A) Prothrombin time (PT)
B) Partial thromboplastin time (PTT)
C) Platelet count
D) Bleeding time

Question 9

How should the nurse respond when a woman, who is a carrier for hemophilia, asks about the risk of having a child with hemophilia? Her partner does not have the gene for hemophilia.

A) "You have a 50% chance of passing the affected chromosome to your sons."
B) "All your sons will have hemophilia."
C) "Your daughters have a 50% chance of having hemophilia."
D) "All your daughters will be carriers."

Question 10

When planning care for a trauma patient, the nurse understands that the response of the extrinsic coagulation pathway to tissue damage begins with the release of:

A) factors VII and IX.
B) platelet factor.
C) factor III.
D) factor VII.

Question 11

Which assessment findings would indicate to the nurse that a child with sickle cell disease is experiencing tissue ischemia?

A) Pain in the legs and chest
B) Bruising and nose bleed
C) Pale skin and fatigue
D) Fever and chills

Question 12

Which laboratory value would the nurse expect to find in the patient with disseminated intravascular coagulation (DIC)?

A) Low platelet count
B) Elevated fibrinogen level
C) Decreased D-dimer level
D) Shortened PT level

Question 13

Which platelet value is consistent with thrombocythemia?

A) 100,000/mm³ or 100,000/uL
B) 150,000/mm³ or 150,000/uL
C) 350,000/mm³ or 350,000/uL
D) 650,000/mm³ or 650,000/uL

Question 14

When planning care for a patient with hypoxia, which concept about erythropoietin should the nurse keep in mind?

A) Erythropoietin is released when renal blood flow increases.
B) Erythropoietin is released when oxygen content in the lungs is high.
C) Erythropoietin is released during anemic states.
D) Erythropoietin is stimulated by kidney damage.

Question 15

Which statement by a patient with primary thrombocytopenia indicates to the nurse that the patient understands the teaching about the disorder?

A) "My disorder may be caused by a low number of platelets."
B) "My platelets are not functioning properly."
C) "I don't have enough coagulation factors."
D) "My disorder is caused by liver disease."

Question 16

When caring for a patient taking warfarin, which laboratory data would alert the nurse to the effectiveness of the medication?

A) Partial thromboplastin time (PTT)
B) Prothrombin time (PT)
C) International normalization ratio (INR)
D) Activated coagulation time

Question 17

Which prothrombin time (PT) would the nurse expect to assess in a patient with normal blood clotting?

A) 10 seconds
B) 13 seconds
C) 14 seconds
D) 16 seconds

Question 18

Which instruction regarding thrombocytopenia would the nurse include in the teaching plan for a patient undergoing chemotherapy?

A) The nadir for the platelet count occurs 3-5 days after treatment.
B) The nadir for the platelet count occurs 5-8 days after treatment.
C) The nadir for the platelet count occurs 7-10 days after treatment.
D) The nadir for the platelet count occurs 10-13 days after treatment.

Question 19

When assessing a patient with thrombotic thrombocytopenia purpura (TTP), which clinical manifestations is the nurse likely to assess?

A) Sickle cell anemia, thrombocytosis, renal insufficiency, fever, mental status changes
B) Iron deficiency anemia, thrombocytopenia, hepatic failure, fever, mental status changes
C) Pernicious anemia, thrombocytopenia, hepatic failure, fever, mental status changes
D) Microangiopathic hemolytic anemia, thrombocytopenia, renal insufficiency, fever, mental status changes

Question 20

Which laboratory values would the nurse expect in a patient with disseminated intravascular coagulation?

A) Prolonged PT and aPTT, elevated D-dimer
B) Prolonged PT and aPTT, reduced D-dimer
C) Shortened PT and aPTT, elevated D-dimer
D) Shortened PT and aPTT, reduced D-dimer