Wk. 4 - Hemostasis Disorders Practice Questions

Which of the following is the correct order of hemostasis? A. Platelet plug formation, vasoconstriction, fibrinolysis, coagulation cascade B. Vasoconstriction, platelet plug formation, coagulation cascade activation, fibrinolysis C. Coagulation cascade activation, fibrinolysis, vasoconstriction, platelet plug formation D. Platelet plug formation, fibrinolysis, vasoconstriction, coagulation cascade

B

True or False: The primary purpose of vasoconstriction in hemostasis is to activate clotting factors.

False

Which laboratory test evaluates the effectiveness of warfarin therapy? A. aPTT B. INR C. D-dimer D. Platelet count

B

A nurse is reviewing coagulation lab values for a patient on heparin therapy. Which result would require immediate intervention? A. aPTT of 38 seconds B. INR of 1.0 C. aPTT of 95 seconds D. Platelet count of 320,000/µL

C

Which of the following statements about INR is correct? A. The normal INR range for a patient on warfarin therapy is 2.0-3.0. B. An INR of 1.5 indicates an increased risk of bleeding. C. INR is used to monitor heparin therapy. D. An INR above 3.0 always requires immediate discontinuation of warfarin.

A

Which clinical manifestations are associated with thrombocytopenia? Select all that apply. A. Petechiae and purpura B. Frequent nosebleeds (epistaxis) C. Hematuria D. Hypertension E. Increased deep vein thrombosis (DVT) risk

A,B,C

True or False: A platelet count of 450,000/µL indicates thrombocytopenia.

False

A nurse is providing education to a patient with thrombocytopenia. Which statements indicate correct understanding? Select all that apply. A. "I will avoid aspirin and NSAIDs." B. "I should use a soft-bristle toothbrush." C. "I can participate in contact sports as long as I wear protective gear." D. "I will report any unusual bruising or bleeding to my healthcare provider." E. "I should shave with a straight razor to avoid cuts."

A,B,D

Which nursing diagnosis is most appropriate for a patient with thrombocytopenia? A. Risk for fluid volume overload related to increased clot formation B. Risk for bleeding related to decreased platelet count C. Impaired gas exchange related to excessive clotting D. Risk for infection related to immunosuppression

B

Which interventions are appropriate for a patient with a platelet count of 50,000/µL? Select all that apply. A. Avoid IM injections and rectal suppositories. B. Administer platelet transfusions immediately. C. Monitor for signs of bleeding, such as hematuria and petechiae. D. Encourage contact sports for muscle strength. E. Educate the patient to avoid aspirin-containing medications.

A,C,E

A patient receiving heparin therapy has a critically high aPTT. Which medication should the nurse anticipate administering? A. Vitamin K B. Protamine sulfate C. Fresh frozen plasma (FFP) D. Andexanet alfa

B

Which anticoagulant requires INR monitoring to ensure therapeutic effectiveness? A. Enoxaparin B. Heparin C. Warfarin D. Rivaroxaban

C

True or False: Direct Factor Xa inhibitors, such as apixaban (Eliquis), require routine monitoring of INR and aPTT.

False

Which patients are at increased risk of developing heparin-induced thrombocytopenia (HIT)? Select all that apply. A. A patient on long-term warfarin therapy B. A postoperative patient receiving heparin for DVT prophylaxis C. A patient with a recent history of thromboembolism receiving IV heparin D. A patient on low-dose aspirin therapy E. A patient with a platelet count of 250,000/µL on heparin for 5 days

B,C,E

Which nursing intervention is most appropriate for a patient diagnosed with HIT? A. Continue heparin and monitor platelet levels closely B. Discontinue heparin and initiate an alternative anticoagulant C. Administer a platelet transfusion to stabilize the patient D. Increase the heparin dose to counteract platelet destruction

B

Which of the following diagnostic findings are consistent with disseminated intravascular coagulation (DIC)? Select all that apply. A. Increased PT and aPTT B. Decreased fibrinogen C. Normal D-dimer levels D. Decreased platelet count E. Increased fibrin degradation products (FDPs)

A,B,D,E

True or False: Patients with immune thrombocytopenia (ITP) are at high risk for clot formation rather than bleeding.

False

A patient with suspected DIC presents with petechiae, ecchymosis, and hematuria. What is the priority intervention? A. Administer IV heparin immediately B. Perform emergency splenectomy C. Identify and treat the underlying cause D. Restrict all fluid intake

C

Which treatments are commonly used in the management of ITP? Select all that apply. A. Corticosteroids B. IV immunoglobulin (IVIG) C. Heparin infusion D. Splenectomy for refractory cases E. Platelet transfusion in life-threatening bleeding

A,B,D

A patient with DIC is experiencing uncontrolled bleeding. What blood product should the nurse anticipate administering? A. Packed red blood cells (PRBCs) B. Fresh frozen plasma (FFP) C. Albumin D. Whole blood

B