RNSG 2539 LATEST EXAM
QUESTIONS AND ANSWERS
What-lab-testing-results-are-indicative-of-DIC?---ans-✔✔-Prothrombin-Time-(PT)
-partial-throboplastin-time-(PTT)
-Activated-Partial-Thrompoplastin-Time-(aPTT)
-Bleeding-Time
-Thrombin-Time
Decrease-levels:--Fibrogen
--Platelets
--Clotine-factor-II,-V,-VIII,-&-X
and-Antithrombin-III
The-nurse-is-reviewing-the-laboratory-test-results-of-a-child-diagnosed-with-disseminated-
intravascular-coagulation-(DIC).-Which-of-the-following-would-the-nurse-interpret-as-
indicative-of-this-disorder?
-
A)-Shortened-prothrombin-time-
B)-Increased-fibrinogen-level-
C)-Positive-fibrin-split-products-
D)-Increased-platelets---ans-✔✔C)-Positive-fibrin-split-products
The-nurse-is-caring-for-a-postpartum-patient-admitted-to-the-intensive-care-unit-with-a-
diagnosis-of-disseminated-intravascular-coagulation-(DIC).-What-is-the-drug-of-choice-to-
treat-this-problem?
A.-Heparin
B.-Urokinase
C.-Aspirin
D.-Warfarin---ans-✔✔A.)-Heparin
In-the-ICU,-a-postsurgical-client-has-developed-sepsis-and-is-being-treated-with-multiple-
medications.-During-the-mid-morning-assessment,-which-finding-leads-the-nurse-to-
suspect-the-client-may-be-developing-a-complication-called-disseminated-intravascular-
coagulation-(DIC)?-Select-all-that-apply.
A)-Headaches-associated-with-light-sensitivity
,B)-Oozing-from-all-previous-puncture-and-intravenous-sites
C)-Decreased-O2-saturation-and-diminished-breath-sounds-in-lower-lobes
D)-Hemorrhage-from-the-surgical-site-requiring-deep-pressure-dressings
E)-Urine-from-the-Foley-catheter-is-bloody---ans-✔✔D)-Hemorrhage-from-the-surgical-site-
requiring-deep-pressure-dressings
A-healthy,-primiparous-(first-time)-mother-delivered-a-healthy-infant-several-hours-ago,-
but-the-mother-has-experienced-postpartum-hemorrhage.-Which-of-the-following-
disorders-is-most-likely-to-underlie-the-client's-excessive-bleeding-after-delivery?
A)-Disseminated-intravascular-coagulation
B)-Hemophilia-A
C)-Von-Willebrand-disease
D)-Thrombotic-thrombocytopenic-purpura-(TTP)---ans-✔✔A)-Disseminated-intravascular-
coagulation
What-is-the-concept-behind-heparin-for-PT-with-DIC?---ans-✔✔-It-prevents-the-clotting-
phase-from-being-completed-which-inhibits-the-breakdown-of-fibrinogen.
--It-also-helps-avoid-hemorrhage-by-preventing-the-body-from-depleting-entire-stage-of-
coagulation-factors.
What-are-some-acute-clinical-manifestations-of-DIC?---ans-✔✔-Directly-related-to-
bleeding-problems-such-as:
-Petechia,-Purpura,-oozing-from-puncture-sites-or-severe-hemorrhaging.
How-does-DIC-happen-in-postpartum-hemorrhaging?---ans-✔✔-Tissue-factors-released-
from-necrotic-place/fetal-tissue-or-amniotic-fluid-my-enter-the-circulation,-inciting-DIC.
What-is-a-common-cause-of-DIC?---ans-✔✔-Sepsis
A-patient-with-DIC-is-at-a-higher-risk-for-what?---ans-✔✔-Deficient-fluid-volume
Increased-levels-of-____________,-_______________,-__________,-and-
________________-will-be-noted-in-DIC:---ans-✔✔-Fibrinolycin,-fibrinopeptide-A,-
positive-fibrin-split-products-and-D-dimers.
DIC-can-occur-secondary-to-what-type-of-conditions?-Select-all-that-apply:---ans-✔✔-
Abrupitoplacente-
-Amniotic-fluid-embolism
-Endotoxin-sepsis
-Retained-dead-fetus
-Post-hemorrhage-shock
-Hydatidformmole-
-Gynecologic-Malinganries
,DIC-can-be-decreased-as-a-loss-of-balance-between-what-two-activities?---ans-✔✔-Clot-
forming-activity-of-thrombin
-Clot-lysin-activity-of-plasmin
What-are-some-ways-to-combat-DIC?-Select-all-that-apply:---ans-✔✔-Anticoagulation-
therapy-(low-molecular-weight-heparin)
-Packed-RBCs
-Platelet-concentrate
-Antithrombin-concentrate
-Nonclotting-Protein--containing-volume-will-expand-like:-plasma-protein-fraction-or-
albumin
How-does-Heparin-work-in-the-circulatory-system?---ans-✔✔-Inhibits-thrombus-and-clot-
production-by-blocking-the-conversion-of-prothrombin-to-thrombin-&-fibrogen-to-fibrin.
What-are-some-adverse-effects-of-Heparin?-Select-all-that-apply:---ans-✔✔-Loss-of-hair
-Bruising
-Chills
-Fever
-Osteoporosis
-Suppression-of-renal-function
If-a-PT-has-an-allergic-reaction-to-Heparin,-what-drug-would-be-administered-as-
treatment?---ans-✔✔--Lepirudin-(refludan)
In-DIC,-microemboli-may-obstruct-blood-vessels-and-cause-tissue-hypoxia/-necrotic-
damage-to-which-organ-structures?-Select-all-that-apply:---ans-✔✔-Kidneys
-Heart
-Lungs
-Brain
The-treatment-of-DIC-is-directed-toward-managing-what?---ans-✔✔-The-Primary-disease
-Replacing-clotting-components
-Preventing-further-activation-of-clotting-mechanisms
How-do-you-correct-the-clotting-factor-deficiency-in-DIC?---ans-✔✔-Transition-of-FFP
--"-"-platelets
--"-"-fibrinogen-containing-cryoprecipitate
How-does-DIC-initiate-activation-of-the-extrinsic-pathway?---ans-✔✔-Occurs-with-
liberation-of-tissue-factor-and-associated-with-obstetric-complications,-trauma,-bacterial-
sepsis-&-cancer
How-does-DIC-initiate-activation-of-the-intrinsic-pathway?---ans-✔✔-Activated-through-
extensive-endothelial-damage-with-activation-of-factor-XII.-This-results-from-viruses,-
infections,-immune-mechanisms,-stasis-of-blood-or-temperature-extremes.
, What-are-some-potential-therapies-to-DIC-other-than-Heparin?---ans-✔✔-Tissue-factor-
pathway-inhibitors,-antithrombin,-Protein-C-concentrates,-&-anti-inflammatory-cytokines-
like-INL-I
What-are-some-obstetric-conditions-that-have-been-associated-with-DIC?---ans-✔✔-
Abrupito-placentratae
-Dead-fetus-syndrome
-Pre-eclampsia-&-eclampsia
-Amniotic-fluid-embolism
What-are-some-Cancers-that-have-been-associated-with-DIC-?---ans-✔✔-Metastatic-
cancer
-Acute-leukemia
What-are-some-infections-associations-with-DIC?---ans-✔✔-Acute-bacterial-infections-
(meningococal-meningitis)
-Histoplasmosis,-Aspergicrosis
-Ricketsial-Infections-(rocky-mountain-spotted-fever)
-Parasitic-infections-(malaria)
-Sepsis/-Septic-shock
What-are-some-trauma-signs-that-have-been-associated-with-DIC?---ans-✔✔-Burns
-Heatstroke
-Massive-traumas
-Snake-bite
-Surgery-including-extracorpeal-circulation?
What-are-some-hematologic-conditions-associated-with-DIC?---ans-✔✔-Blood-
Transfusions-Reactions
What-clinical-manifestations-of-DIC-are-primarily-involved?---ans-✔✔-Compromise-of-
organ-function-or-failure
-PT-typically-develop-mods
How-is-bleeding-characterized-in-DIC?---ans-✔✔-Decreased-Platelet-count
-Decreased-fibrinogen-levels
-Prolonged-PT,-ApT-(thrombiotic)
-Increased-Fibrinogen-Degradation
-Increased-D-dimers
PT-with-Frank-DIC-typically-bleed-from-where?---ans-✔✔-Mucous-Membranes
-Venipuncture-Sites
-GI-Urinary-Tracts
QUESTIONS AND ANSWERS
What-lab-testing-results-are-indicative-of-DIC?---ans-✔✔-Prothrombin-Time-(PT)
-partial-throboplastin-time-(PTT)
-Activated-Partial-Thrompoplastin-Time-(aPTT)
-Bleeding-Time
-Thrombin-Time
Decrease-levels:--Fibrogen
--Platelets
--Clotine-factor-II,-V,-VIII,-&-X
and-Antithrombin-III
The-nurse-is-reviewing-the-laboratory-test-results-of-a-child-diagnosed-with-disseminated-
intravascular-coagulation-(DIC).-Which-of-the-following-would-the-nurse-interpret-as-
indicative-of-this-disorder?
-
A)-Shortened-prothrombin-time-
B)-Increased-fibrinogen-level-
C)-Positive-fibrin-split-products-
D)-Increased-platelets---ans-✔✔C)-Positive-fibrin-split-products
The-nurse-is-caring-for-a-postpartum-patient-admitted-to-the-intensive-care-unit-with-a-
diagnosis-of-disseminated-intravascular-coagulation-(DIC).-What-is-the-drug-of-choice-to-
treat-this-problem?
A.-Heparin
B.-Urokinase
C.-Aspirin
D.-Warfarin---ans-✔✔A.)-Heparin
In-the-ICU,-a-postsurgical-client-has-developed-sepsis-and-is-being-treated-with-multiple-
medications.-During-the-mid-morning-assessment,-which-finding-leads-the-nurse-to-
suspect-the-client-may-be-developing-a-complication-called-disseminated-intravascular-
coagulation-(DIC)?-Select-all-that-apply.
A)-Headaches-associated-with-light-sensitivity
,B)-Oozing-from-all-previous-puncture-and-intravenous-sites
C)-Decreased-O2-saturation-and-diminished-breath-sounds-in-lower-lobes
D)-Hemorrhage-from-the-surgical-site-requiring-deep-pressure-dressings
E)-Urine-from-the-Foley-catheter-is-bloody---ans-✔✔D)-Hemorrhage-from-the-surgical-site-
requiring-deep-pressure-dressings
A-healthy,-primiparous-(first-time)-mother-delivered-a-healthy-infant-several-hours-ago,-
but-the-mother-has-experienced-postpartum-hemorrhage.-Which-of-the-following-
disorders-is-most-likely-to-underlie-the-client's-excessive-bleeding-after-delivery?
A)-Disseminated-intravascular-coagulation
B)-Hemophilia-A
C)-Von-Willebrand-disease
D)-Thrombotic-thrombocytopenic-purpura-(TTP)---ans-✔✔A)-Disseminated-intravascular-
coagulation
What-is-the-concept-behind-heparin-for-PT-with-DIC?---ans-✔✔-It-prevents-the-clotting-
phase-from-being-completed-which-inhibits-the-breakdown-of-fibrinogen.
--It-also-helps-avoid-hemorrhage-by-preventing-the-body-from-depleting-entire-stage-of-
coagulation-factors.
What-are-some-acute-clinical-manifestations-of-DIC?---ans-✔✔-Directly-related-to-
bleeding-problems-such-as:
-Petechia,-Purpura,-oozing-from-puncture-sites-or-severe-hemorrhaging.
How-does-DIC-happen-in-postpartum-hemorrhaging?---ans-✔✔-Tissue-factors-released-
from-necrotic-place/fetal-tissue-or-amniotic-fluid-my-enter-the-circulation,-inciting-DIC.
What-is-a-common-cause-of-DIC?---ans-✔✔-Sepsis
A-patient-with-DIC-is-at-a-higher-risk-for-what?---ans-✔✔-Deficient-fluid-volume
Increased-levels-of-____________,-_______________,-__________,-and-
________________-will-be-noted-in-DIC:---ans-✔✔-Fibrinolycin,-fibrinopeptide-A,-
positive-fibrin-split-products-and-D-dimers.
DIC-can-occur-secondary-to-what-type-of-conditions?-Select-all-that-apply:---ans-✔✔-
Abrupitoplacente-
-Amniotic-fluid-embolism
-Endotoxin-sepsis
-Retained-dead-fetus
-Post-hemorrhage-shock
-Hydatidformmole-
-Gynecologic-Malinganries
,DIC-can-be-decreased-as-a-loss-of-balance-between-what-two-activities?---ans-✔✔-Clot-
forming-activity-of-thrombin
-Clot-lysin-activity-of-plasmin
What-are-some-ways-to-combat-DIC?-Select-all-that-apply:---ans-✔✔-Anticoagulation-
therapy-(low-molecular-weight-heparin)
-Packed-RBCs
-Platelet-concentrate
-Antithrombin-concentrate
-Nonclotting-Protein--containing-volume-will-expand-like:-plasma-protein-fraction-or-
albumin
How-does-Heparin-work-in-the-circulatory-system?---ans-✔✔-Inhibits-thrombus-and-clot-
production-by-blocking-the-conversion-of-prothrombin-to-thrombin-&-fibrogen-to-fibrin.
What-are-some-adverse-effects-of-Heparin?-Select-all-that-apply:---ans-✔✔-Loss-of-hair
-Bruising
-Chills
-Fever
-Osteoporosis
-Suppression-of-renal-function
If-a-PT-has-an-allergic-reaction-to-Heparin,-what-drug-would-be-administered-as-
treatment?---ans-✔✔--Lepirudin-(refludan)
In-DIC,-microemboli-may-obstruct-blood-vessels-and-cause-tissue-hypoxia/-necrotic-
damage-to-which-organ-structures?-Select-all-that-apply:---ans-✔✔-Kidneys
-Heart
-Lungs
-Brain
The-treatment-of-DIC-is-directed-toward-managing-what?---ans-✔✔-The-Primary-disease
-Replacing-clotting-components
-Preventing-further-activation-of-clotting-mechanisms
How-do-you-correct-the-clotting-factor-deficiency-in-DIC?---ans-✔✔-Transition-of-FFP
--"-"-platelets
--"-"-fibrinogen-containing-cryoprecipitate
How-does-DIC-initiate-activation-of-the-extrinsic-pathway?---ans-✔✔-Occurs-with-
liberation-of-tissue-factor-and-associated-with-obstetric-complications,-trauma,-bacterial-
sepsis-&-cancer
How-does-DIC-initiate-activation-of-the-intrinsic-pathway?---ans-✔✔-Activated-through-
extensive-endothelial-damage-with-activation-of-factor-XII.-This-results-from-viruses,-
infections,-immune-mechanisms,-stasis-of-blood-or-temperature-extremes.
, What-are-some-potential-therapies-to-DIC-other-than-Heparin?---ans-✔✔-Tissue-factor-
pathway-inhibitors,-antithrombin,-Protein-C-concentrates,-&-anti-inflammatory-cytokines-
like-INL-I
What-are-some-obstetric-conditions-that-have-been-associated-with-DIC?---ans-✔✔-
Abrupito-placentratae
-Dead-fetus-syndrome
-Pre-eclampsia-&-eclampsia
-Amniotic-fluid-embolism
What-are-some-Cancers-that-have-been-associated-with-DIC-?---ans-✔✔-Metastatic-
cancer
-Acute-leukemia
What-are-some-infections-associations-with-DIC?---ans-✔✔-Acute-bacterial-infections-
(meningococal-meningitis)
-Histoplasmosis,-Aspergicrosis
-Ricketsial-Infections-(rocky-mountain-spotted-fever)
-Parasitic-infections-(malaria)
-Sepsis/-Septic-shock
What-are-some-trauma-signs-that-have-been-associated-with-DIC?---ans-✔✔-Burns
-Heatstroke
-Massive-traumas
-Snake-bite
-Surgery-including-extracorpeal-circulation?
What-are-some-hematologic-conditions-associated-with-DIC?---ans-✔✔-Blood-
Transfusions-Reactions
What-clinical-manifestations-of-DIC-are-primarily-involved?---ans-✔✔-Compromise-of-
organ-function-or-failure
-PT-typically-develop-mods
How-is-bleeding-characterized-in-DIC?---ans-✔✔-Decreased-Platelet-count
-Decreased-fibrinogen-levels
-Prolonged-PT,-ApT-(thrombiotic)
-Increased-Fibrinogen-Degradation
-Increased-D-dimers
PT-with-Frank-DIC-typically-bleed-from-where?---ans-✔✔-Mucous-Membranes
-Venipuncture-Sites
-GI-Urinary-Tracts
