RNSG 2539 EXAM 2 LATEST 2025-2026 ACTUAL EXAM 220
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED A+
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 |- |answer-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 |- |answer-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 |- |answer-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) |- |answer-A) |Disseminated |intravascular |coagulation
What |is |the |concept |behind |heparin |for |PT |with |DIC? |- |answer--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? |- |answer--Directly |related |to |bleeding |problems
|such |as:
Petechia, |Purpura, |oozing |from |puncture |sites |or |severe |hemorrhaging.
How |does |DIC |happen |in |postpartum |hemorrhaging? |- |answer--Tissue |factors |released |from |necrotic
|place/fetal |tissue |or |amniotic |fluid |my |enter |the |circulation, |inciting |DIC.
What |is |a |common |cause |of |DIC? |- |answer--Sepsis
A |patient |with |DIC |is |at |a |higher |risk |for |what? |- |answer--Deficient |fluid |volume
Increased |levels |of | ,| ,| , |and | will |be
|noted |in |DIC: |- |answer--Fibrinolycin, |fibrinopeptide |A, |positive |fibrin |split |products |and |D-
dimers.
DIC |can |occur |secondary |to |what |type |of |conditions? |Select |all |that |apply: |- |answer--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? |- |answer--Clot |forming |activity
|of |thrombin
-Clot |lysin |activity |of |plasmin
What |are |some |ways |to |combat |DIC? |Select |all |that |apply: |- |answer--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? |- |answer--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: |- |answer--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? |- |answer--
|Lepirudin |(refludan)
In |DIC, |microemboli |may |obstruct |blood |vessels |and |cause |tissue |hypoxia/ |necrotic |damage |to |which
|organ |structures? |Select |all |that |apply: |- |answer--Kidneys
-Heart
-Lungs
-Brain
, The |treatment |of |DIC |is |directed |toward |managing |what? |- |answer--The |Primary |disease
-Replacing |clotting |components
-Preventing |further |activation |of |clotting |mechanisms
How |do |you |correct |the |clotting |factor |deficiency |in |DIC? |- |answer--Transition |of |FFP
- " |" |platelets
- " |" |fibrinogen |containing |cryoprecipitate
How |does |DIC |initiate |activation |of |the |extrinsic |pathway? |- |answer--Occurs |with |liberation |of |tissue
|factor |and |associated |with |obstetric |complications, |trauma, |bacterial |sepsis |& |cancer
How |does |DIC |initiate |activation |of |the |intrinsic |pathway? |- |answer--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? |- |answer--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? |- |answer--Abrupito
|placentratae
-Dead |fetus |syndrome
-Pre-eclampsia |& |eclampsia
-Amniotic |fluid |embolism
What |are |some |Cancers |that |have |been |associated |with |DIC |? |- |answer--Metastatic |cancer
-Acute |leukemia
What |are |some |infections |associations |with |DIC? |- |answer--Acute |bacterial |infections |(meningococal
|meningitis)
-Histoplasmosis, |Aspergicrosis
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED A+
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 |- |answer-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 |- |answer-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 |- |answer-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) |- |answer-A) |Disseminated |intravascular |coagulation
What |is |the |concept |behind |heparin |for |PT |with |DIC? |- |answer--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? |- |answer--Directly |related |to |bleeding |problems
|such |as:
Petechia, |Purpura, |oozing |from |puncture |sites |or |severe |hemorrhaging.
How |does |DIC |happen |in |postpartum |hemorrhaging? |- |answer--Tissue |factors |released |from |necrotic
|place/fetal |tissue |or |amniotic |fluid |my |enter |the |circulation, |inciting |DIC.
What |is |a |common |cause |of |DIC? |- |answer--Sepsis
A |patient |with |DIC |is |at |a |higher |risk |for |what? |- |answer--Deficient |fluid |volume
Increased |levels |of | ,| ,| , |and | will |be
|noted |in |DIC: |- |answer--Fibrinolycin, |fibrinopeptide |A, |positive |fibrin |split |products |and |D-
dimers.
DIC |can |occur |secondary |to |what |type |of |conditions? |Select |all |that |apply: |- |answer--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? |- |answer--Clot |forming |activity
|of |thrombin
-Clot |lysin |activity |of |plasmin
What |are |some |ways |to |combat |DIC? |Select |all |that |apply: |- |answer--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? |- |answer--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: |- |answer--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? |- |answer--
|Lepirudin |(refludan)
In |DIC, |microemboli |may |obstruct |blood |vessels |and |cause |tissue |hypoxia/ |necrotic |damage |to |which
|organ |structures? |Select |all |that |apply: |- |answer--Kidneys
-Heart
-Lungs
-Brain
, The |treatment |of |DIC |is |directed |toward |managing |what? |- |answer--The |Primary |disease
-Replacing |clotting |components
-Preventing |further |activation |of |clotting |mechanisms
How |do |you |correct |the |clotting |factor |deficiency |in |DIC? |- |answer--Transition |of |FFP
- " |" |platelets
- " |" |fibrinogen |containing |cryoprecipitate
How |does |DIC |initiate |activation |of |the |extrinsic |pathway? |- |answer--Occurs |with |liberation |of |tissue
|factor |and |associated |with |obstetric |complications, |trauma, |bacterial |sepsis |& |cancer
How |does |DIC |initiate |activation |of |the |intrinsic |pathway? |- |answer--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? |- |answer--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? |- |answer--Abrupito
|placentratae
-Dead |fetus |syndrome
-Pre-eclampsia |& |eclampsia
-Amniotic |fluid |embolism
What |are |some |Cancers |that |have |been |associated |with |DIC |? |- |answer--Metastatic |cancer
-Acute |leukemia
What |are |some |infections |associations |with |DIC? |- |answer--Acute |bacterial |infections |(meningococal
|meningitis)
-Histoplasmosis, |Aspergicrosis
