NR574 LATEST 2026 EXAMS QUESTIONS AND
SOLUTIONS GUARANTEE A+
✔✔The most commonly used TKIs for CML include: - ✔✔imitanib, bosutinib, nilotinib,
ponatinib, and dasatinib.
✔✔Splenic irradiation or splenectomy may be required for those in what stage of CML?
- ✔✔-Late stage-who develop significant pain secondary to splenomegaly or
leukapheresis -may be performed for clients with WBC > 300,000 μL.
✔✔Stem cell transplantation is reserved for which CML patients? - ✔✔clients who fail to
achieve remission with or those who fail imatinib and second-generation TKIs.
✔✔what complications are associated with CLL? - ✔✔-infections,-autoimmune
complications including cytopenias, vasculitis, neuropathies, thrombo-
cytopenia, glomerulonephritis-secondary malignancies: skin, prostate, and breast
cancers. -transformation into lymphomas
✔✔what is Richter's transformation in terms of CLL complications? - ✔✔occurs when
CLL transforms into aggressive diffuse large B-cell lymphoma which has a median
survival rate of only 6 to 16 months.
✔✔What is hemophilia? - ✔✔Hemophilia is a disorder of blood clotting caused by anX-
linked recessive defect (spontaneous or hereditary).-Most hemophilia cases are
inherited, and the disease commonly affects males more than females.-Hemophilia
results from impaired secondary hemostasis due to a defect in the coagulation cascade.
✔✔Hemophilia is classified by identifying the deficient clotting factor: what are the 3
clotting factors? - ✔✔hemophilia A (factor VIII) ~ 80 % of cases hemophilia B (factor IX)
~ 20% of cases hemophilia C (factor XI) ~ very rare < 1%
✔✔what things should you ask a patient with suspected hemophilia in regards to
bleeding? - ✔✔Clients with suspected or diagnosed hemophilia should be assessed for
-prior bleeding episodes;-abnormal bleeding with menstrual cycles,-dental procedures,
or surgical intervention;
-family history of bleeding disorders;-family history of work-up for bleeding disorders.
✔✔Clinical Tip: Petechial bleeding is a common sign of - ✔✔platelet disorders, NOT
coagulation disorders such as hemophilia.
✔✔Hemarthrosis - ✔✔Hemarthrosis is a condition of articular bleeding, that is into the
joint cavity. This can occur after an injury or, more commonly, in bleeding disorders
such as hemophilia. Patients will typically present with pain, swelling and a decreased
range of motion of the involved joint.
,✔✔management of hemarthrosis - ✔✔-receive factor concentrate infusion within 2
hours of presentation with joint bleeding.-The goal of factor concentrate infusion for
hemarthrosis is an activity level of approximately 50 percent.Clients with hemophilia B
should receive 50 to 60 units/kg of factor IX.
✔✔If a patient has Hemophilia A and presents with hemarthrosis, what med- ication
should they receive - ✔✔-Clients with hemophilia A should receive 25 units/kg of factor
VIII. -within 2 hours of presentation with joint bleeding
-If bleeding does not resolve, a higher dose may be required. Clients with joint bleeding
as a result of trauma often require a higher target factor activity level.
✔✔If a patient has Hemophilia B and presents with hemarthrosis, what med- ication
should they receive - ✔✔Clients with hemophilia B should receive 50 to 60 units/kg of
factor IX-within 2 hours of presentation with joint bleeding-If bleeding does not resolve,
a higher dose may be required. Clients with joint bleeding as a result of trauma often
require a higher target factor activity level.
✔✔Clinical findings in hemophilia: Musculoskeletal - ✔✔Spontaneous hemarthrosis
(bleeding into the joint space) is the hallmark of the disease
-Recurrent bleeding in the joint capsule can result in chronic, debilitating hemarthroses
causing synovial thickening, or synovitis, leading to progressive joint deformity.
-Hematomas into the muscle of distal parts of the limbs may lead to external
compression of arteries, veins, or nerves that can evolve into compartment syndrome
-Hemarthrosis is a clinical diagnosis based on complaints of pain, erythema, and
swelling in the affected joint, reduced mobility, and corresponding history.
✔✔Clinical findings in hemophilia: Intracranial - ✔✔Intracranial hemorrhages (ICH)may
occur spontaneously or following trauma. Hemorrhages may occur several weeks after
the initial trauma has occurred. In clients with moderate to severe hemophilia, even
minor trauma may result in ICH.
✔✔Clinical findings in hemophilia: GI/GU - ✔✔Genitourinary (GU) tract-Hematuria is
common. Bleeding may arise from the kidneys or bladder and can persist for days to
weeks.Gastrointestinal (GI) tract-Hematemesis or melena may occur from swallowed
blood after epistaxis.-Bleeding may also occur from esophagitis, gastritis, peptic ulcers,
diverticula, or polyps.
✔✔Clinical findings in hemophiliaL ENT - ✔✔Ear, nose, and throat (ENT)-Epistaxis is
common and can be prolonged and severe but is usually self-limiting.-Bleeding from
oral mucosa and gingiva can occur following dental procedures or from trauma.
✔✔aPTT will be ______ in clients with hemophilia A or B. - ✔✔prolonged
, ✔✔Clients with hemophilia A will have a _______ factor level? - ✔✔diminished factor
VIII level
✔✔Clients with hemophilia B will have a _____ factor level? - ✔✔low factor IX level
✔✔Management of Life-threatening Acute Bleeding: Hemophilia A - ✔✔Acute bleeding
is managed with urgent infusions of factor concentrate.
-The goal of factor concentrate infusions is the production of a factor activity level of80
to 100 percent.
-Clients with hemophilia A should receive 50 units/kg of factor VIII
-Following this initial dose, factor concentrate dosing should be administered at specific
intervals based upon trough and peak factor levels.
✔✔Management of Life-threatening Acute Bleeding: Hemophilia B - ✔✔Acute bleeding
is managed with urgent infusions of factor concentrate.
-The goal of factor concentrate infusions is the production of a factor activity level of80
to 100 percent.-clients with hemophilia B should receive 100-120 units/kg of factor IX.-
Following this initial dose, factor concentrate dosing should be administered at specific
intervals based upon trough and peak factor levels.
✔✔In patient with hemophilia, if they present with bleeding from the gums, after an oral
surgery or from the GI tract, what medication is recommended and why? -
✔✔Antifibrinolytic therapy can be useful for stabilizing clots Meds: e-amino caproic acid
(EACA) or TXAthis is to prevent fibrin degradation by plasmin.
✔✔Hemophilia: TXA dosing - ✔✔-1 week or longer
-25mg/kg 3-4 times per day
✔✔hemophilia: EACA dosing - ✔✔-1week or longer
-loading dose: 200mg/kg (max: 10g)
-followed by 100mg/kg (max 30g/day) q 6 hrs.
✔✔Hemophilia: Emicizumab what is it used for and what is the dosing? - ✔✔Emi-
cizumab is a monoclonal antibody approved for use as a prophylactic agent against
bleeding in infants, children, and adults with hemophilia A.
-Initial dosing in adult clients is 3 mg/kg once weekly via subcutaneous injection for four
weeks. -Maintenance dosing is 1.5 mg/kg once weekly or 3mg/kg once every 2 weeks
or 6 mg/kg once every 4 weeks.
✔✔hemophilia: DDAVP what is it used for? - ✔✔DDAVP is a synthetic vasopressin
analog that causes a transient rise in FVIII and VWF but not FIX (desmopressin acetate
tablets) (will work in type A not type B)
SOLUTIONS GUARANTEE A+
✔✔The most commonly used TKIs for CML include: - ✔✔imitanib, bosutinib, nilotinib,
ponatinib, and dasatinib.
✔✔Splenic irradiation or splenectomy may be required for those in what stage of CML?
- ✔✔-Late stage-who develop significant pain secondary to splenomegaly or
leukapheresis -may be performed for clients with WBC > 300,000 μL.
✔✔Stem cell transplantation is reserved for which CML patients? - ✔✔clients who fail to
achieve remission with or those who fail imatinib and second-generation TKIs.
✔✔what complications are associated with CLL? - ✔✔-infections,-autoimmune
complications including cytopenias, vasculitis, neuropathies, thrombo-
cytopenia, glomerulonephritis-secondary malignancies: skin, prostate, and breast
cancers. -transformation into lymphomas
✔✔what is Richter's transformation in terms of CLL complications? - ✔✔occurs when
CLL transforms into aggressive diffuse large B-cell lymphoma which has a median
survival rate of only 6 to 16 months.
✔✔What is hemophilia? - ✔✔Hemophilia is a disorder of blood clotting caused by anX-
linked recessive defect (spontaneous or hereditary).-Most hemophilia cases are
inherited, and the disease commonly affects males more than females.-Hemophilia
results from impaired secondary hemostasis due to a defect in the coagulation cascade.
✔✔Hemophilia is classified by identifying the deficient clotting factor: what are the 3
clotting factors? - ✔✔hemophilia A (factor VIII) ~ 80 % of cases hemophilia B (factor IX)
~ 20% of cases hemophilia C (factor XI) ~ very rare < 1%
✔✔what things should you ask a patient with suspected hemophilia in regards to
bleeding? - ✔✔Clients with suspected or diagnosed hemophilia should be assessed for
-prior bleeding episodes;-abnormal bleeding with menstrual cycles,-dental procedures,
or surgical intervention;
-family history of bleeding disorders;-family history of work-up for bleeding disorders.
✔✔Clinical Tip: Petechial bleeding is a common sign of - ✔✔platelet disorders, NOT
coagulation disorders such as hemophilia.
✔✔Hemarthrosis - ✔✔Hemarthrosis is a condition of articular bleeding, that is into the
joint cavity. This can occur after an injury or, more commonly, in bleeding disorders
such as hemophilia. Patients will typically present with pain, swelling and a decreased
range of motion of the involved joint.
,✔✔management of hemarthrosis - ✔✔-receive factor concentrate infusion within 2
hours of presentation with joint bleeding.-The goal of factor concentrate infusion for
hemarthrosis is an activity level of approximately 50 percent.Clients with hemophilia B
should receive 50 to 60 units/kg of factor IX.
✔✔If a patient has Hemophilia A and presents with hemarthrosis, what med- ication
should they receive - ✔✔-Clients with hemophilia A should receive 25 units/kg of factor
VIII. -within 2 hours of presentation with joint bleeding
-If bleeding does not resolve, a higher dose may be required. Clients with joint bleeding
as a result of trauma often require a higher target factor activity level.
✔✔If a patient has Hemophilia B and presents with hemarthrosis, what med- ication
should they receive - ✔✔Clients with hemophilia B should receive 50 to 60 units/kg of
factor IX-within 2 hours of presentation with joint bleeding-If bleeding does not resolve,
a higher dose may be required. Clients with joint bleeding as a result of trauma often
require a higher target factor activity level.
✔✔Clinical findings in hemophilia: Musculoskeletal - ✔✔Spontaneous hemarthrosis
(bleeding into the joint space) is the hallmark of the disease
-Recurrent bleeding in the joint capsule can result in chronic, debilitating hemarthroses
causing synovial thickening, or synovitis, leading to progressive joint deformity.
-Hematomas into the muscle of distal parts of the limbs may lead to external
compression of arteries, veins, or nerves that can evolve into compartment syndrome
-Hemarthrosis is a clinical diagnosis based on complaints of pain, erythema, and
swelling in the affected joint, reduced mobility, and corresponding history.
✔✔Clinical findings in hemophilia: Intracranial - ✔✔Intracranial hemorrhages (ICH)may
occur spontaneously or following trauma. Hemorrhages may occur several weeks after
the initial trauma has occurred. In clients with moderate to severe hemophilia, even
minor trauma may result in ICH.
✔✔Clinical findings in hemophilia: GI/GU - ✔✔Genitourinary (GU) tract-Hematuria is
common. Bleeding may arise from the kidneys or bladder and can persist for days to
weeks.Gastrointestinal (GI) tract-Hematemesis or melena may occur from swallowed
blood after epistaxis.-Bleeding may also occur from esophagitis, gastritis, peptic ulcers,
diverticula, or polyps.
✔✔Clinical findings in hemophiliaL ENT - ✔✔Ear, nose, and throat (ENT)-Epistaxis is
common and can be prolonged and severe but is usually self-limiting.-Bleeding from
oral mucosa and gingiva can occur following dental procedures or from trauma.
✔✔aPTT will be ______ in clients with hemophilia A or B. - ✔✔prolonged
, ✔✔Clients with hemophilia A will have a _______ factor level? - ✔✔diminished factor
VIII level
✔✔Clients with hemophilia B will have a _____ factor level? - ✔✔low factor IX level
✔✔Management of Life-threatening Acute Bleeding: Hemophilia A - ✔✔Acute bleeding
is managed with urgent infusions of factor concentrate.
-The goal of factor concentrate infusions is the production of a factor activity level of80
to 100 percent.
-Clients with hemophilia A should receive 50 units/kg of factor VIII
-Following this initial dose, factor concentrate dosing should be administered at specific
intervals based upon trough and peak factor levels.
✔✔Management of Life-threatening Acute Bleeding: Hemophilia B - ✔✔Acute bleeding
is managed with urgent infusions of factor concentrate.
-The goal of factor concentrate infusions is the production of a factor activity level of80
to 100 percent.-clients with hemophilia B should receive 100-120 units/kg of factor IX.-
Following this initial dose, factor concentrate dosing should be administered at specific
intervals based upon trough and peak factor levels.
✔✔In patient with hemophilia, if they present with bleeding from the gums, after an oral
surgery or from the GI tract, what medication is recommended and why? -
✔✔Antifibrinolytic therapy can be useful for stabilizing clots Meds: e-amino caproic acid
(EACA) or TXAthis is to prevent fibrin degradation by plasmin.
✔✔Hemophilia: TXA dosing - ✔✔-1 week or longer
-25mg/kg 3-4 times per day
✔✔hemophilia: EACA dosing - ✔✔-1week or longer
-loading dose: 200mg/kg (max: 10g)
-followed by 100mg/kg (max 30g/day) q 6 hrs.
✔✔Hemophilia: Emicizumab what is it used for and what is the dosing? - ✔✔Emi-
cizumab is a monoclonal antibody approved for use as a prophylactic agent against
bleeding in infants, children, and adults with hemophilia A.
-Initial dosing in adult clients is 3 mg/kg once weekly via subcutaneous injection for four
weeks. -Maintenance dosing is 1.5 mg/kg once weekly or 3mg/kg once every 2 weeks
or 6 mg/kg once every 4 weeks.
✔✔hemophilia: DDAVP what is it used for? - ✔✔DDAVP is a synthetic vasopressin
analog that causes a transient rise in FVIII and VWF but not FIX (desmopressin acetate
tablets) (will work in type A not type B)
