MCA III Final Exam - Practice Questions And Answers (Answered)

MCA III Final Exam - Practice Questions And Answers (Answered) Which client would be most at risk for developing disseminated intravascular coagulation (DIC)? 1. A 35 year old pregnant client with placenta previa 2. A 42 year old client with a pulmonary embolus 3. A 60 year old client receiving hemodialyasis 3 days a week 4. A 78 year old client with septicemia 4. A 78 year old client with septicemia DIC is a clinical syndrome that develops as a complication of a wide variety of other disorders, with sepsis being the most common cause of DIC The client is admitted with full-thickness burns may be developing DIC. Which signs/symptoms would support the diagnosis of DIC? 1. Oozing blood from the IV catheter site 2. Sudden onset of chest pain and frothy sputum 3. Foul smelling, concentrated urine 4. A reddened, inflamed central line catheter site 1. Oozing blood from the IV catheter site Signs and symptoms of DIC result from clotting and bleeding, ranging from oozing blood to bleeding from every body orifice and into the tissues Which lab result would the nurse expect in the client diagnosed with DIC? 1. A decreased prothrombin time (PT) 2. A low fibrinogen level 3. An increased platelet count 4. An increased white blood cell count 2. A low fibrinogen level Fibrinogen level helps predict bleeding in DIC. As it becomes lower, the risk of bleeding increases. Which collaborative treatment would the nurse anticipate in the client diagnosed with DIC? 1. Administer oral anticoagulants 2. Prepare for plasmapheresis 3. Administer fresh frozen plasma 4. Calculate the intake and output 3. Administer fresh frozen plasma Fresh frozen plasma and platelet concentrates are administered to restore clotting factors and platelets The nurse writes a diagnosis of "potential for fluid volume deficit related to bleeding" for a client diagnosed with DIC. Which would be an appropriate goal?  1. The client's clot formations will resolve in two days 2. The saturation of the client's dressings will be documented 3. The client will use lemon-glycerin swabs for oral care 4. The client's urine output will be > 30 mL per hour 4. The client's urine output will be > 30 mL per hour The problem is addressing the potential for hemorrhage, and a urine output of greater than 30 mL/hr indicates the kidneys are being adequately perfused and the body is not in shock. A patient with possible disseminated intravascular coagulation arrives in the emergency department with a blood pressure of 82/40, temperature 102° F (38.9° C), and severe back pain. Which physician order will the nurse implement first? a. Administer morphine sulfate 4 mg IV. b. Give acetaminophen (Tylenol) 650 mg. c. Infuse normal saline 500 mL over 30 minutes. d. Schedule complete blood count and coagulation studies. c. Infuse normal saline 500 mL over 30 minutes. The patient's blood pressure indicates hypovolemia caused by blood loss and should be addressed immediately to improve perfusion to vital organs. A patient with septicemia develops prolonged bleeding from venipuncture sites and blood in the stools. Which action is most important for the nurse to take?  a. Avoid other venipunctures.  b. Apply dressings to the sites.  c. Notify the health care provider.  d. Give prescribed proton-pump inhibitors. c. Notify the health care provider.  The patient's new onset of bleeding and diagnosis of sepsis suggest that disseminated intravascular coagulation (DIC) may have developed, which will require collaborative actions such as diagnostic testing, blood product administration, and heparin administration. The other actions are also appropriate, but the most important action should be to notify the health care provider so that DIC treatment can be initiated rapidly A patient's family member asks the nurse what caused the patient to develop disseminated intravascular coagulation (DIC). The nurse tells the family member that DIC a. is caused by an abnormal activation of clotting. b. occurs when the immune system attacks platelets. c. is a complication of cancer chemotherapy. d. is caused when hemolytic processes destroy erythrocytes. a. is caused by an abnormal activation of clotting. DIC is a disorder in which: a. the coagulation pathway is genetically altered, leading to thrombus formation in all major blood vessels b. an underlying disease depletes hemolytic factors in the blood, leading to diffuse thrombotic episodes and infarcts c. a disease process stimulates coagulation processes with resultant thrombosis, as well as depletion of clotting factors, leading to diffuse clotting and hemorrhage d. an inherited predisposition causes a deficiency of clotting factors that leads to overstimulation of coagulation processes in the vasculature c. a disease process stimulates coagulation processes with resultant thrombosis, as well as depletion of clotting factors, leading to diffuse clotting and hemorrhage The patient with leukemia has acute disseminated intravascular coagulation (DIC) and is bleeding. What diagnostic findings should the nurse expect to find?