NR574 ACUTE CARE PRACTICUM STUDY
GUIDE 2026 COMPLETE QUESTIONS AND
ANSWERS
◉ Clinical findings in hemophilia: Intracranial Answer: 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 Answer: 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 Answer: 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. Answer:
prolonged
,◉ Clients with hemophilia A will have a _______ factor level? Answer:
diminished factor VIII level
◉ Clients with hemophilia B will have a _____ factor level? Answer:
low factor IX level
◉ Management of Life-threatening Acute Bleeding: Hemophilia A
Answer: 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
Answer: 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? Answer: 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 Answer: -1 week or longer
-25mg/kg 3-4 times per day
◉ hemophilia: EACA dosing Answer: -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? Answer: 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? Answer: 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)
-can be administered intranasally, subcutaneously, or intravenously
prior to elective procedures in clients with mild hemophilia A. These
clients must receive a test dose with a documented response prior to
elective administration.
◉ A 13-year-old boy is brought to the emergency department after
falling from his bicycle. He presents with a large, painfully swollen
knee; aspiration shows gross hemarthrosis. On further questioning,
the client's parents say that he bruises easily and has frequent
nosebleeds. His maternal uncle had similar bleeding difficulties.
Which of the following laboratory studies should prompt the
AGACNP to suspect the presence of hemophilia? Answer: Normal
platelet count, prolonged aPTT, normal PT
◉ Which of the following genetic markers are used to diagnose
CML? Answer: Philadelphia chromosome
◉ Jerome is a 72-year-old client who presents to the emergency
department (ED) with an acute exacerbation of chronic obstructive
pulmonary disease (COPD). A review of symptoms reveals SOB,
wheezing, and increased rescue inhaler over the last 2 days.findings
also include unintentional weight loss (> 10% in 6 months), fever,
GUIDE 2026 COMPLETE QUESTIONS AND
ANSWERS
◉ Clinical findings in hemophilia: Intracranial Answer: 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 Answer: 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 Answer: 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. Answer:
prolonged
,◉ Clients with hemophilia A will have a _______ factor level? Answer:
diminished factor VIII level
◉ Clients with hemophilia B will have a _____ factor level? Answer:
low factor IX level
◉ Management of Life-threatening Acute Bleeding: Hemophilia A
Answer: 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
Answer: 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? Answer: 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 Answer: -1 week or longer
-25mg/kg 3-4 times per day
◉ hemophilia: EACA dosing Answer: -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? Answer: 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? Answer: 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)
-can be administered intranasally, subcutaneously, or intravenously
prior to elective procedures in clients with mild hemophilia A. These
clients must receive a test dose with a documented response prior to
elective administration.
◉ A 13-year-old boy is brought to the emergency department after
falling from his bicycle. He presents with a large, painfully swollen
knee; aspiration shows gross hemarthrosis. On further questioning,
the client's parents say that he bruises easily and has frequent
nosebleeds. His maternal uncle had similar bleeding difficulties.
Which of the following laboratory studies should prompt the
AGACNP to suspect the presence of hemophilia? Answer: Normal
platelet count, prolonged aPTT, normal PT
◉ Which of the following genetic markers are used to diagnose
CML? Answer: Philadelphia chromosome
◉ Jerome is a 72-year-old client who presents to the emergency
department (ED) with an acute exacerbation of chronic obstructive
pulmonary disease (COPD). A review of symptoms reveals SOB,
wheezing, and increased rescue inhaler over the last 2 days.findings
also include unintentional weight loss (> 10% in 6 months), fever,
