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RNSG 2539 FINAL EXAM AND STUDY GUIDE NEWEST

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RNSG 2539 FINAL EXAM AND STUDY GUIDE NEWEST 2025/ 2026 TEST BANK| COMPLETE 850 REAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) GRADED A+| RNSG 2539 EXAM PREP (BRAND NEW!!) 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 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) A) Disseminated intravascular coagulation What is the concept behind heparin for PT with DIC? -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? problems such as: -Directly related to bleeding Petechia, Purpura, oozing from puncture sites or severe hemorrhaging. How does DIC happen in postpartum hemorrhaging? -Tissue factors released from necrotic place/fetal tissue or amniotic fluid my enter the circulation, inciting DIC. What is a common cause of DIC? -Sepsis A patient with DIC is at a higher risk for what? -Deficient fluid volume Increased levels of ____________, _______________, __________, and ________________ will be noted in DIC: -Fibrinolycin, fibrinopeptide A, positive fibrin split products and D-dimers. DIC can occur secondary to what type of conditions? Select all that apply: -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? -Clot forming activity of thrombin -Clot lysin activity of plasmin What are some ways to combat DIC? Select all that apply: -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? -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: -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?- Lepirudin (refludan) In DIC, microemboli may obstruct blood vessels and cause tissue hypoxia/ necrotic damage to which organ structures? Select all that apply: -Heart -Lungs -Brain -Kidneys The treatment of DIC is directed toward managing what? -The Primary disease -Replacing clotting components -Preventing further activation of clotting mechanisms How do you correct the clotting factor deficiency in DIC? -Transition of FFP - " " platelets - " " fibrinogen containing cryoprecipitate How does DIC initiate activation of the extrinsic pathway? -Occurs with liberation of tissue factor and associated with obstetric complications, trauma, bacterial sepsis & cancer How does DIC initiate activation of the intrinsic pathway? -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? -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? -Abrupito placentratae -Dead fetus syndrome -Pre-eclampsia & eclampsia -Amniotic fluid embolism What are some Cancers that have been associated with DIC ? -Acute leukemia -Metastatic cancer What are some infections associations with DIC? -Acute bacterial infections (meningococal meningitis)

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RNSG 2539
Course
RNSG 2539

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RNSG 2539 FINAL EXAM AND STUDY GUIDE NEWEST 2025/ 2026 TEST BANK| COMPLETE 850
REAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) GRADED
A+| RNSG 2539 EXAM PREP (BRAND NEW!!)



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 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) A) Disseminated intravascular coagulation



What is the concept behind heparin for PT with DIC? -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? -Directly related to bleeding
problems such as:

Petechia, Purpura, oozing from puncture sites or severe hemorrhaging.



How does DIC happen in postpartum hemorrhaging? -Tissue factors released from
necrotic place/fetal tissue or amniotic fluid my enter the circulation, inciting DIC.



What is a common cause of DIC? -Sepsis



A patient with DIC is at a higher risk for what? -Deficient fluid volume



Increased levels of ____________, _______________, __________, and ________________ will
be noted in DIC: -Fibrinolycin, fibrinopeptide A, positive fibrin split products and D-dimers.



DIC can occur secondary to what type of conditions? Select all that apply: -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? -Clot forming activity
of thrombin

-Clot lysin activity of plasmin

,What are some ways to combat DIC? Select all that apply: -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? -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: -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?
- Lepirudin (refludan)



In DIC, microemboli may obstruct blood vessels and cause tissue hypoxia/ necrotic damage to
which organ structures? Select all that apply: -Kidneys

-Heart

-Lungs

-Brain



The treatment of DIC is directed toward managing what? -The Primary disease

, -Replacing clotting components

-Preventing further activation of clotting mechanisms



How do you correct the clotting factor deficiency in DIC? -Transition of FFP

- " " platelets

- " " fibrinogen containing cryoprecipitate



How does DIC initiate activation of the extrinsic pathway? -Occurs with liberation of tissue
factor and associated with obstetric complications, trauma, bacterial sepsis & cancer



How does DIC initiate activation of the intrinsic pathway? -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? -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? -Abrupito
placentratae

-Dead fetus syndrome

-Pre-eclampsia & eclampsia

-Amniotic fluid embolism



What are some Cancers that have been associated with DIC ? -Metastatic cancer

-Acute leukemia



What are some infections associations with DIC? -Acute bacterial infections (meningococal
meningitis)

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Institution
RNSG 2539
Course
RNSG 2539

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