NSG 210 Clotting Test Questions and Answers Rated A
A patient who has been receiving IV heparin heparin-induced thrombocytopenia (HIT)?
infusion and oral warfarin (Coumadin) for a deep
vein thrombosis (DVT) is diagnosed with heparin- a. Prothrombin time
induced thrombocytopenia (HIT) when the b. Erythrocyte count
platelet level drops to 110,000/µL. Which action c. Fibrinogen degradation products
will the nurse include in the plan of care? d. Activated partial thromboplastin time - -
ANS: D. Activated partial thromboplastin time
a. Prepare for platelet transfusion.
b. Discontinue the heparin infusion. Platelet aggregation in HIT causes neutralization
c. Administer prescribed warfarin (Coumadin). of heparin, so the activated partial thromboplastin
d. Use low-molecular-weight heparin (LMWH). - time will be shorter, and more heparin will be
-ANS: B. Discontinue the heparin infusion. needed to maintain therapeutic levels. The other
data will not be affected by HIT.
All heparin is discontinued when HIT is
diagnosed. The patient should be instructed to
never receive heparin or LMWH. Warfarin is
usually not given until the platelet count has The nurse is caring for a patient with type A
returned to 150,000/µL. The platelet count does hemophilia being admitted to the hospital with
not drop low enough in HIT for a platelet severe pain and swelling in the right knee. The
transfusion, and platelet transfusions increase nurse should
the risk for thrombosis.
a. Apply heat to the knee.
b. Immobilize the knee joint.
c. Assist the patient with light weight bearing.
Which intervention will be included in the nursing d. Perform passive range of motion to the knee. -
care plan for a patient with immune -ANS: B. Immobilize the knee joint.
thrombocytopenic purpura (ITP)?
The initial action should be total rest of the knee
a. Assign the patient to a private room. to minimize bleeding. Ice packs are used to
b. Avoid intramuscular (IM) injections. decrease bleeding. Range of motion (ROM) and
c. Use rinses rather than a soft toothbrush for weight-bearing exercise are contraindicated
oral care. initially, but after the bleeding stops, ROM and
d. Restrict activity to passive and active range of physical therapy are started.
motion. - -ANS: B. Avoid intramuscular
(IM) injections.
IM or subcutaneous injections should be avoided Which assessment finding should the nurse
because of the risk for bleeding. A soft caring for a patient with thrombocytopenia
toothbrush can be used for oral care. There is no communicate immediately to the health care
need to restrict activity or place the patient in a provider?
private room.
a. The platelet count is 52,000/µL.
b. The patient is difficult to arouse.
c. There are purpura on the oral mucosa.
Which laboratory result will the nurse expect to d. There are large bruises on the patient's back. -
show a decreased value if a patient develops -ANS: B. The patient is difficult to arouse.
, NSG 210 Clotting Test Questions and Answers Rated A
-ANS: C. Administer PRN acetaminophen
Difficulty in arousing the patient may indicate a (Tylenol).
cerebral hemorrhage, which is life threatening
and requires immediate action. The other The patient's clinical manifestations are
information should be documented and reported consistent with a febrile, nonhemolytic
but would not be unusual in a patient with transfusion reaction. The transfusion should be
thrombocytopenia. stopped and antipyretics administered for the
fever as ordered. A urine specimen is needed if
an acute hemolytic reaction is suspected.
Diphenhydramine is used for allergic reactions.
The nurse is planning to administer a transfusion This type of reaction does not indicate incorrect
of packed red blood cells (PRBCs) to a patient crossmatching.
with blood loss from gastrointestinal hemorrhage.
Which action can the nurse delegate to
unlicensed assistive personnel (UAP)?
A patient in the emergency department
a. Verify the patient identification (ID) according complains of back pain and difficulty breathing 15
to hospital policy. minutes after a transfusion of packed red blood
b. Obtain the temperature, blood pressure, and cells is started. The nurse's first action should be
pulse before the transfusion. to
c. Double-check the product numbers on the
PRBCs with the patient ID band. a. Administer oxygen therapy at a high flow rate.
d. Monitor the patient for shortness of breath or b. Obtain a urine specimen to send to the
chest pain during the transfusion. - -ANS: laboratory.
B. Obtain the temperature, blood pressure, and c. Notify the health care provider about the
pulse before the transfusion. symptoms.
d. Disconnect the transfusion and infuse normal
UAP education includes measurement of vital saline. - -ANS: D. Disconnect the
signs. UAP would report the vital signs to the transfusion and infuse normal saline.
registered nurse (RN). The other actions require
more education and a larger scope of practice The patient's symptoms indicate a possible acute
and should be done by licensed nursing staff hemolytic reaction caused by the transfusion.
members. The first action should be to disconnect the
transfusion and infuse normal saline. The other
actions also are needed but are not the highest
priority.
A postoperative patient receiving a transfusion of
packed red blood cells develops chills, fever,
headache, and anxiety 35 minutes after the
transfusion is started. After stopping the A patient with immune thrombocytopenic purpura
transfusion, what action should the nurse take? (ITP) has an order for a platelet transfusion.
Which information indicates that the nurse should
a. Give the PRN diphenhydramine . consult with the health care provider before
b. Send a urine specimen to the laboratory. obtaining and administering platelets?
c. Administer PRN acetaminophen (Tylenol).
d. Draw blood for a new type and crossmatch. - a. Platelet count is 42,000/uL.
A patient who has been receiving IV heparin heparin-induced thrombocytopenia (HIT)?
infusion and oral warfarin (Coumadin) for a deep
vein thrombosis (DVT) is diagnosed with heparin- a. Prothrombin time
induced thrombocytopenia (HIT) when the b. Erythrocyte count
platelet level drops to 110,000/µL. Which action c. Fibrinogen degradation products
will the nurse include in the plan of care? d. Activated partial thromboplastin time - -
ANS: D. Activated partial thromboplastin time
a. Prepare for platelet transfusion.
b. Discontinue the heparin infusion. Platelet aggregation in HIT causes neutralization
c. Administer prescribed warfarin (Coumadin). of heparin, so the activated partial thromboplastin
d. Use low-molecular-weight heparin (LMWH). - time will be shorter, and more heparin will be
-ANS: B. Discontinue the heparin infusion. needed to maintain therapeutic levels. The other
data will not be affected by HIT.
All heparin is discontinued when HIT is
diagnosed. The patient should be instructed to
never receive heparin or LMWH. Warfarin is
usually not given until the platelet count has The nurse is caring for a patient with type A
returned to 150,000/µL. The platelet count does hemophilia being admitted to the hospital with
not drop low enough in HIT for a platelet severe pain and swelling in the right knee. The
transfusion, and platelet transfusions increase nurse should
the risk for thrombosis.
a. Apply heat to the knee.
b. Immobilize the knee joint.
c. Assist the patient with light weight bearing.
Which intervention will be included in the nursing d. Perform passive range of motion to the knee. -
care plan for a patient with immune -ANS: B. Immobilize the knee joint.
thrombocytopenic purpura (ITP)?
The initial action should be total rest of the knee
a. Assign the patient to a private room. to minimize bleeding. Ice packs are used to
b. Avoid intramuscular (IM) injections. decrease bleeding. Range of motion (ROM) and
c. Use rinses rather than a soft toothbrush for weight-bearing exercise are contraindicated
oral care. initially, but after the bleeding stops, ROM and
d. Restrict activity to passive and active range of physical therapy are started.
motion. - -ANS: B. Avoid intramuscular
(IM) injections.
IM or subcutaneous injections should be avoided Which assessment finding should the nurse
because of the risk for bleeding. A soft caring for a patient with thrombocytopenia
toothbrush can be used for oral care. There is no communicate immediately to the health care
need to restrict activity or place the patient in a provider?
private room.
a. The platelet count is 52,000/µL.
b. The patient is difficult to arouse.
c. There are purpura on the oral mucosa.
Which laboratory result will the nurse expect to d. There are large bruises on the patient's back. -
show a decreased value if a patient develops -ANS: B. The patient is difficult to arouse.
, NSG 210 Clotting Test Questions and Answers Rated A
-ANS: C. Administer PRN acetaminophen
Difficulty in arousing the patient may indicate a (Tylenol).
cerebral hemorrhage, which is life threatening
and requires immediate action. The other The patient's clinical manifestations are
information should be documented and reported consistent with a febrile, nonhemolytic
but would not be unusual in a patient with transfusion reaction. The transfusion should be
thrombocytopenia. stopped and antipyretics administered for the
fever as ordered. A urine specimen is needed if
an acute hemolytic reaction is suspected.
Diphenhydramine is used for allergic reactions.
The nurse is planning to administer a transfusion This type of reaction does not indicate incorrect
of packed red blood cells (PRBCs) to a patient crossmatching.
with blood loss from gastrointestinal hemorrhage.
Which action can the nurse delegate to
unlicensed assistive personnel (UAP)?
A patient in the emergency department
a. Verify the patient identification (ID) according complains of back pain and difficulty breathing 15
to hospital policy. minutes after a transfusion of packed red blood
b. Obtain the temperature, blood pressure, and cells is started. The nurse's first action should be
pulse before the transfusion. to
c. Double-check the product numbers on the
PRBCs with the patient ID band. a. Administer oxygen therapy at a high flow rate.
d. Monitor the patient for shortness of breath or b. Obtain a urine specimen to send to the
chest pain during the transfusion. - -ANS: laboratory.
B. Obtain the temperature, blood pressure, and c. Notify the health care provider about the
pulse before the transfusion. symptoms.
d. Disconnect the transfusion and infuse normal
UAP education includes measurement of vital saline. - -ANS: D. Disconnect the
signs. UAP would report the vital signs to the transfusion and infuse normal saline.
registered nurse (RN). The other actions require
more education and a larger scope of practice The patient's symptoms indicate a possible acute
and should be done by licensed nursing staff hemolytic reaction caused by the transfusion.
members. The first action should be to disconnect the
transfusion and infuse normal saline. The other
actions also are needed but are not the highest
priority.
A postoperative patient receiving a transfusion of
packed red blood cells develops chills, fever,
headache, and anxiety 35 minutes after the
transfusion is started. After stopping the A patient with immune thrombocytopenic purpura
transfusion, what action should the nurse take? (ITP) has an order for a platelet transfusion.
Which information indicates that the nurse should
a. Give the PRN diphenhydramine . consult with the health care provider before
b. Send a urine specimen to the laboratory. obtaining and administering platelets?
c. Administer PRN acetaminophen (Tylenol).
d. Draw blood for a new type and crossmatch. - a. Platelet count is 42,000/uL.
