Chapter_12-_Disorders_of_Hemostasis My Nursing Test Banks

 

1.

With the exception of the first two steps, what is required in all steps of the clotting process?

A)

Calcium

B)

Prothrombin

C)

Tissue factor

D)

Plasminogen

2.

The first step of hemostasis occurs as a:

A)

fibrin clot.

B)

platelet plug.

C)

clot retraction.

D)

vessel spasm.

3.

To form a platelet plug, platelets are attracted to the damaged vessel, and then platelet ___________ occurs.

A)

adhesion

B)

fibrinolysis

C)

thrombosis

D)

thromboxane A2

4.

Blood coagulation is initiated by either of two pathways. The intrinsic pathway requires circulating ________ to begin the step-wise coagulation cascade.

A)

protein C

B)

thrombin

C)

factor XII

D)

tissue factor

5.

Increased platelet function, and consequent hypercoagulability, can be caused by:

A)

factor V mutation.

B)

platelet insensitivity.

C)

vascular wall damage.

D)

decreased platelet numbers.

6.

Immune thrombocytopenia purpura (ITP) is a/an ________ disorder that destroys ________.

A)

allergic; fibrinogen

B)

alloimmune; factor VIII

C)

autoimmune; platelets

D)

immunoglobulin; B cells

7.

Thrombotic thrombocytopenic purpura (TTP) causes which of the following manifestations? Select all that apply.

A)

Purpura

B)

Jaundice

C)

Petechiae

D)

Erythema

E)

Confusion

8.

Hemophilia A is a hereditary blood disorder caused by inadequate activity or absent:

A)

factor VIII.

B)

prothrombin.

C)

vWF complex.

D)

intrinsic factor.

9.

Disseminated intravascular coagulation (DIC) is characterized by:

A)

headaches.

B)

platelet loss.

C)

hypertension.

D)

hemorrhage.

10.

In persons with a bleeding disorder caused by vascular defects, laboratory tests will most often reveal:

A)

normal values.

B)

hypocalcemia.

C)

polycythemia.

D)

thrombocytopenia.

11.

Removal of a patients peripheral intravenous catheter resulted in brief bleeding and the loss of a small amount of blood. Which of the following processes occurred during the formation of the platelet plug that helped to stop blood flow?

A)

Activation of factor X

B)

Conversion of prothrombin to thrombin

C)

Release of von Willebrand factor from the epithelium

D)

Conversion of fibrinogen to fibrin threads

12.

A 69-year-old patient who is obese and has a diagnosis of angina pectoris has been prescribed clopidogrel (Plavix) by his primary care provider. The patients medication achieves its therapeutic effect in which of the following ways?

A)

Prevention of platelet aggregation

B)

Activation of plasminogen

C)

Inhibition of the intrinsic clotting pathway

D)

Deactivation of factor X

13.

A public health nurse is conducting a health promotion campaign under the auspices of the local community center. Which of the following measures that the nurse is promoting are likely to influence the participants risk of hypercoagulability disorders? Select all that apply.

A)

Smoking cessation

B)

Blood glucose screening

C)

Weight management

D)

Cholesterol screening and management

E)

Blood pressure screening and management

14.

During a patients admission assessment prior to reduction mammoplasty surgery, the nurse notes a reference to a Leiden mutation in the patients history. The nurse would recognize the patients increased risk for

A)

Hemorrhage

B)

Myocardial infarction

C)

Hemophilia A or B

D)

Deep vein thrombosis

15.

The most recent blood work of a patient with a diagnosis of acute myelogenous leukemia (AML) reveals thrombocytopenia. Where is the patient most likely to experience abnormal bleeding as a result of low platelets?

A)

In the brain

B)

Skin and mucous membranes

C)

Sclerae of the eyes

D)

Nephrons and ureters

16.

A patient was started on a protocol for the prevention of deep vein thrombosis shortly after admission, and has been receiving 5000 units of heparin twice daily for the last 5 days. An immune response to this treatment may increase the patients chance of developing which health problem?

A)

Antiphospholipid syndrome

B)

Disseminated intravascular coagulation (DIC)

C)

Von Willebrand disease

D)

Thrombocytopenia

17.

In light of the presence of numerous risk factors for coronary artery disease, a patients primary care provider has recommended that he take low-dose aspirin once daily. Doing so will reduce the patients risk of myocardial infarction by altering which of the following stages of hemostasis?

A)

Vessel spasm

B)

Platelet plug formation

C)

Blood coagulation

D)

Clot lysis

18.

A 23-year-old female patient has been diagnosed with von Willebrand disease following a long history of heavy periods and occasional nosebleeds. Which of the patients following statements demonstrates a sound understanding of her new diagnosis?

A)

Im really disappointed that I wont be able to do sports anymore.

B)

I read on a website that I might have to get blood transfusions from time to time.

C)

Ill make sure to take Tylenol instead of aspirin when I get aches and pains.

D)

I hope my insurance covers the injections that Ill need to help my blood clot.

19.

Which of the following patients likely faces the highest risk of an acquired hypocoagulation disorder and vitamin K deficiency?

A)

A patient who has a diagnosis of liver failure secondary to alcohol abuse

B)

A patient who has chronic renal failure as a result of type 1 diabetes mellitus

C)

A patient who is immunocompromised as a result of radiation therapy for the treatment of lung cancer

D)

A patient with dehydration and hypokalemia that have resulted from Clostridium difficileassociated diarrhea

20.

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 patients excessive bleeding after delivery?

A)

Disseminated intravascular coagulation

B)

Hemophilia A

C)

Von Willebrand disease

D)

Thrombotic thrombocytopenic purpura (TTP)

Answer Key

1.

A

2.

D

3.

A

4.

C

5.

C

6.

C

7.

A, C, E

8.

A

9.

D

10.

A

11.

C

12.

A

13.

A, B, C, D, E

14.

D

15.

B

16.

D

17.

B

18.

C

19.

A

20.

A

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