Chapter 27: Hematological Disorders and Oncological Emergencies

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Disseminated intravascular coagulation (DIC) is also known as:

a.	hemophilia.
b.	consumptive coagulopathy.
c.	porphyria.
d.	Tay-Sachs disease.

 

ANS:   B

DIC, also known as consumptive coagulopathy, is characterized by both bleeding and thrombosis, which result from depletion of clotting factors, platelets, and red blood cells.

 

DIF:    Cognitive Level: Knowledge REF:    576

OBJ:    Nursing Process: N/A TOP:    Hematological Issues

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

2. The nurse recognizes that sepsis will have what effect on the critical care patient’s risk for DIC?

a.	Decrease significantly
b.	Increase significantly
c.	Decrease somewhat
d.	No effect whatsoever

 

ANS:   B

Sepsis, particularly that caused by gram-negative organisms, can be identified as the culprit in as many as 20% of cases of DIC, which makes it the most common cause of this disorder.

 

DIF:    Cognitive Level: Comprehension       REF:    576

OBJ:    Nursing Process: Planning      TOP:    Hematological Issues

MSC:   NCLEX: Physiological Integrity: Reduction of Risk Potential

 

3. Damage to the endothelium can lead to DIC because of which of the following?

a.	Activation of the coagulation mechanism
b.	Activation of the complement system
c.	Deactivation of the intrinsic pathway
d.	Deactivation of thrombin production

 

ANS:   A

Regardless of the cause, the common thread in the development of DIC is damage to the endothelium, which results in activation of the coagulation mechanism.

 

DIF:    Cognitive Level: Comprehension       REF:    576

OBJ:    Nursing Process: N/A TOP:    Hematological Issues

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

4. The priority actions of the nurse in working with a patient who has DIC are:

a.	treating and evaluating.
b.	planning and implementing.
c.	assessing and monitoring.
d.	educating and supporting.

 

ANS:   C

Assessment and monitoring are the primary weapons in the critical care nurse’s arsenal where DIC is concerned. Knowing the diseases and conditions that are most often associated with DIC and understanding the pathophysiological mechanisms involved enable the critical care nurse to anticipate its development and intervene quickly.

 

DIF:    Cognitive Level: Comprehension       REF:    579

OBJ:    Nursing Process: Planning      TOP:    Hematological Issues

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

5. A nursing student asks the nurse what caused the patient to develop DIC. The nurse tells the student that DIC:

a.	occurs when the immune system develops antibodies against platelets.
b.	occurs when large numbers of cancer cells are rapidly killed.
c.	is caused when hemolytic processes destroy erythrocytes.
d.	is caused by an abnormal activation of the coagulation system.

 

ANS:   D

Regardless of the cause, the common thread in the development of DIC is damage to the endothelium that results in activation of the coagulation mechanism.

 

DIF:    Cognitive Level: Comprehension       REF:    576

OBJ:    Nursing Process: N/A TOP:    Hematological Issues

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation