Chapter 3 Hematopoietic Function
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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) Vessel spasm
- B) Platelet plug
- C) Clot retraction
- D) Fibrin clot
3. To form a platelet plug, platelets are attracted to the damaged vessel, and then platelet ____ occurs.
- A) Adhesion
- B) Fibrinolysis
- C) Thrombosis
- D) Aggregation (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 patient's 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). The patient's 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. Which of the following measures 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 patient's admission assessment prior to reduction mammoplasty surgery, the nurse notes a reference to a Leiden mutation in the patient's history. The nurse would recognize the patient's 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 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 has been receiving 5000 units of heparin twice daily for the last 5 days. An immune response to this treatment may increase the patient's chance of developing which health problem?
- A) Antiphospholipid syndrome
- B) Disseminated intravascular coagulation (DIC)
- C) Von Willebrand disease
- D) Thrombocytopenia
17. A patient's primary care provider has recommended low-dose aspirin once daily to reduce the risk of myocardial infarction. Doing so will alter 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. Which of the patient's following statements demonstrates a sound understanding of her new diagnosis?
- A) "I'm really disappointed that I won't 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) "I'll make sure to take Tylenol instead of aspirin when I get aches and pains."
- D) "I hope my insurance covers the injections that I'll 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 lung cancer
- D) A patient with dehydration and hypokalemia resulting from Clostridium difficile-associated diarrhea
20. A healthy, primiparous (first-time) mother delivered a healthy infant several hours ago, but has experienced postpartum hemorrhage. Which of the following disorders is most likely to underlie the patient's excessive bleeding after delivery?
- A) Disseminated intravascular coagulation
- B) Hemophilia A
- C) Von Willebrand disease
- D) Thrombotic thrombocytopenic purpura (TTP)
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