Hematopoietic Function: Applied Pathophysiology for the Advanced Practice Nurse

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

A)                            Calcium

B)                            Prothrombin

Answer: C)             Tissue factor

D)                            Plasminogen

2.           The first step of hemostasis occurs as a:

Answer: 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

Answer: 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

Answer:  D)           tissue factor

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

A)               factor V mutation.

Answer: 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

Answer: 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

Answer: 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.

Answer: C) vWF complex.

D)               intrinsic factor.

9.           Disseminated intravascular coagulation (DIC) is characterized by:

A)               headaches.

B)                platelet loss.

C)                hypertension.

Answer:  D)           hemorrhage.

10           In persons with a bleeding disorder caused by vascular defects, laboratory

.           tests will most often reveal:

A)               normal values.

Answer: 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

Answer: 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?

Answer: 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

Answer:  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

Answer: A) Hemorrhage

Answer: B) Myocardial infarction

Answer: 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?

Answer: 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)

Answer: 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?

Answer: A) Vessel spasm

B)                Platelet plug formation