NURS 170 Clotting #1-5 (HESI Concept) NCLEX
Exam With Complete Solutions
Which diagnostic study is used to detect deep vein thrombosis in the client's
lower extremities?
A. Thermography
B. Plethysmography
C. Duplex venous Doppler
D. Somatosensory evoked potential - ANSWER C. Duplex venous Doppler
Duplex venous doppler records an ultrasound of the veins, including blood flow
abnormalities of the lower extremities, aiding detection of deep vein thrombosis.
Thermography, which measures the heat radiating from the skin surface, is used
to determine client response to antiinflammatory drug therapy and inflamed
joints. Plethysmography is used to record variations in volume and pressure of
blood passing through tissues; test is nonspecific. Somatosensory evoked
potential is used to identify subtle dysfunction of lower motor neurons and
primary muscle disease.
Enoxaparin 40 mg subcutaneously daily is prescribed for a client who had
abdominal surgery. The nurse explains that the medication is given for what
purpose?
A. To control postoperative fever
B. To provide a constant source of mild analgesia
C. To limit the postsurgical inflammatory response
D. To provide prophylaxis against postoperative thrombus formation - ANSWER
D. To provide prophylaxis against postoperative thrombus formation
Enoxaparin (Lovenox), a low-molecular-weight heparin, prevents the conversion
of fibrinogen to fibrin and prothrombin to thrombin by enhancing the inhibitory
effects of antithrombin III.)
Which oxytocic medication may help to control uterine bleeding postdelivery
and promote milk ejection?
A. Oxytocin
B. Mifepristone
C. Dinoprostone
D. Ergot alkaloids - ANSWER A. Oxytocin
Oxytocin is used to induce labor, control uterine bleeding after delivery, and
promote milk ejection during lactation. Mifepristone is generally used to induce
abortion. Dinoprostone induces labor but has no effect on milk ejection or
,uterine bleeding. Although ergot alkaloids control uterine bleeding after
delivery, they do not cause milk ejection during lactation.
Which is the purpose of a vitamin K injection in a newborn?
A. It promotes conjugation of bilirubin
B. It promotes formation of RBCs
C. It prevents destruction of RBCs
D. It provides protection from hemorrhage - ANSWER D. It provides protection
from hemorrhage
Vitamin K prevents hemorrhagic disease of the newborn because it activates
coagulation factors in the liver (necessary for the synthesis of clotting factors
VII, IX, and X). Its role in the liver is to activate blood coagulation, not bilirubin
conjugation. The mechanism by which vitamin K prevents hemorrhage is
unrelated to formation or destruction of RBCs, for which vitamin K does not have
a role.
When teaching a client with atrial fibrillation about a new prescription for
warfarin, the nurse will include information about which vitamin?
A. Vitamin K
B. Vitamin D
C. Vitamin B1
D. Vitamin B12 - ANSWER A. Vitamin K
Warfarin causes inhibition of vitamin K-dependent clotting factors, and use of
vitamin K would affect the therapeutic effect of warfarin. Vitamin D has no effect
on warfarin. Vitamin B1 does not affect warfarin or clotting. Vitamin B12 does
not affect warfarin affectiveness.
After the nurse has finished teaching a client about sickle cell anemia, which
statement indicates that the client has a correct understanding of the condition?
A. "I have abnormal platelets"
B. "I have abnormal hemoglobin"
C. "I have abnormal hematocrit"
D. "I have abnormal white blood cells" - ANSWER B. "I have abnormal
hemoglobin"
The patient with sickle cell anemia has abnormal hemoglobin, hemoglobin S,
causing the RBCs to stiffen and elongate into a sickle. Although it can affect
hematocrit, it is really a result of the abnormal hemoglobin. The disorder affects
hemoglobin rather than platelets or WBCs.
How is hemophilia A inherited?
A. X-linked recessive trait
B. Y-linked recessive trait
C. X-linked dominant trait
, D. Y-linked dominant trait - ANSWER A. X-linked recessive trait
Hemophilia A is an X-linked recessive trait, not a dominant trait, meaning
daughters who have the gene are carriers, and sons with the gene have the
condition. The trait is not carried on the Y chromosome.
How would the nurse explain the purpose of early ambulation to a client who had
surgery the previous day?
A. Promote healing of the incision
B. Decrease the incidence of urinary tract infections
C. Allow nursing staff to change the bedding
D. Keep blood from pooling in the legs to prevent clots - ANSWER D. Keep blood
from pooling in the legs to prevent clots
The muscular action during ambulation facilitates the return of venous blood to
the heart; this reduces venous stasis and minimizes the risk of postoperative
thrombophlebitis. Protein and vitamin C promote wound healing. Walking is not
related to the prevention of UTIs. Although nursing staff do often change the bed
when clients are up ambulating, the purpose of early ambulation is prevention of
client complications, not making nursing actions more convenient for the staff.
Identify the primary causes of adrenal insufficiency. Select all that apply
A. Hemorrhage
B. Tuberculosis
C. Pituitary tumors
D. Postpartum pituitary necrosis
E. Acquired immunodeficiency syndrome (AIDS) - ANSWER A. Hemorrhage
B. Tuberculosis
E. Acquired immunodeficiency syndrome (AIDS)
The primary causes of adrenal insufficiency are hemorrhage, tuberculosis, and
AIDS. Pituitary tumors and postpartum pituitary necrosis are the secondary
causes of adrenal insufficiency.
Which medication would the nurse expect to administer to control bleeding in a
child with hemophilia A?
A. Albumin
B. Fresh frozen plasma
C. Factor VII concentrate
D. Factors II, VII, IX, X complex - ANSWER C. Factor VII concentrate
Factor VII is the missing plasma component necessary to control bleeding in a
child with hemophilia A. Factor VII is not provided by albumin. Although fresh
frozen plasma does contain factor VIII, there is an insufficient amount of plasma
transfusion; a higher volume is required. A complex of factors II, VII, IX, and X is
not useful in this situation.
Exam With Complete Solutions
Which diagnostic study is used to detect deep vein thrombosis in the client's
lower extremities?
A. Thermography
B. Plethysmography
C. Duplex venous Doppler
D. Somatosensory evoked potential - ANSWER C. Duplex venous Doppler
Duplex venous doppler records an ultrasound of the veins, including blood flow
abnormalities of the lower extremities, aiding detection of deep vein thrombosis.
Thermography, which measures the heat radiating from the skin surface, is used
to determine client response to antiinflammatory drug therapy and inflamed
joints. Plethysmography is used to record variations in volume and pressure of
blood passing through tissues; test is nonspecific. Somatosensory evoked
potential is used to identify subtle dysfunction of lower motor neurons and
primary muscle disease.
Enoxaparin 40 mg subcutaneously daily is prescribed for a client who had
abdominal surgery. The nurse explains that the medication is given for what
purpose?
A. To control postoperative fever
B. To provide a constant source of mild analgesia
C. To limit the postsurgical inflammatory response
D. To provide prophylaxis against postoperative thrombus formation - ANSWER
D. To provide prophylaxis against postoperative thrombus formation
Enoxaparin (Lovenox), a low-molecular-weight heparin, prevents the conversion
of fibrinogen to fibrin and prothrombin to thrombin by enhancing the inhibitory
effects of antithrombin III.)
Which oxytocic medication may help to control uterine bleeding postdelivery
and promote milk ejection?
A. Oxytocin
B. Mifepristone
C. Dinoprostone
D. Ergot alkaloids - ANSWER A. Oxytocin
Oxytocin is used to induce labor, control uterine bleeding after delivery, and
promote milk ejection during lactation. Mifepristone is generally used to induce
abortion. Dinoprostone induces labor but has no effect on milk ejection or
,uterine bleeding. Although ergot alkaloids control uterine bleeding after
delivery, they do not cause milk ejection during lactation.
Which is the purpose of a vitamin K injection in a newborn?
A. It promotes conjugation of bilirubin
B. It promotes formation of RBCs
C. It prevents destruction of RBCs
D. It provides protection from hemorrhage - ANSWER D. It provides protection
from hemorrhage
Vitamin K prevents hemorrhagic disease of the newborn because it activates
coagulation factors in the liver (necessary for the synthesis of clotting factors
VII, IX, and X). Its role in the liver is to activate blood coagulation, not bilirubin
conjugation. The mechanism by which vitamin K prevents hemorrhage is
unrelated to formation or destruction of RBCs, for which vitamin K does not have
a role.
When teaching a client with atrial fibrillation about a new prescription for
warfarin, the nurse will include information about which vitamin?
A. Vitamin K
B. Vitamin D
C. Vitamin B1
D. Vitamin B12 - ANSWER A. Vitamin K
Warfarin causes inhibition of vitamin K-dependent clotting factors, and use of
vitamin K would affect the therapeutic effect of warfarin. Vitamin D has no effect
on warfarin. Vitamin B1 does not affect warfarin or clotting. Vitamin B12 does
not affect warfarin affectiveness.
After the nurse has finished teaching a client about sickle cell anemia, which
statement indicates that the client has a correct understanding of the condition?
A. "I have abnormal platelets"
B. "I have abnormal hemoglobin"
C. "I have abnormal hematocrit"
D. "I have abnormal white blood cells" - ANSWER B. "I have abnormal
hemoglobin"
The patient with sickle cell anemia has abnormal hemoglobin, hemoglobin S,
causing the RBCs to stiffen and elongate into a sickle. Although it can affect
hematocrit, it is really a result of the abnormal hemoglobin. The disorder affects
hemoglobin rather than platelets or WBCs.
How is hemophilia A inherited?
A. X-linked recessive trait
B. Y-linked recessive trait
C. X-linked dominant trait
, D. Y-linked dominant trait - ANSWER A. X-linked recessive trait
Hemophilia A is an X-linked recessive trait, not a dominant trait, meaning
daughters who have the gene are carriers, and sons with the gene have the
condition. The trait is not carried on the Y chromosome.
How would the nurse explain the purpose of early ambulation to a client who had
surgery the previous day?
A. Promote healing of the incision
B. Decrease the incidence of urinary tract infections
C. Allow nursing staff to change the bedding
D. Keep blood from pooling in the legs to prevent clots - ANSWER D. Keep blood
from pooling in the legs to prevent clots
The muscular action during ambulation facilitates the return of venous blood to
the heart; this reduces venous stasis and minimizes the risk of postoperative
thrombophlebitis. Protein and vitamin C promote wound healing. Walking is not
related to the prevention of UTIs. Although nursing staff do often change the bed
when clients are up ambulating, the purpose of early ambulation is prevention of
client complications, not making nursing actions more convenient for the staff.
Identify the primary causes of adrenal insufficiency. Select all that apply
A. Hemorrhage
B. Tuberculosis
C. Pituitary tumors
D. Postpartum pituitary necrosis
E. Acquired immunodeficiency syndrome (AIDS) - ANSWER A. Hemorrhage
B. Tuberculosis
E. Acquired immunodeficiency syndrome (AIDS)
The primary causes of adrenal insufficiency are hemorrhage, tuberculosis, and
AIDS. Pituitary tumors and postpartum pituitary necrosis are the secondary
causes of adrenal insufficiency.
Which medication would the nurse expect to administer to control bleeding in a
child with hemophilia A?
A. Albumin
B. Fresh frozen plasma
C. Factor VII concentrate
D. Factors II, VII, IX, X complex - ANSWER C. Factor VII concentrate
Factor VII is the missing plasma component necessary to control bleeding in a
child with hemophilia A. Factor VII is not provided by albumin. Although fresh
frozen plasma does contain factor VIII, there is an insufficient amount of plasma
transfusion; a higher volume is required. A complex of factors II, VII, IX, and X is
not useful in this situation.
