RNSG 2539 EXAM 2 LATEST ACTUAL EXAM 228 QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) ALREADY GRADED A+.pdf

RNSG 2539 EXAM 2 LATEST 2023-
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2024 ACTUAL EXAM 220 QUESTIONS AND CORRECT DETAIL
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ED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+
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The nnurse nisnreviewingnthenlaboratoryntestnresultsnof nanchildndiagnosednwithndisseminatednintravascularnc
oagulationn(DIC).nWhichnof nthe nfollowingnwouldnthe nnurse ninterpretnasnindicative nofnthisndisorder?

A) Shortenednprothrombinntime

B) Increasednfibrinogennlevel

C) Positive nfibrinnsplitnproducts

D) Increasednplateletsn-nanswer-C) nPositive nfibrinnsplitnproducts



The nnurse nisncaringnfornanpostpartumnpatientnadmittedntonthe nintensivencare nunitnwithnandiagnosisnofndisse
minatednintravascularncoagulationn(DIC).nWhatnisnthe ndrugnofnchoice ntontreatnthisnproblem?

A. Heparin

B. Urokinase

C. Aspirin
D. Warfarinn-nanswer-A.) nHeparin



Innthe nICU,nanpostsurgicalnclientnhasndevelopednsepsisnandnisnbeingntreatednwithnmultiple nmedications.nDur
ingnthe nmid-
morningnassessment,nwhichnfindingnleadsnthennursentonsuspectnthe nclientnmaynbendevelopingnancomplicati
onncalledndisseminatednintravascularncoagulationn(DIC)?nSelectnallnthatnapply.
A) Headachesnassociatednwithnlightnsensitivity

B) Oozingnfromnallnpreviousnpuncture nandnintravenousnsites

C) DecreasednO2nsaturationnandndiminishednbreathnsoundsninnlowernlobes

D) Hemorrhage nfromnthe nsurgicalnsite nrequiringndeepnpressure ndressings

E) Urine nfromnthe nFoleyncatheternisnbloodyn-nanswer-
D) nHemorrhage nfromnthe nsurgicalnsite nrequiringndeepnpressure ndressings



Anhealthy,nprimiparousn(first-
time) nmotherndeliverednanhealthyninfantnseveralnhoursnago,nbutnthenmothernhasnexperiencednpostpartumn
hemorrhage.nWhichnofnthenfollowingndisordersnisnmostnlikelyntonunderlie nthe nclient'snexcessivenbleedingnaf
terndelivery?

A) Disseminatednintravascularncoagulation

,B) HemophilianA

C) VonnWillebrandndisease

D) Thromboticnthrombocytopenicnpurpuran(TTP) n-nanswer-A) nDisseminatednintravascularncoagulation



Whatnisnthe nconceptnbehindnheparinnfornPTnwithnDIC?n-nanswer--
Itnpreventsnthe nclottingnphase nfromnbeingncompletednwhichninhibitsnthe nbreakdownnofnfibrinogen.

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n Itn alson helpsn avoidnhemorrhagenbynpreventingnthe nbody nfromndepletingnentire nstagenofn coagulation n factor

s.



Whatnare nsome nacute nclinicalnmanifestationsnofnDIC?n-nanswer--
Directlynrelatedntonbleedingnproblemsnsuchnas:

Petechia,nPurpura,noozingnfromnpuncture nsitesnornsevere nhemorrhaging.



HowndoesnDICnhappenninnpostpartumnhemorrhaging?n-nanswer--
Tissue nfactorsnreleasednfromnnecroticnplace/fetalntissuenornamnioticnfluidnmynenternthe ncirculation,nincitin
gnDIC.


Whatnisnancommonncause nof nDIC?n-nanswer--Sepsis



AnpatientnwithnDICnisnatnanhighernrisknfornwhat?n-nanswer--Deficientnfluidnvolume



Increasednlevelsnof n ,n ,n ,nandn
willnbe nnotedninnDIC:n-nanswer--
Fibrinolycin,nfibrinopeptide nA,npositive nfibrinnsplitnproductsnandnD-dimers.



DICncannoccurnsecondaryntonwhatntype nof nconditions?nSelectnallnthatnapply:n-nanswer--Abrupitoplacente

-Amnioticnfluidnembolism

-Endotoxinnsepsis

-Retainedndeadnfetus

-Postnhemorrhage nshock

-Hydatidformmole

-GynecologicnMalinganries

,DICncannbe ndecreasednasnanlossnofnbalance nbetweennwhatntwonactivities?n-nanswer--
Clotnformingnactivitynof nthrombin

-Clotnlysinnactivitynofnplasmin



Whatnare nsome nwaysntoncombatnDIC?nSelectnallnthatnapply:n-nanswer--Anticoagulationntherapyn(low-
n molecularn weightn heparin)



-PackednRBCs

-Plateletnconcentrate

-Antithrombinn concentrate

-NonclottingnProtein-ncontainingnvolume nwillnexpandnlike:nplasmanproteinnfractionnornalbumin



HowndoesnHeparinnworkninnthe ncirculatorynsystem?n-nanswer--
Inhibitsnthrombusnandnclotnproductionnbynblockingnthe nconversionnofnprothrombinntonthrombinn&nfibroge
nntonfibrin.



Whatnare nsome nadverse neffectsnofnHeparin?nSelectnallnthatnapply:n-nanswer--Lossnofnhair

-Bruising

-Chills

-Fever

-Osteoporosis

-Suppressionnofnrenalnfunction



IfnanPTnhasnannallergicnreactionntonHeparin,nwhatndrugnwouldnbe nadministerednasntreatment?n-nanswer--
n Lepirudin n (refludan)




InnDIC,nmicroembolinmaynobstructnbloodnvesselsnandncausentissuenhypoxia/nnecroticndamage ntonwhichnorg
annstructures?nSelectnallnthatnapply:n-nanswer--Kidneys

-Heart

-Lungs

-Brain

, The ntreatmentnofnDICnisndirectedntowardnmanagingnwhat?n-nanswer--The nPrimaryndisease

-Replacingnclottingncomponents

-Preventingnfurthernactivationnof nclottingnmechanisms



Howndonyouncorrectnthe nclottingnfactorndeficiencyninnDIC?n-nanswer--Transitionnof nFFP

- "n"nplatelets

- "n"nfibrinogenncontainingncryoprecipitate



HowndoesnDICninitiate nactivationnofnthe nextrinsicnpathway?n-nanswer--
Occursnwithnliberationnofntissuenfactornandnassociatednwithnobstetricncomplications,ntrauma,nbacterialnsep
sisn&ncancer


HowndoesnDICninitiate nactivationnofnthe nintrinsicnpathway?n-nanswer--
Activatednthroughnextensivenendothelialndamage nwithnactivationnofnfactornXII.nThisnresultsnfromnviruses,ni
nfections,nimmune nmechanisms,nstasisnof nbloodnorntemperature nextremes.



Whatnare nsome npotentialntherapiesntonDICnothernthannHeparin?n-nanswer--
Tissue nfactornpathwayninhibitors,nantithrombin, nProteinnCnconcentrates,n&nanti-
inflammatoryncytokinesnlike nINL-I



Whatnare nsome nobstetricnconditionsnthatnhave nbeennassociatednwithnDIC?n-nanswer--
Abrupitonplacentratae

-Deadnfetusnsyndrome

-Pre-eclampsian&neclampsia

-Amnioticnfluidnembolism



Whatnare nsome nCancersnthatnhave nbeennassociatednwithnDICn?n-nanswer--Metastaticncancer

-Acute nleukemia



Whatnare nsome ninfectionsnassociationsnwithnDIC?n-nanswer--
Acute nbacterialninfectionsn(meningococalnmeningitis)

-Histoplasmosis,nAspergicrosis