A nurse is assessing a client with disseminated intravascular coagulation (DIC). Which specific clinical manifestation should the nurse identify as indicative of the condition's bleeding phase?
Petechiae and ecchymosis on the skin
Elevated white blood cell count and fever
Increased blood pressure and decreased heart rate
Palpitations and respiratory rate of 22 breaths/min
The Correct Answer is A
Rationale:
A. During the bleeding phase of DIC, widespread consumption of platelets and clotting factors leads to spontaneous bleeding. Petechiae (tiny pinpoint hemorrhages) and ecchymoses (larger bruises) on the skin are classic signs of thrombocytopenia and coagulopathy. These manifestations indicate that the body’s hemostatic mechanisms are overwhelmed, resulting in excessive bleeding. Other bleeding signs may include mucosal bleeding, hematuria, or gastrointestinal bleeding.
B. These are nonspecific signs of infection or inflammation, not indicators of the bleeding phase of DIC. While DIC can be triggered by sepsis, WBC elevation and fever do not reflect coagulopathy or platelet consumption.
C. Hemodynamic changes like hypotension and tachycardia are more likely in severe bleeding or shock, but elevated BP with bradycardia is not characteristic of DIC.
D. These are nonspecific signs and may reflect anxiety, pain, or mild hypoxia, but they are not specific indicators of DIC or its bleeding phase.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","E"]
Explanation
Rationale:
A. AB- blood contains both A and B antigens on the red blood cells. A recipient with blood type A- has anti-B antibodies in their plasma. If AB- blood is transfused, the recipient’s immune system will recognize the B antigens as foreign, leading to a potentially dangerous hemolytic reaction.
B. While A+ blood has the A antigen that matches the recipient’s ABO type, it is Rh-positive, and the recipient is Rh-negative (A-). Transfusing Rh-positive blood to an Rh-negative individual can trigger alloimmunization, where the immune system develops antibodies against the Rh factor. This is especially concerning in women of childbearing age, as it may affect future pregnancies, and it can also cause hemolytic transfusion reactions.
C. O- blood has no A or B antigens and is Rh-negative, making it the universal donor for red blood cells. An A- recipient will not react immunologically to O- red blood cells because there are no antigens to trigger an antibody response. O- blood is safe for emergency transfusions when a perfectly matched unit is unavailable.
D. AB+ blood contains A and B antigens as well as Rh-positive antigen. Transfusing AB+ to an A- recipient is incompatible because the B antigens would trigger anti-B antibodies and the Rh-positive factor could cause alloimmunization, making this combination unsafe.
E. A- blood is both ABO compatible (A antigen matches) and Rh compatible (negative). This is the ideal match for an A- recipient because it eliminates the risk of immune-mediated hemolysis and ensures safe transfusion.
F. Although O blood lacks A and B antigens, O+ blood contains the Rh D antigen, which is incompatible with an Rh-negative recipient. Transfusing O+ blood to an A- recipient could trigger alloimmunization or hemolytic reaction, so it is unsafe.
Correct Answer is ["C","D","F"]
Explanation
Rationale:
A. Ibuprofen should not be redosed this quickly. The typical dosing interval is every 6–8 hours, depending on the formulation. Taking an additional dose too soon increases the risk of gastrointestinal, renal, and cardiovascular adverse effects.
B. Combining NSAIDs (e.g., ibuprofen with naproxen or aspirin) increases the risk of GI bleeding, kidney injury, and other adverse effects. NSAIDs should not be combined unless specifically directed by a healthcare provider.
C. Ibuprofen is an NSAID, which can irritate the stomach lining and increase the risk of gastritis or ulcers. Taking it with food, milk, or antacids helps reduce GI irritation.
D. Acetaminophen is not an NSAID and does not affect platelet function or the GI mucosa. It is generally safer for patients at risk of GI bleeding or those who require normal coagulation.
E. Incorrect for typical adult dosing. The maximum recommended daily dose for healthy adults is 3,000–4,000 mg, depending on guidelines and liver function. 1,200 mg is usually a limit for over-the-counter preparations or special populations, but education should reflect safe adult dosing and emphasize not exceeding the recommended maximum.
F. NSAIDs like ibuprofen can cause GI bleeding, so patients should be instructed to report symptoms such as dark/tarry stools, vomiting blood, or abdominal pain.
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