The nurse analyzes the laboratory results of a patient with hemophilia. The nurse understands that which result will most likely be abnormal in this patient?

Hematocrit level

Partial thromboplastin time

Hemoglobin level

Platelet count

Answer and Explanation

The Correct Answer is B

Choice A reason: Hematocrit level measures red blood cell volume and is typically normal in hemophilia, a clotting factor disorder. It may decrease only if significant bleeding occurs, but this is not a primary feature. Hemophilia affects coagulation, not red cell production, so hematocrit is not the most likely abnormal result.

Choice B reason: Partial thromboplastin time (PTT) is prolonged in hemophilia due to deficiencies in clotting factors VIII or IX, impairing the intrinsic coagulation pathway. This leads to prolonged bleeding and is a hallmark lab finding. PTT is the primary test to monitor hemophilia severity and treatment efficacy, making it consistently abnormal.

Choice C reason: Hemoglobin level may decrease in hemophilia only if significant bleeding occurs, causing anemia. However, it is not primarily affected, as hemophilia is a coagulation disorder, not a red cell production issue. Hemoglobin is less likely to be abnormal compared to PTT, which directly reflects the clotting defect.

Choice D reason: Platelet count is typically normal in hemophilia, as it is a disorder of clotting factors, not platelets. Platelets contribute to primary hemostasis, which is unaffected in hemophilia. Abnormal PTT, not platelet count, is the key lab finding, as hemophilia impairs secondary hemostasis in the coagulation cascade.

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Correct Answer is C

Explanation

Choice A reason: Respiratory failure is a concern in peritonitis if abdominal distension impairs diaphragm movement, but it is not the highest priority. Sepsis, from bacterial spread, poses a more immediate life-threatening risk, causing systemic inflammation and shock. Monitoring respiratory status is secondary to addressing the infectious source driving peritonitis complications.

Choice B reason: Diabetes is not a direct complication of peritonitis. While it may complicate management by predisposing to infections, peritonitis itself does not cause diabetes. Sepsis is the primary concern, as bacterial peritonitis can rapidly progress to systemic infection, requiring urgent antibiotics and monitoring to prevent multi-organ failure.

Choice C reason: Sepsis is the highest priority in peritonitis, as bacterial contamination from gastrointestinal perforation or infection can lead to systemic inflammatory response syndrome, shock, and organ failure. Early recognition of fever, tachycardia, and hypotension is critical to initiate antibiotics and fluids, preventing mortality in this life-threatening complication of peritonitis.

Choice D reason: Heart attack is not a primary complication of peritonitis. While sepsis may strain the cardiovascular system, increasing myocardial demand, peritonitis itself does not cause coronary occlusion. Sepsis is the more immediate threat, as it drives systemic inflammation and shock, requiring urgent intervention to prevent progression to multi-organ dysfunction.

A. DIC occurs when the immune system attacks platelets and causes massive bleeding B. DIC is caused by abnormal activation of the clotting pathway, causing excessive amounts of tiny clots to form inside organs C. DIC is caused when hemolytic processes destroy erythrocytes D. DIC is a complication of an autoimmune disease that attacks the body’s own cells

Correct Answer is B

Explanation

Choice A reason: DIC is not caused by the immune system attacking platelets. This describes conditions like immune thrombocytopenic purpura (ITP). In DIC, widespread clotting consumes platelets and clotting factors, leading to bleeding. The immune system is not the primary driver; rather, it’s triggered by conditions like sepsis or trauma.

Choice B reason: DIC results from abnormal activation of the clotting cascade, often triggered by sepsis, trauma, or malignancy. This causes microclots to form in small vessels, consuming clotting factors and platelets, leading to bleeding. Organ damage occurs from microthrombi, and depletion of coagulation components causes hemorrhage, accurately describing DIC’s pathophysiology.

Choice C reason: Hemolytic processes destroying erythrocytes describe hemolytic anemia, not DIC. While hemolysis may occur in DIC due to microangiopathic changes, it is not the primary cause. DIC involves widespread clotting and factor consumption, not primarily red cell destruction, making this an inaccurate explanation of its etiology.

Choice D reason: DIC is not primarily a complication of autoimmune diseases attacking cells. It is triggered by conditions like sepsis, cancer, or obstetric complications, activating the clotting cascade. Autoimmune diseases like lupus may rarely contribute, but DIC’s hallmark is coagulopathy from external triggers, not autoimmunity, making this explanation incorrect.

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The nurse analyzes the laboratory results of a patient with hemophilia. The nurse understands that which result will most likely be abnormal in this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing care for a patient who has peritonitis. Which of the following conditions is the highest priority for the nurse to monitor?

Correct Answer is C

Explanation

A patient’s family member asks the nurse why disseminated intravascular coagulation (DIC) occurs. Which statement by the nurse correctly explains the cause of DIC?

Correct Answer is B

Explanation

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