A nurse is teaching a client who has stage IV pancreatic cancer about the development of disseminated intravascular coagulation (DIC). Which of the following statements should the nurse make?
"DIC is controllable with lifelong heparin usage.”.
"DIC is caused by abnormal coagulation involving fibrinogen.”.
"DIC is a genetic disorder involving a vitamin K deficiency.”.
"DIC is characterized by an elevated platelet count.”.
The Correct Answer is B
Choice A rationale
DIC is not controllable with lifelong heparin usage. Heparin may be used to manage DIC, but it is not a permanent solution, and the underlying cause of DIC must be addressed.
Choice B rationale
DIC is caused by abnormal coagulation involving fibrinogen. It is characterized by widespread activation of the clotting cascade, leading to both clot formation and bleeding due to consumption of clotting factors and platelets.
Choice C rationale
DIC is not a genetic disorder involving a vitamin K deficiency. It is an acquired condition resulting from severe illnesses or injuries that trigger abnormal clotting and bleeding processes.
Choice D rationale
DIC is not characterized by an elevated platelet count. Instead, it involves thrombocytopenia due to the consumption of platelets in widespread clotting, leading to a decreased platelet count.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Encouraging the client to drink cool water or sports drinks is appropriate for mild dehydration or heat exhaustion but not sufficient for severe heat-related illness like heat stroke, where immediate medical intervention is needed.
Choice B rationale
Administering acetaminophen 650 mg orally can help reduce fever, but it does not address the underlying issue of hyperthermia and will not provide immediate cooling needed in this emergency.
Choice C rationale
Starting an intravenous line and infusing 0.9% saline solution helps rapidly replace fluids lost through sweating and can stabilize the client's condition by rehydrating and cooling them effectively.
Choice D rationale
Encouraging rest and reassessing in 15 minutes would delay necessary medical treatment in a situation where immediate action is critical due to the severity of the client's symptoms.
Correct Answer is B
Explanation
Choice A rationale
Hyperactive deep tendon reflexes are not associated with thrombocytopenia (low platelet count). Thrombocytopenia primarily affects bleeding and clotting functions rather than neuromuscular reflexes.
Choice B rationale
Spontaneous bleeding is a significant risk with a platelet count of 9,000/mm³, which is critically low. Platelets are essential for blood clotting, and severe thrombocytopenia increases the risk of spontaneous bleeding.
Choice C rationale
Oliguria, or decreased urine output, is not directly related to thrombocytopenia. It may be associated with kidney function issues, but it is not a consequence of low platelet counts.
Choice D rationale
Infection is not directly related to a low platelet count. While patients with severe thrombocytopenia may be at risk for bleeding complications, their susceptibility to infections is more related to their white blood cell counts and immune function.
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