Which of the following findings is most consistent with disseminated intravascular coagulation (DIC)?
elevated D-dimer
decreased prothrombin time
decreased partial thromboplastin time
elevated fibrinogen level
The Correct Answer is A
Disseminated intravascular coagulation (DIC) is a condition characterized by both widespread activation of the coagulation system and excessive clotting, leading to the consumption of clotting factors and platelets. This results in a prothrombotic state, which can lead to organ dysfunction and bleeding manifestations.
Elevated D-dimer levels are a characteristic finding in DIC. D-dimer is a fibrin degradation product that is elevated when there is excessive fibrin formation and breakdown. Elevated D-dimer indicates ongoing fibrinolysis and activation of the clotting system.
B. Decreased prothrombin time in (option B) is incorrect because: DIC is characterized by consumption of clotting factors, which can result in prolongation of the prothrombin time (PT) as well as other coagulation tests.
C. Decreased partial thromboplastin time in (option C) is incorrect because Similar to the prothrombin time, the partial thromboplastin time (PTT) can also be prolonged in DIC due to the consumption of clotting factors.
D. Elevated fibrinogen level in (option D) is incorrect because, In DIC, there is consumption of fibrinogen along with other clotting factors. Therefore, elevated fibrinogen levels are not consistent with the pathophysiology of DIC.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["9"]
Explanation
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Doseinmcg/min=2mcg/kg/min×60kg=120mcg/min
Convert this to mg/min since the concentration is in mg:
120mcg/min=0.12mg/min120 \text{ mcg/min} = 0.12 \text{ mg/min}120mcg/min=0.12mg/min
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Determine the concentration of Dopamine:
- Total amount of Dopamine: 200 mg in 250 mL of saline
- Concentration:
Concentration=200mg250mL=0.8mg/mL\text{Concentration} = \frac{200 \text{ mg}}{250 \text{ mL}} = 0.8 \text{ mg/mL}Concentration=250mL200mg=0.8mg/mL
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Calculate the pump rate in mL/min:
To find the rate in mL/min needed to deliver 0.12 mg/min:
Pumprate=Desireddose(mg/min)Concentration(mg/mL)\text{Pump rate} = \frac{\text{Desired dose (mg/min)}}{\text{Concentration (mg/mL)}}Pumprate=Concentration(mg/mL)Desireddose(mg/min)
Pumprate=0.12mg/min0.8mg/mL=0.15mL/min\text{Pump rate} = \frac{0.12 \text{ mg/min}}{0.8 \text{ mg/mL}} = 0.15 \text{ mL/min}Pumprate=0.8mg/mL0.12mg/min=0.15mL/min
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Convert the pump rate to mL/hour:
Multiply by 60 to convert from mL/min to mL/hour:
Pumprate=0.15mL/min×60min/hour=9mL/hour\text{Pump rate} = 0.15 \text{ mL/min} \times 60 \text{ min/hour} = 9 \text{ mL/hour}Pumprate=0.15mL/min×60min/hour=9mL/hour
So, you should set the pump to deliver Dopamine at a rate of 9 mL/hour.
Correct Answer is B
Explanation
A. Oxygen saturation of 92% in (option A) is incorrect because While an oxygen saturation of 92% is suboptimal and may require intervention, it may not have the same immediate implications as low blood pressure. The healthcare provider should be informed, but addressing the blood pressure takes priority.
B. Skin cool and clammy in (option B) is correct because Cool and clammy skin is often associated with inadequate peripheral perfusion, which is a characteristic of septic shock.
C. Septic shock is characterized by systemic inflammation, vasodilation, and hypotension. Inadequate blood pressure is a significant concern in septic shock as it indicates poor tissue perfusion and compromised organ function. However, the mean arterial pressure is till acceptable.
D. Heart rate of 118 beats/minute in (option D) is incorrect because: Tachycardia is a common finding in septic shock and reflects the body's compensatory response to maintain cardiac output. While it is a significant finding, low blood pressure takes precedence in terms of urgency.
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