Clotting Quiz: Thrombocytopenia & Clotting Disorders

1. A patient receiving dabigatran (direct thrombin inhibitor) overdoses. What is the reversal agent?

Vitamin K

Fresh frozen plasma

Idarucizumab

Protamine sulfate

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6. Which clinical finding best indicates improvement in a patient treated for DIC?

Decreased platelet count and increased fibrinogen

Normalized PT, aPTT, platelet count, and fibrinogen

Elevated D-dimer with normal PT

Increased bleeding from previous sites

7. A patient is prescribed apixaban (Factor Xa inhibitor). What patient education is most important?

Take with food to enhance absorption

Report unusual bleeding and avoid NSAIDs

INR monitoring is required weekly

Vitamin K supplementation is needed

8. Which patient population is most at risk for acquired thrombocytopenia?

Patients with chronic kidney disease

Patients receiving chemotherapy or certain antibiotics

Patients with elevated blood pressure

Patients with hypothyroidism

9. A patient with acute leukemia develops DIC. What is the rationale for administering fresh frozen plasma?

To replace consumed clotting factors and fibrinogen

To increase platelet count directly

To inhibit thrombin formation

To prevent platelet aggregation

10. Which nursing assessment is essential for a patient with suspected thrombocytopenia?

Check for petechiae, ecchymosis, and mucosal bleeding

Assess for calf pain and swelling only

Monitor only vital signs and oxygen saturation

Evaluate joint pain and stiffness

11. A 45-year-old patient presents with petechiae and a platelet count of 15,000/μL. What is the primary nursing priority?

Monitor for signs of intracranial hemorrhage

Encourage ambulation to improve circulation

Initiate anticoagulation therapy

Increase sodium intake

12. Which finding suggests a patient is at high risk for thrombosis?

Platelet count 50,000/μL with normal coagulation studies

Prolonged aPTT with elevated factor VIII levels

Elevated D-dimer with normal fibrinogen

Low INR on anticoagulation therapy

13. A patient with liver cirrhosis has prolonged PT and aPTT. What is the underlying cause?

Decreased synthesis of clotting factors by hepatocytes

Increased platelet destruction in the spleen

Bone marrow suppression from alcohol toxicity

Autoimmune antibodies against clotting factors

14. Which medication increases bleeding risk by inhibiting platelet aggregation?

Enoxaparin

Clopidogrel

Warfarin

Apixaban

15. A patient develops heparin-induced thrombocytopenia (HIT). What is the priority nursing action?

Discontinue heparin and switch to direct thrombin inhibitor

Continue heparin but reduce the dose

Administer platelet transfusions immediately

Start aspirin therapy without stopping heparin

16. Which statement accurately describes von Willebrand disease?

It is an X-linked recessive disorder affecting males exclusively

It involves deficiency or dysfunction of von Willebrand factor

It causes excessive thrombus formation in arteries

It is managed solely with anticoagulation therapy

17. A patient with hemophilia A requires surgery. Which clotting factor replacement is indicated?

Factor II, VII, IX, X complex

Factor VIII concentrate

Fresh frozen plasma only

Platelet transfusion

18. Which lab finding is most consistent with disseminated intravascular coagulation (DIC)?

Elevated fibrinogen, normal PT, normal aPTT

Decreased platelets, decreased fibrinogen, elevated D-dimer

Elevated platelets, normal PT, elevated aPTT

Normal platelets, elevated fibrinogen, normal D-dimer

19. A patient on warfarin therapy has an INR of 8.2. What is the most appropriate initial intervention?

Continue current dose; recheck in one week

Administer vitamin K and fresh frozen plasma

Increase warfarin dose to achieve therapeutic range

Discontinue warfarin immediately without bridging

20. Which mechanism best explains thrombocytopenia in immune thrombocytopenic purpura (ITP)?

Increased platelet production in bone marrow

Autoimmune destruction of circulating platelets

Decreased thrombopoietin synthesis

Bone marrow infiltration by malignant cells

Clotting Quiz: Too Much or Too Little?