DIC Quiz: Disseminated Intravascular Coagulation Nursing

1. A 62-year-old with sepsis develops petechiae, oozing from IV sites, and a platelet count dropping from 250 to 80 K/µL in 6 hours. Which lab finding would MOST support DIC diagnosis?

Elevated PT/INR, low fibrinogen, elevated D-dimer, low platelets

Normal PT, elevated fibrinogen, low D-dimer, normal platelets

Low PT, normal fibrinogen, normal D-dimer, elevated platelets

Elevated PT, elevated fibrinogen, low D-dimer, normal platelets

2. In suspected DIC, which initial nursing action is MOST appropriate?

Administer anticoagulation immediately

Notify provider, obtain stat coagulation labs, and assess for bleeding

Restrict all fluids

Discharge patient home for outpatient follow-up

3. Which statement about DIC prognosis is accurate?

DIC is always fatal regardless of treatment

Outcome depends primarily on treating the underlying trigger

Platelet transfusion alone resolves DIC

DIC never causes chronic complications

4. A patient with sepsis-induced DIC requires transfusion. Which product addresses both low platelets and low fibrinogen?

Packed red blood cells only

Fresh frozen plasma and platelet transfusion

Cryoprecipitate only

Whole blood

5. Which malignancy is MOST strongly associated with DIC?

Breast cancer

Acute promyelocytic leukemia

Melanoma

Prostate cancer

6. A patient with DIC receives packed RBCs. Which monitoring parameter is MOST critical?

Urine color and output

Coagulation studies and fibrinogen levels

Heart rate and blood pressure only

Temperature trends

7. Which medication is contraindicated in acute DIC management?

Heparin (at any dose)

Fresh frozen plasma for severe bleeding

Platelets for thrombocytopenia

Antibiotics for sepsis-triggered DIC

8. The ISTH scoring system for DIC uses which parameters?

Platelet count, D-dimer, PT, fibrinogen

Hemoglobin, WBC, blood glucose, albumin

Creatinine, BUN, potassium, sodium

Troponin, BNP, CK, myoglobin

9. Which lab result pattern is LEAST consistent with active DIC?

Low fibrinogen, elevated PT, elevated D-dimer, low platelets

Normal fibrinogen, normal PT, low D-dimer, normal platelets

Progressively falling fibrinogen over 24 hours with rising D-dimer

Elevated LDH with schistocytes on blood smear

10. In DIC, low platelet counts result from which mechanism?

Decreased platelet production in bone marrow

Consumption by ongoing coagulation and fibrinolysis

Immune destruction by antibodies

Sequestration in the spleen only

11. A trauma patient with massive transfusions develops DIC. Which intervention is PRIORITY in acute management?

Administer fresh frozen plasma immediately

Treat the underlying cause and provide supportive care

Give aspirin to prevent thrombosis

Restrict all fluid intake

12. Which clinical finding is MOST specific for DIC rather than other coagulopathies?

Low platelets alone

Elevated PT/INR alone

Simultaneous thrombosis and bleeding with low fibrinogen and elevated D-dimer

High hemoglobin

13. A patient with DIC has a fibrinogen level of 85 mg/dL. What is the PRIMARY consequence of this level?

Increased risk of thrombosis and stroke

Severe impairment of clot formation and increased bleeding risk

Enhanced platelet aggregation

Improved tissue perfusion

14. Which condition is MOST commonly associated with triggering DIC in hospitalized patients?

Mild urinary tract infection

Sepsis from gram-negative bacteria

Type 2 diabetes mellitus

Chronic hypertension

15. Which pathophysiologic mechanism is PRIMARY in the development of Disseminated Intravascular Coagulation?

Excessive platelet aggregation without thrombin activation

Widespread activation of coagulation cascade leading to simultaneous clotting and bleeding

Isolated fibrinolysis without coagulation system involvement

Primary platelet dysfunction from bone marrow suppression

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DIC Quiz: Can You Catch This Emergency?