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Hemostasis, Fluids and Electrolytes

Coagulation Disorders Practice Questions

20 free Coagulation Disorders practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.

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Question 1 of 20 Medium

Which condition is most likely for a male patient presenting with spontaneous hemarthroses and factor VIII deficiency?

  1. A Von Willebrand disease
  2. B Hemophilia B
  3. C Hemophilia A
  4. D Immune thrombocytopenic purpura (ITP)

Correct answer: Hemophilia A

Hemophilia A is due to factor VIII deficiency, leading to repeated bleeding episodes, especially joint bleeds, predominantly in males.

Question 2 of 20 Easy

Which inheritance pattern is typical for classic hemophilia?

  1. A Autosomal dominant
  2. B Autosomal recessive
  3. C X-linked recessive
  4. D Mitochondrial

Correct answer: X-linked recessive

Hemophilia A and B are inherited in an X-linked recessive pattern, explaining male predominance and female carriers.

Question 3 of 20 Hard

What is the nurse's primary concern when a patient with known hemophilia reports a headache and nausea after a minor fall?

  1. A Pulmonary embolism from clot migration
  2. B Intracranial hemorrhage from the head trauma
  3. C Gastrointestinal bleed causing the nausea
  4. D Deep vein thrombosis in the lower limb

Correct answer: Intracranial hemorrhage from the head trauma

In hemophilia, even minor trauma may precipitate intracranial bleeding, which is life-threatening and requires urgent evaluation.

Question 4 of 20 Medium

What is the cornerstone of management for hemophilia during a bleeding episode?

  1. A Random-donor platelet transfusion
  2. B Desmopressin given for factor IX deficiency
  3. C Replacement of the deficient clotting factor
  4. D Anticoagulation with intravenous heparin

Correct answer: Replacement of the deficient clotting factor

Replacement of the specific deficient clotting factor is the primary treatment for bleeding control in hemophilia.

Question 5 of 20 Hard

Which lab result is most typical in acute DIC?

  1. A Elevated fibrinogen, normal D-dimer, normal PT
  2. B Decreased platelets, prolonged PT and PTT, elevated D-dimer
  3. C Increased platelets, shortened PT, normal fibrinogen
  4. D Normal platelets, normal clotting times, elevated fibrinogen

Correct answer: Decreased platelets, prolonged PT and PTT, elevated D-dimer

In DIC, there is consumption of platelets and clotting factors, leading to thrombocytopenia, prolonged PT/PTT, and elevated D-dimer from fibrin breakdown.

Question 6 of 20 Medium

A patient with sudden bleeding from IV sites, oozing gums, and petechiae in the context of sepsis likely has which condition?

  1. A Hemophilia A
  2. B Von Willebrand disease
  3. C DIC
  4. D Immune thrombocytopenia

Correct answer: DIC

DIC may present with widespread bleeding from invasive sites, mucous membranes and skin in the context of severe illness like sepsis.

Question 7 of 20 Easy

What is the most appropriate nursing intervention for a patient with DIC?

  1. A Encourage early ambulation and activity
  2. B Monitor for bleeding and organ dysfunction; treat the cause
  3. C Administer aspirin to prevent clot formation
  4. D Withhold all intravenous fluids from the patient

Correct answer: Monitor for bleeding and organ dysfunction; treat the cause

Nursing care focuses on monitoring for bleeding or clotting complications, supporting organ perfusion, and treating the underlying trigger in DIC.

Question 8 of 20 Medium

Which prophylactic measure can reduce joint damage from recurrent bleeds in hemophilia?

  1. A Routine aspirin therapy
  2. B Scheduled factor replacement and safe exercise
  3. C Use of anticoagulants during bleeds
  4. D Frequent blood draws for monitoring

Correct answer: Scheduled factor replacement and safe exercise

Prophylactic factor replacement prevents recurrent joint bleeds and subsequent arthropathy, along with safe physical activity.

Question 9 of 20 Hard

In acute DIC, what is the most urgent next step for a patient with hypotension, rising creatinine, and very low fibrinogen?

  1. A Scheduled factor replacement with safe exercise
  2. B Use of anticoagulants to manage acute bleeds
  3. C Frequent venous blood draws for close monitoring
  4. D Routine daily low-dose aspirin therapy

Correct answer: Scheduled factor replacement with safe exercise

In acute DIC with bleeding and organ dysfunction, urgent replacement of coagulation factors and fibrinogen, along with hemodynamic support, is crucial.

Question 10 of 20 Medium

What distinguishes hemophilia from a platelet disorder?

  1. A Normal bleeding time, prolonged PTT, normal platelets
  2. B Prolonged bleeding time, normal PTT, low platelet count
  3. C Elevated PT with otherwise normal coagulation studies
  4. D Elevated platelet count with normal clotting times

Correct answer: Normal bleeding time, prolonged PTT, normal platelets

Hemophilia affects the clotting cascade not platelets; bleeding time and platelet count are normal but PTT is prolonged.

Question 11 of 20 Medium

When a patient with DIC shows signs of organ involvement from thrombosis not just bleeding, what is the clinical sign to indicate this?

  1. A Widespread bruising over the skin
  2. B Visible blood in the urine (hematuria)
  3. C Oliguria with a rising serum creatinine
  4. D Urticaria with generalized itching

Correct answer: Oliguria with a rising serum creatinine

Microvascular thrombosis in DIC can impair organ perfusion, leading to signs like oliguria, renal failure, or altered mental status, not just bleeding.

Question 12 of 20 Hard

When developing a nursing plan for a hemophilia patient undergoing surgery, what is most important to include?

  1. A Plan for no factor replacement before surgery
  2. B Give pre-op factor replacement; minimize invasive procedures
  3. C Withhold all physical therapy indefinitely after surgery
  4. D Use high-dose heparin throughout the surgical procedure

Correct answer: Give pre-op factor replacement; minimize invasive procedures

Surgical preparation in hemophilia should ensure adequate factor levels, minimize invasive procedures, and be ready for bleed control to prevent peri-operative hemorrhage.

Question 13 of 20 Medium

In DIC lab monitoring, what does an increasing D-dimer level indicate?

  1. A Decrease in fibrin formation
  2. B Increase in fibrin breakdown and fibrinolysis
  3. C Exclusive platelet function improvement
  4. D Increase in vitamin K activity

Correct answer: Increase in fibrin breakdown and fibrinolysis

Elevated D-dimer levels in DIC reflect increased fibrin formation and breakdown (fibrinolysis) in the consumptive process.

Question 14 of 20 Easy

When teaching a hemophilia patient about home care, what should be included?

  1. A There is no need to inform schools or workplaces
  2. B Avoid high bleed-risk activities; recognize internal bleeding
  3. C Take aspirin regularly for routine pain control
  4. D Only seek treatment for bleeds when they are severe

Correct answer: Avoid high bleed-risk activities; recognize internal bleeding

Patients with hemophilia must avoid high-risk activities, wear protective gear, and be educated on recognizing internal bleeds for prompt treatment.

Question 15 of 20 Medium

What is a non-hemorrhagic complication of DIC?

  1. A Easy bruising
  2. B Petechiae
  3. C Organ ischemia from microthrombi
  4. D Prolonged bleeding after venipuncture

Correct answer: Organ ischemia from microthrombi

DIC involves widespread clotting as well as bleeding; microthrombi can cause ischemia and multi-organ dysfunction beyond bleeding.

Question 16 of 20 Medium

For a child with severe hemophilia A admitted with a joint bleed, what treatment is anticipated?

  1. A Immune-globulin replacement
  2. B Factor VIII infusion and joint care
  3. C Platelet transfusion only
  4. D Broad-spectrum antibiotics

Correct answer: Factor VIII infusion and joint care

Hemarthrosis in hemophilia A is managed with factor VIII replacement, joint care, and analgesia to prevent joint damage.

Question 17 of 20 Easy

Which condition is a known trigger for DIC?

  1. A Mild seasonal upper respiratory infection
  2. B Severe trauma, sepsis, or obstetric catastrophe
  3. C Long-standing well-controlled hypertension
  4. D Stable osteoarthritis of the knee joints

Correct answer: Severe trauma, sepsis, or obstetric catastrophe

DIC is always secondary to a severe underlying condition such as sepsis, major trauma or obstetric complication.

Question 18 of 20 Hard

What best describes the pathophysiology of DIC?

  1. A Isolated destruction of circulating platelets
  2. B Systemic coagulation activation, factor consumption, then bleeding
  3. C Reduced clotting factor production by the diseased liver
  4. D An isolated dietary deficiency of vitamin K

Correct answer: Systemic coagulation activation, factor consumption, then bleeding

DIC involves widespread activation of coagulation, forming micro-thrombi, consuming clotting factors and platelets, leading to bleeding and organ damage.

Question 19 of 20 Medium

When a nurse receives factor IX concentrate for a patient with hemophilia B, what is the correct response?

  1. A Give aspirin to the patient prior to dosing
  2. B Administer factor IX per protocol; watch for inhibitors
  3. C Reverse the infusion with protamine sulfate afterward
  4. D Delay the infusion until bleeding becomes significant

Correct answer: Administer factor IX per protocol; watch for inhibitors

Hemophilia B is managed with factor IX replacement; monitoring for inhibitor formation is crucial for effective therapy.

Question 20 of 20 Medium

What is the appropriate nursing action for a patient with DIC and overt bleeding?

  1. A Encourage early ambulation around the unit
  2. B Avoid all blood product transfusions during care
  3. C Give platelets, FFP, and cryoprecipitate; monitor closely
  4. D Give high-dose heparin regardless of active bleeding

Correct answer: Give platelets, FFP, and cryoprecipitate; monitor closely

In DIC with bleeding, replacement of platelets and clotting factors through transfusions is essential while monitoring for clotting and bleeding.

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