CCRN Hematology and Immunology 2

Question 1

A patient with disseminated intravascular coagulation (DIC) would be expected to have which laboratory profile?

Accepted Answer

Low platelets, high D-dimer, prolonged PT/PTT, low fibrinogen

Answer

DIC consumes platelets and clotting factors and generates fibrin degradation products, producing thrombocytopenia, elevated D-dimer, prolonged PT/PTT, and low fibrinogen.

Question 2

Which transfusion reaction is most life-threatening and typically results from ABO incompatibility?

Accepted Answer

Acute hemolytic reaction

Answer

Acute hemolytic transfusion reactions from ABO incompatibility cause intravascular hemolysis, shock, and renal failure and require immediate cessation of the transfusion.

Question 3

A patient receiving heparin develops a platelet count drop of more than 50% on day 6. What condition should be suspected?

Accepted Answer

Heparin-induced thrombocytopenia (HIT)

Answer

HIT is an immune-mediated reaction occurring 5-10 days after heparin exposure, causing thrombocytopenia and a paradoxical thrombosis risk.

Question 4

Which finding best indicates a neutropenic patient is at highest infection risk?

Accepted Answer

Absolute neutrophil count below 500/mm3

Answer

An ANC below 500/mm3 defines severe neutropenia and markedly increases the risk of serious infection.

Question 5

What is the priority intervention for a neutropenic patient who develops a fever of 38.5C?

Accepted Answer

Obtain cultures and start broad-spectrum antibiotics promptly

Answer

Neutropenic fever is an emergency requiring blood cultures and empiric broad-spectrum antibiotics within an hour to prevent sepsis.

CCRN Review Practice Test

CCRN Review Practice Test

CCRN Hematology and Immunology 2