Question 1

A nursing student who is preparing to care for a postoperative patient with deep vein thrombosis asks the nurse why the patient must take heparin rather than warfarin. Which response by the nurse is correct?

Accepted Answer

A)   "Heparin has a longer half-life."
B)   "Heparin has fewer adverse effects."
C)   "The onset of warfarin is delayed."
D)   "Warfarin prevents platelet aggregation."

Question 2

A 50-year-old female patient asks a nurse about taking aspirin to prevent heart disease. The patient does not have a history of myocardial infarction. Her cholesterol and blood pressure are normal, and she does not smoke. What will the nurse tell the patient?

Accepted Answer

A)   Aspirin is useful only for preventing a second myocardial infarction.
B)   She should ask her provider about using a P2Y12 ADP receptor antagonist.
C)   She should take one 81-mg tablet per day to prevent myocardial infarction.
D)   There is most likely no protective benefit for patients of her age.

Question 3

A patient is receiving heparin postoperatively to prevent deep vein thrombosis. The nurse notes that the patient has a blood pressure of 90/50 mm Hg and a heart rate of 98 beats/min. The patient's most recent aPTT is greater than 90 seconds. The patient reports lumbar pain. The nurse will request an order for:

Accepted Answer

A)   a repeat aPTT to be drawn immediately.
B)   analgesic medication.
C)   changing heparin to aspirin.
D)   protamine sulfate. D

Question 4

A patient who takes warfarin for atrial fibrillation undergoes hip replacement surgery. On the second postoperative day, the nurse assesses the patient and notes an oxygen saturation of 83%, pleuritic chest pain, shortness of breath, and hemoptysis. The nurse will contact the provider to report possible ____ and request an order for ____.

Accepted Answer

A)   congestive heart failure; furosemide [Lasix]
B)   hemorrhage; vitamin K (phytonadione) 
C)   myocardial infarction; tissue plasminogen activator (tP
A)  
D)   pulmonary embolism; heparin

Question 5

A patient who is taking clopidogrel [Plavix] calls the nurse to report black, tarry stools and coffee-ground emesis. The nurse will tell the patient to:

Accepted Answer

A)   ask the provider about using aspirin instead of clopidogrel.
B)   consume a diet high in vitamin K.
C)   continue taking the clopidogrel until talking to the provider.
D)   stop taking the clopidogrel immediately.

Question 6

A patient who has taken warfarin [Coumadin] for a year begins taking carbamazepine. The nurse will anticipate an order to:

Accepted Answer

A)   decrease the dose of carbamazepine.
B)   increase the dose of warfarin.
C)   perform more frequent aPTT monitoring.
D)   provide extra dietary vitamin K.

Question 7

A patient has been taking warfarin [Coumadin] for atrial fibrillation. The provider has ordered dabigatran etexilate [Pradaxa] to replace the warfarin. The nurse teaches the patient about the change in drug regimen. Which statement by the patient indicates understanding of the teaching?

Accepted Answer

A)   "I may need to adjust the dose of dabigatran after weaning off the warfarin."
B)   "I should continue to take the warfarin after beginning the dabigatran until my INR is greater than 3."
C)   "I should stop taking the warfarin 3 days before starting the dabigatran."
D)   "I will stop taking the warfarin and will start taking the dabigatran when my INR is less than 2."

Question 8

The nurse has just received an order for tenecteplase [TNKase] for a patient experiencing an acute myocardial infarction. The nurse should administer this drug:

Accepted Answer

A)   by bolus injection.
B)   by infusion pump over 24 hours.
C)   slowly over 90 minutes.
D)   via monitored, prolonged infusion. A

Question 9

A postoperative patient will begin anticoagulant therapy with rivaroxaban [Xarelto] after knee replacement surgery. The nurse performs a history and learns that the patient is taking erythromycin. The patient's creatinine clearance is 50 mL/min. The nurse will:

Accepted Answer

A)   administer the first dose of rivaroxaban as ordered.
B)   notify the provider to discuss changing the patient's antibiotic.
C)   request an order for a different anticoagulant medication.
D)   request an order to increase the dose of rivaroxaban.

Question 10

A patient who is taking warfarin [Coumadin] has just vomited blood. The nurse notifies the provider, who orders laboratory work revealing a PT of 42 seconds and an INR of 3.5. The nurse will expect to administer:

Accepted Answer

A)   phytonadione (vitamin K1)  1 mg IV over 1 hour.
B)   phytonadione (vitamin K1)  2.5 mg PO.
C)   protamine sulfate 20 mg PO.
D)   protamine sulfate 20 mg slow IV push.

Question 11

A patient has been receiving heparin while in the hospital to treat deep vein thromboses and will be discharged home with a prescription for enoxaparin [Lovenox]. The nurse provides teaching for the nursing student who asks about the advantages of enoxaparin over heparin. Which statement by the student indicates a need for further teaching?

Accepted Answer

A)   "Enoxaparin does not require coagulation monitoring."
B)   "Enoxaparin has greater bioavailability than heparin."
C)   "Enoxaparin is more cost-effective than heparin."
D)   "Enoxaparin may be given using a fixed dosage."

Question 12

A patient is admitted to the emergency department with chest pain. An electrocardiogram shows changes consistent with an evolving myocardial infarction. The patient's cardiac enzymes are pending. The nurse caring for this patient will expect to:

Accepted Answer

A)   administer aspirin when cardiac enzymes are completed.
B)   give alteplase [Activase] within 2 hours.
C)   give tenecteplase [TNKase] immediately.
D)   obtain an order for an INR.

Question 13

A patient who takes warfarin [Coumadin] is brought to the emergency department after accidentally taking too much warfarin. The patient's heart rate is 78 beats/min, and the blood pressure is 120/80 mm Hg. A dipstick urinalysis is normal. The patient does not have any obvious hematoma or petechiae and does not complain of pain. The nurse will anticipate an order for:

Accepted Answer

A)   vitamin K (phytonadione) .
B)   protamine sulfate.
C)   a PTT.
D)   a PT and an INR.

Question 14

A patient is admitted to the hospital with unstable angina and will undergo a percutaneous coronary intervention. Which drug regimen will the nurse expect to administer to prevent thrombosis in this patient?

Accepted Answer

A)   Aspirin, clopidogrel, omeprazole
B)   Aspirin, heparin, abciximab [ReoPro]
C)   Enoxaparin [Lovenox], prasugrel [Effient], warfarin [Coumadin]
D)   Heparin, alteplase, abciximab [ReoPro] B

Question 15

A patient will begin taking dabigatran etexilate [Pradaxa] to prevent stroke. The nurse will include which statement when teaching this patient?

Accepted Answer

A)   Dabigatran should be taken on an empty stomach to improve absorption.
B)   It is important not to crush, chew, or open capsules of dabigatran.
C)   The risk of bleeding with dabigatran is less than that with warfarin [Coumadin].
D)   To remember to take dabigatran twice daily, a pill organizer can be useful.

Question 16

A postoperative patient reports pain in the left lower extremity. The nurse notes swelling in the lower leg, which feels warm to the touch. The nurse will anticipate giving which medication?

Accepted Answer

A)   Aspirin
B)   Clopidogrel [Plavix]
C)   Enoxaparin [Lovenox]
D)   Warfarin [Coumadin]

Question 17

A nurse caring for a patient receiving heparin therapy notes that the patient has a heart rate of 98 beats/min and a blood pressure of 110/72 mm Hg. The patient's fingertips are purplish in color. A stat CBC shows a platelet count of less than 100,000 mm³. The nurse will:

Accepted Answer

A)   administer oxygen and notify the provider.
B)   discontinue the heparin and notify the provider.
C)   request an order for protamine sulfate.
D)   request an order for vitamin K (phytonadione) .

Question 18

A patient with atrial fibrillation is receiving warfarin [Coumadin]. The nurse notes that the patient's INR is 2.7. Before giving the next dose of warfarin, the nurse will notify the provider and:

Accepted Answer

A)   administer the dose as ordered.
B)   request an order to decrease the dose.
C)   request an order to give vitamin K (phytonadione) .
D)   request an order to increase the dose.

Exam 52: Anticoagulant, Antiplatelet, and Thrombolytic Drugs

A nursing student who is preparing to care for a postoperative patient with deep vein thrombosis asks the nurse why the patient must take heparin rather than warfarin. Which response by the nurse is correct?

Correct Answer
verified

A 50-year-old female patient asks a nurse about taking aspirin to prevent heart disease. The patient does not have a history of myocardial infarction. Her cholesterol and blood pressure are normal, and she does not smoke. What will the nurse tell the patient?

Correct Answer
verified

Correct Answer
verified
D

Correct Answer
verified

A patient who is taking clopidogrel [Plavix] calls the nurse to report black, tarry stools and coffee-ground emesis. The nurse will tell the patient to:

Correct Answer
verified

A patient who has taken warfarin [Coumadin] for a year begins taking carbamazepine. The nurse will anticipate an order to:

Correct Answer
verified

A patient has been taking warfarin [Coumadin] for atrial fibrillation. The provider has ordered dabigatran etexilate [Pradaxa] to replace the warfarin. The nurse teaches the patient about the change in drug regimen. Which statement by the patient indicates understanding of the teaching?

Correct Answer
verified

The nurse has just received an order for tenecteplase [TNKase] for a patient experiencing an acute myocardial infarction. The nurse should administer this drug:

Correct Answer
verified
A

A postoperative patient will begin anticoagulant therapy with rivaroxaban [Xarelto] after knee replacement surgery. The nurse performs a history and learns that the patient is taking erythromycin. The patient's creatinine clearance is 50 mL/min. The nurse will:

Correct Answer
verified

A patient who is taking warfarin [Coumadin] has just vomited blood. The nurse notifies the provider, who orders laboratory work revealing a PT of 42 seconds and an INR of 3.5. The nurse will expect to administer:

Correct Answer
verified

Correct Answer
verified

A patient is admitted to the emergency department with chest pain. An electrocardiogram shows changes consistent with an evolving myocardial infarction. The patient's cardiac enzymes are pending. The nurse caring for this patient will expect to:

Correct Answer
verified

Correct Answer
verified

A patient is admitted to the hospital with unstable angina and will undergo a percutaneous coronary intervention. Which drug regimen will the nurse expect to administer to prevent thrombosis in this patient?

Correct Answer
verified
B

A patient will begin taking dabigatran etexilate [Pradaxa] to prevent stroke. The nurse will include which statement when teaching this patient?

Correct Answer
verified

A postoperative patient reports pain in the left lower extremity. The nurse notes swelling in the lower leg, which feels warm to the touch. The nurse will anticipate giving which medication?

Correct Answer
verified

A nurse caring for a patient receiving heparin therapy notes that the patient has a heart rate of 98 beats/min and a blood pressure of 110/72 mm Hg. The patient's fingertips are purplish in color. A stat CBC shows a platelet count of less than 100,000 mm³. The nurse will:

Correct Answer
verified

A patient with atrial fibrillation is receiving warfarin [Coumadin]. The nurse notes that the patient's INR is 2.7. Before giving the next dose of warfarin, the nurse will notify the provider and:

Correct Answer
verified

Exam 52: Anticoagulant, Antiplatelet, and Thrombolytic Drugs

A nursing student who is preparing to care for a postoperative patient with deep vein thrombosis asks the nurse why the patient must take heparin rather than warfarin. Which response by the nurse is correct?

Correct AnswerverifiedShow Answer

A 50-year-old female patient asks a nurse about taking aspirin to prevent heart disease. The patient does not have a history of myocardial infarction. Her cholesterol and blood pressure are normal, and she does not smoke. What will the nurse tell the patient?

Correct AnswerverifiedShow Answer

Correct AnswerverifiedD

Correct AnswerverifiedShow Answer

A patient who is taking clopidogrel [Plavix] calls the nurse to report black, tarry stools and coffee-ground emesis. The nurse will tell the patient to:

Correct AnswerverifiedShow Answer

A patient who has taken warfarin [Coumadin] for a year begins taking carbamazepine. The nurse will anticipate an order to:

Correct AnswerverifiedShow Answer

A patient has been taking warfarin [Coumadin] for atrial fibrillation. The provider has ordered dabigatran etexilate [Pradaxa] to replace the warfarin. The nurse teaches the patient about the change in drug regimen. Which statement by the patient indicates understanding of the teaching?

Correct AnswerverifiedShow Answer

The nurse has just received an order for tenecteplase [TNKase] for a patient experiencing an acute myocardial infarction. The nurse should administer this drug:

Correct AnswerverifiedA

A postoperative patient will begin anticoagulant therapy with rivaroxaban [Xarelto] after knee replacement surgery. The nurse performs a history and learns that the patient is taking erythromycin. The patient's creatinine clearance is 50 mL/min. The nurse will:

Correct AnswerverifiedShow Answer

A patient who is taking warfarin [Coumadin] has just vomited blood. The nurse notifies the provider, who orders laboratory work revealing a PT of 42 seconds and an INR of 3.5. The nurse will expect to administer:

Correct AnswerverifiedShow Answer

Correct AnswerverifiedShow Answer

A patient is admitted to the emergency department with chest pain. An electrocardiogram shows changes consistent with an evolving myocardial infarction. The patient's cardiac enzymes are pending. The nurse caring for this patient will expect to:

Correct AnswerverifiedShow Answer

Correct AnswerverifiedShow Answer

A patient is admitted to the hospital with unstable angina and will undergo a percutaneous coronary intervention. Which drug regimen will the nurse expect to administer to prevent thrombosis in this patient?

Correct AnswerverifiedB

A patient will begin taking dabigatran etexilate [Pradaxa] to prevent stroke. The nurse will include which statement when teaching this patient?

Correct AnswerverifiedShow Answer

A postoperative patient reports pain in the left lower extremity. The nurse notes swelling in the lower leg, which feels warm to the touch. The nurse will anticipate giving which medication?

Correct AnswerverifiedShow Answer

A nurse caring for a patient receiving heparin therapy notes that the patient has a heart rate of 98 beats/min and a blood pressure of 110/72 mm Hg. The patient's fingertips are purplish in color. A stat CBC shows a platelet count of less than 100,000 mm³. The nurse will:

Correct AnswerverifiedShow Answer

A patient with atrial fibrillation is receiving warfarin [Coumadin]. The nurse notes that the patient's INR is 2.7. Before giving the next dose of warfarin, the nurse will notify the provider and:

Correct AnswerverifiedShow Answer

Correct Answer
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Correct Answer
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D

Correct Answer
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A

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B

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Correct Answer
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