NR 293 Week 4 Quiz 2 Take Home Assignment ( Pre-class questions Week 4) | Already GRADED A
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NR 293
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Chamberlain College Of Nursing
NR293 Pharmacology Pre-class Questions Week 4 Answer the following questions. Give rationales for each question asked and include the reference and page number where the answer was found. Rationales must be TYPED, chapter and pg. no should be included. Upload test questions and rationales to the su...
1 the nurse will include which instructions in the plan of care for a patient receiving warfarin therapy
2 the nurse is preparing to administer an anticoagulant to a patient which action
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NR293 Pharmacology
Pre-class Questions Week 4
Answer the following questions. Give rationales for each question asked and include the
reference and page number where the answer was found. Rationales must be TYPED, chapter
and pg. no should be included. Upload test questions and rationales to the submission tab under
the course shell. Questions will be graded for accuracy. Each question along with the rationale
will be worth 0.5 points, for a total of 20 points possible. The assignment is due Sunday
02/02/20 at 11:59 pm. No late submissions will be accepted. Late submissions will result in zero
points for the assignment. Please submit the original document.
1. The nurse will include which instructions in the plan of care for a patient receiving
warfarin therapy?
a. "Do not take aspirin for pain."
b. "Avoid the use of acetaminophen."
c. "Do not eat foods with potassium."
d. "Increase your intake of dark, leafy green vegetables."
Rationale: Under Table 26.3 “Anticoagulants: Drug Interactions”
Under the drug, Warfarin, it is advised to not take “aspirin, other NSAIDs, broad-spectrum
antibiotics” due to the result of “increased anticoagulant effects” which is a bleeding risk,
Chapter 408, Chapter 26
2. The nurse is preparing to administer an anticoagulant to a patient. Which action, if
observed, is in error?
a. The nurse administers warfarin orally to a patient.
b. The nurse administers dabigatran orally to a patient.
c. The nurse administers heparin subcutaneously to a patient.
d. The nurse administers enoxaparin intramuscularly to a patient.
Rationale: “Under the table “Pharmacokinetics: Enoxaparin” showing that the injections are
intended for SubQ route only” Chapter 26, page 409
3. The nurse is reviewing laboratory data before initiating a patient's heparin infusion.
Which finding requires immediate action?
a. Platelet count of 95,000/mm3
b. Potassium level of 3.5 mEq/L
c. International normalized ratio (INR) of 1
d. Activated partial thromboplastin time (aPTT) of 37 seconds
Rationale: “If platelet counts are at or fall below 80,000 cells/mm3, notify the prescriber; in such
a case antiplatelet therapy most likely will not be initiated (or will be discontinued)” Chapter 26,
page 410, 419
4. A patient has overdosed on warfarin. Which substance will the nurse administer to
reverse the effect of warfarin?
a. Aspirin
, 2
b. Calcium
c. Potassium
d. Vitamin K
Rationale: “In the event of warfarin toxicity or overdose, the first step is to discontinue the
warfarin. As with heparin, the toxicity associated with warfarin is an extension of its therapeutic
effects on the clotting cascade. However, because warfarin inactivates the vitamin K–dependent
clotting factors and these clotting factors are synthesized in the liver, it may take 36 to 42 hours
before the liver can resynthesize enough clotting factors to reverse warfarin’s effects. Giving
vitamin K1 (phytonadione) can hasten the return to normal coagulation” Chapter 27, page 407
5. The nurse is caring for a patient who is scheduled to begin warfarin treatment and is
currently being treated with amiodarone. Based on this information, the nurse anticipates
which change will be made to the medication regimen?
a. The dosage of the warfarin will be increased by half.
b. The dosage of the warfarin will be decreased by half.
c. The dosage of the amiodarone will be increased by half.
d. The dosage of the amiodarone will be decreased by half.
Rationale: “Combining warfarin and amiodarone will lead to a 50% increase in the INR. When
amiodarone is added to warfarin therapy, it is recommended that the warfarin dose be cut in half”
Chapter 26, page 411
6. The nurse is caring for a newly admitted patient who will begin heparin therapy. While
documenting the patient history, the nurse notes that the patient is currently undergoing
treatment with enoxaparin. What is the nurse's highest priority?
a. Notify the provider that the patient is at risk for an allergic reaction.
b. Notify the provider that heparin should not be started on the patient.
c. Notify the provider that the dosage of heparin will need to be increased.
d. Notify the provider that the dosage of heparin will need to be decreased.
Rationale: Also, “a potentially deadly medication error is to give heparin in combination with
enoxaparin (or any LMWH, dabigatran, rivaroxaban, apixaban, edoxaban or betrixaban). Always
double-check that enoxaparin and other anticoagulants are never given to the same patient.”
“LMWHs, especially enoxaparin, are also routinely used as anticoagulant bridge therapy in
situations in which a patient must stop warfarin for surgery or other invasive medical procedures.
The term bridge therapy refers to the fact that enoxaparin acts as a bridge to provide
anticoagulation while the patient must be off of his or her warfarin therapy” Chapter 26, Page
406, 407, 409
7. A patient who has been receiving intravenous heparin as treatment for a deep vein
thrombosis requires immediate surgery for a suspected bowel perforation. Which
intervention is essential at this time?
a. Administer vitamin K
b. Administer protamine sulfate
c. Assess the INR before surgery
d. Provide patient teaching about the heparin
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