Chapter 48 - Drugs Affecting Blood Coagulation |Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
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Focus on Nursing Pharmacology
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Focus On Nursing Pharmacology
1. A patient is admitted to the hospital with deep vein thrombosis. A 10,000-unit dose of heparin is administered subcutaneously. What drug does the nurse keep on hand to reverse the effects of heparin if the patient begins to bleed?
a. Antithrombin (Thrombate III)
b. Desirudin (Iprivask)
c. Pro...
Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
1. A patient is admitted to the hospital with deep vein thrombosis. A 10,000-unit dose
of heparin is administered subcutaneously. What drug does the nurse keep on hand
to reverse the effects of heparin if the patient begins to bleed?
a. Antithrombin (Thrombate III)
b. Desirudin (Iprivask)
c. Protamine sulfate
d. Vitamin K
Ans: C
Feedback:
The antidote for heparin is protamine sulfate. This drug forms stable salts as soon as it
comes in contact with heparin. The reaction immediately reverses heparin’s
anticoagulation effects. Vitamin K reverses the effect of warfarin. Antithrombin and
desirudin are anticoagulants that would not be administered with heparin.
2. Prior to beginning anticoagulant therapy, the nurse will question the female patient
about what?
a. Last menstrual period
b. Peptic ulcers
c. Urinary tract infection
d. Weight
Ans: B
Feedback:
The nurse should screen for conditions that could be exacerbated by increased
bleeding tendencies, including hemorrhagic disorders, recent trauma, spinal puncture,
gastrointestinal (GI) ulcers, recent surgery, intrauterine device placement,
tuberculosis, presence of indwelling catheters, and threatened abortion. Beginning
anticoagulant therapy with active peptic ulcers could result in severe bleeding. Last
menstrual period, urinary tract infection, and weight should not impact anticoagulant
therapy.
3. The nurse is caring for a female patient who is nursing her 3-month-old infant.
What will the nurse instruct the patient to do prior to starting heparin to treat
venous thrombosis?
a. Wait an hour after taking the anticoagulant before feeding the infant.
b. Push fluids to clear the drug from her system before feeding the infant.
, c. Find another method of feeding the infant while taking this drug.
d. Continue breast-feeding because heparin does not enter breast milk.
Ans: D
Feedback:
Although some adverse fetal effects have been reported with its use during pregnancy,
heparin does not enter breast milk, and so it is the anticoagulant of choice if one is
needed during lactation. As a result, there is no need to wait an hour, push fluids, or
find another method of feeding the baby.
4. The nurse receives a patient having an acute myocardial infarction (MI) to the
emergency department. What drug will the nurse administer before transferring the
patient to a larger facility?
a. Anagrelide (Agrylin)
b. Clopidogrel (Plavix)
c. Ticlopidine (Ticlid)
d. Tenecteplase (TNKase)
Ans: D
Feedback:
Arrange to administer tenecteplase to reduce mortality associated with acute MI as
soon as possible after the onset of symptoms because the timing for the administration
of tenecteplase is critical to resolve the clot before permanent damage occurs to the
myocardial cells. Anagrelide is used to treat essential thrombocytopenia. Clopidogrel
is used to treat patients who are at risk for ischemic events; ticlopidine is used to
reduce the risk of thrombotic stroke.
5. A nurse is preparing to discharge a patient newly prescribed warfarin (Coumadin).
While assessing the patient’s knowledge of the drug, what would indicate that the
patient needs further instruction concerning drug therapy?
a. I love to eat homegrown tomatoes in the summer.
b. I take aspirin for my arthritis.
c. I walk 2 miles a day.
d. I drink a glass of wine about once a week.
Ans: B
Feedback:
Increased bleeding can occur if a salicylate is taken in combination with warfarin. The
nurse will instruct the patient to stop taking aspirin. Walking, eating tomatoes, and
drinking an occasional glass of wine should not interfere with the therapeutic effects
of warfarin.
6. The nurse is caring for a patient with a fever and severe diarrhea in addition to
thrombophlebitis. How will this patient’s condition impact the clotting process?
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