Nursing 1141- Pharmacology » Fall 2022 » Mastery EAQ Ch. 26

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Question #1
A patient has overdosed on warfarin. Which substance will the nurse administer to reverse the effect of warfarin?
A.   Potassium
B.   Calcium
C.   Aspirin
D.   Vitamin K
Question #2
A patient who is on enoxaparin therapy has hematuria, melena, petechiae, and bleeding from the gums. Which treatment strategy will be beneficial for the patient?
A.   Infusing 50 mL of warfarin sodium
B.   Administering protamine sulfate
C.   Administering vitamin K1
D.   Increasing the dose of enoxaparin
Question #3
A patient who was admitted with deep vein thrombophlebitis is complaining of difficulty breathing and chest pain. Which is the most likely cause of these symptoms?
A.   Medication reaction
B.   Embolus to the lungs
C.   Anxiety
D.   Fatigue from walking with pain
Question #4
Cilostazol belongs to which drug class?
A.   Anticoagulant
B.   Antiplatelet
C.   Antifibrinolytic
D.   Thrombolytic
Question #5
The nurse is teaching a patient about therapy with anticoagulants. Which is essential information to include in the teaching plan?
A.   Anticoagulants interfere with drug metabolism.
B.   Anticoagulants alter platelet function.
C.   Anticoagulants dissolve clots.
D.   Anticoagulants prevent clots from forming.
Question #6
Which subclass of anticoagulants may cause the adverse effect of purple toes?
A.   Selective factor Xa inhibitors
B.   Warfarin
C.   Direct thrombin inhibitors
D.   Heparins
Question #7
Which anticoagulant can be given orally?
A.   Fondaparinux
B.   Dabigatran
C.   Argatroban
D.   Enoxaparin
Question #8
Which antiplatelet drug works by inhibiting the cyclooxygenase in the platelet irreversibly so that the platelet cannot regenerate this enzyme, thereby preventing clot formation?
A.   Dipyridamole
B.   Aspirin
C.   Cilostazol
D.   Pentoxifylline
Question #9
Which condition is an indication for thrombolytic therapy?
A.   Coronary artery disease
B.   Heart failure
C.   Cardiomyopathy
D.   Acute myocardial infarction
Question #10
Which class of drugs is also known as hemostatic drugs?
A.   Anticoagulant
B.   Thrombolytic
C.   Antifibrinolytic
D.   Antiplatelet
Question #11
Which antifibrinolytic agent is used for surgical and postoperative hemostasis?
A.   Aminocaproic acid
B.   Alteplase
C.   Desmopressin
D.   Tranexamic acid
Question #12
A nurse understands that warfarin works by affecting which substance?
A.   Antithrombin III
B.   Vitamin K
C.   Factor Xa
D.   Thrombin
Question #13
A patient with deep vein thrombosis is receiving fondaparinux therapy. After reviewing the patient’s laboratory reports, the nurse believes that discontinuing the therapy will be beneficial for the patient. Which finding supports the nurse’s suspicion?
A.   Hemoglobin level of 16.5 g/dL
B.   Fasting blood glucose level of 95 mg/dL
C.   Creatinine clearance value of 40 mL/min
D.   Platelet count of 75,000 cell/μL
Question #14
A patient is receiving an intravenous heparin drip. Which laboratory value requires immediate action by the nurse?
A.   International normalized ratio (INR) of 1.0
B.   Platelet count of 150,000 mm3
C.   Activated partial thromboplastin time (aPTT) of 120 seconds
D.   Blood urea nitrogen (BUN) level of 12 mg/dL
Question #15
The patient has been placed on aspirin as an antiplatelet drug. Which is a side effect of aspirin therapy?
A.   Itching
B.   Edema
C.   Chest pain
D.   Nausea
Question #16
The patient is being treated with dabigatran and opens a new bottle of the medication on July 1. The nurse will instruct the patient to discard any unused medication by which date?
A.   August 29
B.   July 31
C.   October 1
D.   September 15
Question #17
A patient who is receiving heparin therapy has bruises covering the abdomen as well as red-colored urine. Which assessment does the nurse need to address?
A.   Ingestion of acetaminophen
B.   Platelet level
C.   Urine culture
D.   Over-the-counter medications
Question #18
The nurse is preparing to administer an anticoagulant to a patient. Which medication and route of administration is in error?
A.   Dabigatran orally
B.   Heparin subcutaneously
C.   Enoxaparin intramuscularly
D.   Warfarin orally
Question #19
Which condition is a contraindication to therapy with an antiplatelet drug?
A.   Peripheral vascular disease
B.   Acute unstable angina
C.   Transient ischemic attack
D.   Vitamin K deficiency
Question #20
A patient is diagnosed with hemophilia. Which medication therapy is essential?
A.   Vitamin K daily
B.   Recombinant factors
C.   Aspirin daily (i.e., 81 mg)
D.   Warfarin daily
Question #21
A patient who has been taking warfarin is admitted with coffee-ground emesis. Which medication would the nurse anticipate being prescribed for this patient?
A.   Calcium gluconate
B.   Vitamin K
C.   Vitamin E
D.   Protamine sulfate
Question #22
A patient is receiving warfarin for a chronic condition. Which patient statement requires immediate action by the nurse?
A.   "I will increase dark green leafy vegetables in my diet."
B.   "I will contact my health care provider if I develop excessive bruising."
C.   "I will avoid contact sports."
D.   "I will take my medication at the same time each day."
Question #23
A nurse is preparing to administer enoxaparin sodium to a patient for prevention of deep vein thrombosis. Which nursing intervention is essential?
A.   Rub the administration site after injecting.
B.   Draw up the medication in a syringe with a 22-gauge, 1.5-inch needle.
C.   Utilize the Z-track method to inject the medication.
D.   Administer the medication into subcutaneous tissue of the abdomen.
Question #24
The patient asks the nurse to explain the difference between dalteparin and regular heparin. Which response by the nurse is accurate?
A.   "The only difference is that regular heparin dosing is based on the patient’s weight."
B.   "Dalteparin is a low-molecular-weight heparin that is more predictable in its effect and has a lower risk of bleeding."
C.   "There is no real difference; dalteparin is interchangeable with regular heparin."
D.   "You should ask your doctor why dalteparin was ordered instead of regular heparin."
Question #25
The nurse confirms that a patient has understood discharge teaching regarding warfarin based on which statement by the patient?
A.   "I should use a soft toothbrush for dental hygiene."
B.   "I will double my dose if I forget to take it the day before."
C.   "I should keep taking ibuprofen for my arthritis."
D.   "I should decrease the dose if I start bruising easily."
Question #26
The nurse is teaching a patient who is receiving aminocaproic acid the measures to prevent adverse effects. Which statement made by the patient indicates the need for further teaching?
A.   "I should take oral contraceptives during the therapy."
B.   "I should not use any acetaminophen during the therapy."
C.   "I should follow a low-cholesterol diet during the therapy."
D.   "I should refrain from eating broccoli during the therapy."
Question #27
The nurse is administering tenecteplase (TNKase) therapy to a patient experiencing an acute myocardial infarction. Which outcome is expected from this therapy?
A.   Prevention of new clots from forming
B.   A quick decrease in pain
C.   Dissolution of the clot that caused the heart attack
D.   Reversal of damage from the infarction
Question #28
A patient receiving warfarin has an international normalized ratio (INR) of 6. Which action would the nurse take?
A.   Administer protamine sulfate IV.
B.   Administer vitamin K1 (phytonadione) IV.
C.   Wait for the INR to decrease.
D.   Stop the intravenous (IV) drip.
Question #29
The patient is being treated with a continuous intravenous infusion of heparin. Which action is the nurse’s highest priority?
A.   Ensure that a loading dose was initially administered when beginning
B.   Have protamine sulfate readily available at all times.
C.   Teach the patient about dietary restrictions while on the medication.
D.   Monitor the patient’s laboratory values correctly.
Question #30
A patient with atrial fibrillation is admitted to the emergency unit for symptoms of warfarin toxicity. The primary health care provider instructs the nurse to administer 6 mg of vitamin K to the patient. Which medication would be included in the patient’s prescription to provide safe and effective treatment?
A.   Furosemide
B.   Enoxaparin
C.   Amiodarone
D.   Ketoconazole
Question #31
Which instruction will the nurse provide to the patient regarding storing dabigatran for home use?
A.   "Discard the drug within 21 days of opening the original container."
B.   "Refrigerate and keep away from direct sunlight."
C.   "Remove from the original package and place in aluminum foil."
D.   "Store the drug with the desiccant-drying agent in the packing cap."
Question #32
The patient is receiving warfarin therapy, and the nurse finds the international normalized ratio (INR) to be 4.0. Which interpretation of the INR finding is correct?
A.   Outside the expected target therapeutic level of anticoagulation; it is too high
B.   The prothrombin time and activated partial thromboplastin time (aPTT) value are needed to interpret the finding.
C.   Within the expected target therapeutic level of anticoagulation
D.   Outside the expected target therapeutic level of anticoagulation; it is too low
Question #33
The nurse is reviewing laboratory data before initiating a patient’s heparin infusion. Which finding requires immediate action?
A.   Activated partial thromboplastin time (aPTT) of 37 seconds
B.   International normalized ratio (INR) of 1
C.   Platelet count of 95,000/mm3
D.   Potassium level of 3.5 mEq/L
Question #34
Which condition is a contraindication for dabigatran?
A.   History of myocardial infarction, Chronic obstructive pulmonary disease
B.   Atrial fibrillation, History of myocardial infarction
C.   Peptic ulcer disease, Chronic kidney disease
D.   Chronic obstructive pulmonary disease, Atrial fibrillation
Question #35
After reviewing the laboratory reports of a patient who was prescribed long-term heparin therapy, the nurse is asked to administer argatroban. Which laboratory result indicates the need for this medication?
A.   Prothrombin time: 13 sec
B.   Platelet count: 100,000/mm3
C.   Leukocyte count: 3000 cells/mm3
D.   Hemoglobin level: 11 g/dL
Question #36
A patient who is undergoing treatment with heparin therapy has an activated partial thromboplastin time (aPTT) level of 98 seconds. Which interpretation of this level is correct?
A.   Outside the expected target therapeutic level of anticoagulation; it is too high
B.   Within the expected target therapeutic level of anticoagulation
C.   Outside the expected target therapeutic level of anticoagulation; it is too low
D.   Cannot be interpreted without knowing the prothrombin time and international normalized ratio
Question #37
  
A.   Notify the health care provider immediately.
B.   Monitor the patient and check the therapeutic range.
C.   Increase the dose of heparin.
D.   Stop the medication.
Question #38
Alteplase therapy is indicated for a patient with which condition?
A.   Local thrombosis from a peripheral intravenous line
B.   Peptic ulcer disease
C.   Gastrointestinal bleed
D.   Severe chest pain for the past 2 hours
Question #39
The nurse is caring for a patient who is being treated with warfarin. The patient has just been administered cimetidine. Which action would the nurse take?
A.   Instruct the patient to notify the nurse if he or she begins to experience discomfort.
B.   Monitor the patient for decreased action of the anticoagulant.
C.   Continue to administer cimetidine with each dose of warfarin.
D.   Monitor the patient for increased action of the anticoagulant.
Question #40
The nurse is caring for a patient who is scheduled to begin warfarin treatment and is currently being treated with amiodarone. Considering this information, the nurse anticipates that which change will be made to the medication regimen?
A.   The dosage of the amiodarone will be increased by half.
B.   The dosage of the warfarin will be increased by half.
C.   The dosage of the warfarin will be decreased by half.
D.   The dosage of the amiodarone will be decreased by half.
Question #41
A patient is prescribed dabigatran to treat atrial fibrillation. On a follow-up visit, the medication dose is reduced by half. Which assessment finding supports the change in the prescribed dose?
A.   Loss of 10 pounds
B.   Diagnosis of diabetes mellitus
C.   Creatinine clearance of 25 mL/min
D.   Platelet count of 80,000/mm3
Question #42
Which patient statement indicates a need for additional teaching about the safe use of dabigatran?
A.   "I will take the medication with food."
B.   "I will store the bottle in a dry place."
C.   "I will place the pills in an organizer for easy use."
D.   "I will use the medication within 60 days after it is opened."
Question #43
The nurse is caring for a patient who is prescribed long-term aspirin therapy to prevent a stroke. Which parameters would the nurse assess as a result of this prescription?
A.   Hemoglobin, Platelet count, Activated partial thromboplastin time (aPTT)
B.   Platelet count, Heart rate, Blood pressure
C.   Activated partial thromboplastin time (aPTT), Blood pressure, Heart rate
D.   Heart rate, Hemoglobin, Blood pressure
Question #44
In a patient receiving warfarin therapy, the addition of which medication would require the dose of warfarin to be increased?
A.   Carbamazepine
B.   Cimetidine
C.   Cholestyramine
D.   Barbiturate
Question #45
A patient is experiencing chest pain, dyspnea, hemoptysis, and hypotension. The patient’s arterial blood gas analysis indicates a decreased level of oxygen. Which medication prescription would the nurse expect for the patient based on the current assessment data?
A.   Phytonadione
B.   Aminocaproic acid
C.   Tranexamic acid
D.   Alteplase
Question #46
  
A.   "I get up and walk around at least once an hour."
B.   "I avoid tight-fitting stockings or leggings."
C.   "I never sit with my legs crossed at the knees."
D.   "I’ve been on prolonged bed rest."
Question #47
After talking with a patient who is receiving warfarin sodium therapy, the nurse believes that the patient is at increased risk for bleeding. Which statement made by the patient supports the nurse’s conclusion?
A.   "I take ginkgo supplements for memory enhancement."
B.   "I eat 1 cup of green leafy vegetables daily."
C.   "I refrain from drinking coffee and citrus fruit juices daily."
D.   "I do not take aspirin for pain relief."
Question #48
A registered nurse is teaching a student nurse about safe and effective administration of heparin. Which action by the student nurse is appropriate?
A.   Checking if the patient’s prescription contains enoxaparin
B.   Administering the medication intramuscularly in the vastus lateralis
C.   Massaging the site after the injection
D.   Administering the medication when convenient
Question #49
Which nursing intervention is essential for a patient receiving alteplase?
A.   Monitor liver enzymes.
B.   Administer prescribed vitamin K if bruising is observed.
C.   Assess for dysrhythmias.
D.   Stop the medication if the systolic blood pressure drops below 110 mm Hg.
Question #50
The nurse assesses the patient’s prothrombin time (PT) to determine the effectiveness of anticoagulant therapy and notes that it is 32 seconds. Which interpretation of this PT value is correct?
A.   Inadequate to evaluate treatment
B.   Significantly elevated
C.   Significantly decreased
D.   Within normal limits
Question #51
The nurse assesses the patient’s activated partial thromboplastin time (aPTT) to determine the effectiveness of the heparin regimen and notes that it is 35 seconds. Which interpretation of this aPTT is correct?
A.   Inadequate to evaluate treatment
B.   Too high
C.   Within normal limits
D.   Too low
Question #52
The nurse is screening a patient for candidacy for treatment with fondaparinux. The nurse reviews the patient’s laboratory test results and finds a creatinine clearance of 20 mL/min and a body weight of 48 kg. Which interpretation of these findings is correct?
A.   Is a candidate for fondaparinux based on sufficient creatinine clearance and after body weight attains an adequate level
B.   Not a candidate for fondaparinux based on an insufficient creatinine clearance
C.   Is a candidate for fondaparinux based on a sufficient creatinine clearance and adequate body weight
D.   Not a candidate for fondaparinux based on both an insufficient creatinine clearance and an inadequate body weight
Question #53
The nurse is caring for a patient who is being treated with fondaparinux and notes a platelet count of 80,000/mm3. Based on this information, the nurse anticipates which change to the medication regimen?
A.   The dose will be unchanged.
B.   The dose will be decreased.
C.   The medication will be stopped.
D.   The dose will be increased.

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