Deck 45: Anticoagulants, Antiplatelets, and Thrombolytics

Question 1

A client receiving clopidogrel (Plavix) has the following conditions as part of the health history. Which causes the greatest concern to the nurse?

A) Asthma
B) Glaucoma
C) Allergy to shellfish
D) Active peptic ulcer

Answer 1

Active peptic ulcer

Question 2

The client is being treated with warfarin sodium. She complains to the nurse of soreness in her mouth. The highest priority nursing intervention is to call the physician because the client is _____ the medication.

A) beginning to hemorrhage from
B) developing a clot from
C) experiencing an expected side effect of
D) experiencing an adverse reaction to

Answer 2

experiencing an adverse reaction to

Question 3

A new nurse is listing the interventions he should employ when caring for a client on thrombolytic therapy. Which nursing intervention is inappropriate for the client during thrombolytic therapy?

A) Monitor vital signs and reporting changes.
B) Check for active bleeding for 24 hours after therapy.
C) Inform the client that aspirin and NSAIDs may be taken for discomfort.
D) Monitor electrocardiogram strips for cardiac dysrhythmias.

Answer 3

Inform the client that aspirin and NSAIDs may be taken for discomfort.

Question 4

A client is to receive a heparin injection. The highest priority nursing intervention before administration of the medication is to check the:

A) PT and INR.
B) PTT and APTT.
C) CBC.
D) platelet count.

Question 5

The client has received an overdose of a thrombolytic drug. The nurse anticipates that he will be treated with:

A) naloxone (Narcan).
B) protamine sulfate.
C) vitamin E.
D) aminocaproic acid (Amicar).

Question 6

A client is being treated with warfarin (Coumadin). The highest priority nursing intervention before administration of the medication is to check the:

A) PTT and APTT.
B) PT and INR.
C) most current CBC.
D) most current platelet count.

Question 7

In planning care for a client receiving heparin, the nurse is aware that the dose is administered subcutaneously. What is the reason for using this route?

A) Heparin is absorbed readily by the gastrointestinal mucosa and protected by the liver.
B) Heparin is poorly absorbed by the gastrointestinal mucosa and destroyed by liver enzymes.
C) The effective absorption of heparin can be hampered by food.
D) The effective absorption of heparin is hampered by the stomach's inadequate blood flow.

Question 8

The client is being treated with warfarin sodium as well as a diuretic. The nurse anticipates that the interaction of the two drugs will produce a(n) _____ effect from the _____.

A) increased; warfarin sodium
B) decreased; warfarin sodium
C) increased; diuretic
D) decreased; diuretic

Question 9

A client receiving warfarin (Coumadin) is noted to have significant bleeding from the gums while on therapy. The physician orders an antidote. If excess bleeding occurs because of warfarin accumulation in the body, what is the antidote?

A) Vitamin K
B) Vitamin E
C) Naloxone (Narcan)
D) Protamine sulfate

Question 10

The client is being treated with Plavix. He complains to the nurse of experiencing chest pain. The highest priority nursing intervention is to call the physician because the client is experiencing a(n):

A) adverse reaction to the medication.
B) myocardial infarction.
C) expected side effect of the medication.
D) anaphylactic reaction to the medication.

Question 11

Which statement made by a client receiving (warfarin) Coumadin therapy indicates a need for further teaching?

A) "I shouldn't take aspirin while I'm on Coumadin."
B) "I will use a toothbrush with soft bristles."
C) "I will eat large quantities of green leafy vegetables."
D) "I will use an electric razor to avoid shaving cuts."

Question 12

The client has been ordered treatment with warfarin. She tells the nurse that she self-medicates with herbal remedies as much as possible. The highest priority teaching point that the nurse should give the client is the avoid the use of _____ while taking warfarin.

A) ephedra and dill
B) black cohosh and licorice
C) garlic and ginkgo
D) ginseng and green tea

Question 13

The client is being treated with heparin and also with nitroglycerin. The nurse anticipates that the interaction of the two drugs will produce which effect?

A) Inadequate effect from the nitroglycerin
B) Decreased effect from the heparin
C) Toxic dose of the nitroglycerin
D) Increased effect from the heparin

Question 14

The client who is most likely to be ordered low-molecular-weight heparin would be the client who is considered to be at high risk to develop:

A) venous thrombosis.
B) arterial embolism.
C) thrombocytopenia.
D) leukopenia.