Question 1

An elderly patient has had hip surgery and will be receiving heparin,4000 units subcutaneously every 12 hours.The heparin is available in vials of 5000 units/mL.Calculate how much heparin the nurse will administer for this dose._______

Accepted Answer

The answer of An elderly patient has had hip surgery...

Question 2

The nurse is reviewing new medication orders for a patient who has an epidural catheter for pain relief.One of the orders is for enoxaparin (Lovenox),a low-molecular-weight heparin (LMWH).What is the nurse's priority action?

Accepted Answer

LMWH is contraindicated in patients with an epidural catheter because it can increase the risk of spinal bleeding. The nurse should contact the prescriber to clarify the medication order and avoid potential harm to the patient.

Question 3

A patient is receiving thrombolytic therapy,and the nurse monitors the patient for adverse effects.What is the most common undesirable effect of thrombolytic therapy?

Accepted Answer

Thrombolytic therapy carries a high risk of bleeding, including internal and superficial bleeding. This is the most common undesirable effect of thrombolytic therapy. The other options may also occur, but at a lower frequency.

Question 4

The nurse notes in the patient's medication orders that the patient will be starting anticoagulant therapy.What is the primary goal of anticoagulant therapy?

Accepted Answer

The primary goal of anticoagulant therapy is to prevent thrombus formation by inhibiting the clotting cascade. It does not dissolve existing clots or dilate vessels around a clot, and is not typically used to stabilize an existing clot.

Question 5

A patient is receiving heparin therapy as part of the treatment for a pulmonary embolism.The nurse monitors the results of which laboratory test to check the drug's effectiveness?

Accepted Answer

Activated partial thromboplastin time (aPTT) is the laboratory test that measures the effectiveness of heparin. Heparin works by inhibiting clotting factors and prolonging aPTT. Therefore, monitoring aPTT levels is essential to make dosage adjustments and ensure the patient's safety during heparin therapy. Bleeding times, PT/INR, and Vitamin K levels are not specific to heparin therapy and are not used to monitor its effectiveness.

Question 6

A patient has received an overdose of intravenous heparin,and is showing signs of excessive bleeding.Which substance is the antidote for heparin overdose?

Accepted Answer

The antidote for heparin overdose is protamine sulfate, which is a positively charged molecule that binds to the negatively charged heparin and neutralizes its anticoagulant effect. Vitamin E and potassium chloride are not used as antidotes for heparin overdose, and while vitamin K is used as an antidote for warfarin overdose, it is not effective for heparin overdose.

Question 7

A patient is being discharged on anticoagulant therapy.The nurse will include in the patient-education conversation that it is important to avoid herbal products that contain which substance?

Accepted Answer

Ginkgo is known to interact with anticoagulants and increase the risk of bleeding, so it is important for patients on anticoagulant therapy to avoid herbal products that contain ginkgo. Valerian, soy, and saw palmetto do not interact with anticoagulants in the same way as ginkgo.

Question 8

A patient has received an overdose of enoxaparin (Lovenox).The order was for 30 mg,but the patient received 90 mg.The nurse notes that the patient is showing signs of bleeding (oozing blood from the intravenous sites,increased bruising)and notifies the physician,who prescribes protamine sulfate to cover the excess amount of enoxaparin that the patient received.Calculate how much protamine sulfate the patient will receive._______

Accepted Answer

The answer of A patient has received an overdose of...

Question 9

When administering heparin subcutaneously,the nurse will follow which procedure?

Accepted Answer

When administering heparin subcutaneously, a 1/2- to 5/8-inch 25- to 28-gauge needle is used. The nurse should not aspirate the syringe before injecting the medication, massage the site after injection, or apply heat to the injection site.

Question 10

A patient who has been anticoagulated with warfarin (Coumadin)has been admitted for gastrointestinal bleeding.The history and physical examination indicates that the patient may have taken too much warfarin.The nurse anticipates that the patient will receive which antidote?

Accepted Answer

Vitamin K is the antidote for warfarin, as it promotes the synthesis of clotting factors II, VII, IX, and X. Vitamin E does not have any effect on warfarin or clotting factors. Protamine sulfate is the antidote for heparin, not warfarin. Potassium chloride does not have any effect on warfarin or clotting factors.

Question 11

A patient has been prescribed warfarin (Coumadin)in addition to a heparin infusion.The patient asks the nurse why he has to be on two medications.The nurse's response is based on which rationale?

Accepted Answer

Heparin is used to start anticoagulation so as to allow time for the blood levels of warfarin to reach adequate levels. Warfarin is slower acting and requires several days to achieve adequate blood levels needed for therapeutic effect. Therefore, heparin is used initially to start anticoagulation while waiting for the effects of warfarin to become effective. Once the therapeutic level of warfarin is reached, heparin is usually discontinued.

Question 12

A patient will be receiving a thrombolytic drug as part of the treatment for acute myocardial infarction.The nurse explains to the patient that this drug is used for which purpose?

Accepted Answer

Thrombolytic drugs are used to dissolve blood clots, which is necessary in cases of acute myocardial infarction to restore blood flow to the affected area of the heart. The other options listed are not the primary action of thrombolytic drugs.

Question 13

A patient has been instructed to take one enteric-coated low-dose aspirin a day as part of therapy to prevent strokes.The nurse will provide which instruction when providing patient teaching about this medication?

Accepted Answer

Taking the medication with 6 to 8 ounces of water and with food helps to decrease the risk of gastric irritation and bleeding. It is not recommended to crush enteric-coated tablets as this can alter their absorption and effectiveness. Low-dose aspirin therapy can still cause bleeding, although the risk is lower than with higher doses. Aspirin should not be taken on an empty stomach as this can increase the risk of gastric irritation and ulceration.

Question 14

A patient will be taking dabigatran (Pradaxa)as part of treatment for chronic atrial fibrillation.Which statements about dabigatran are true? (Select all that apply.)

Accepted Answer

Dabigatran dose is reduced in patients with decreased renal function. Bleeding is a common adverse effect. Dabigatran is a prodrug that becomes activated in the liver.

Question 15

A patient has had recent mechanical heart valve surgery and is receiving anticoagulant therapy.While monitoring the patient's laboratory work,the nurse interprets that the patient's international normalized ratio (INR)level of 3 indicates that:

Accepted Answer

An INR level of 3 is within the therapeutic range for a patient receiving anticoagulant therapy. The target INR range for patients with mechanical heart valves is typically between 2.5-3.5, although this may vary depending on the patient's individual circumstances. If the INR is below the therapeutic range, the patient may not be receiving enough anticoagulation and may be at risk for clotting. If the INR is above the therapeutic range, the patient may be at risk for bleeding. This question does not mention intravenous heparin, so options C and D can be eliminated.

Quiz 26: Coagulation Modifier Drugs

An elderly patient has had hip surgery and will be receiving heparin,4000 units subcutaneously every 12 hours.The heparin is available in vials of 5000 units/mL.Calculate how much heparin the nurse will administer for this dose._______

The nurse is reviewing new medication orders for a patient who has an epidural catheter for pain relief.One of the orders is for enoxaparin (Lovenox) ,a low-molecular-weight heparin (LMWH) .What is the nurse's priority action?

A patient is receiving thrombolytic therapy,and the nurse monitors the patient for adverse effects.What is the most common undesirable effect of thrombolytic therapy?

The nurse notes in the patient's medication orders that the patient will be starting anticoagulant therapy.What is the primary goal of anticoagulant therapy?

A patient is receiving heparin therapy as part of the treatment for a pulmonary embolism.The nurse monitors the results of which laboratory test to check the drug's effectiveness?

A patient has received an overdose of intravenous heparin,and is showing signs of excessive bleeding.Which substance is the antidote for heparin overdose?

A patient is being discharged on anticoagulant therapy.The nurse will include in the patient-education conversation that it is important to avoid herbal products that contain which substance?

When administering heparin subcutaneously,the nurse will follow which procedure?

A patient who has been anticoagulated with warfarin (Coumadin) has been admitted for gastrointestinal bleeding.The history and physical examination indicates that the patient may have taken too much warfarin.The nurse anticipates that the patient will receive which antidote?

A patient has been prescribed warfarin (Coumadin) in addition to a heparin infusion.The patient asks the nurse why he has to be on two medications.The nurse's response is based on which rationale?

A patient will be receiving a thrombolytic drug as part of the treatment for acute myocardial infarction.The nurse explains to the patient that this drug is used for which purpose?

A patient has been instructed to take one enteric-coated low-dose aspirin a day as part of therapy to prevent strokes.The nurse will provide which instruction when providing patient teaching about this medication?

A patient will be taking dabigatran (Pradaxa) as part of treatment for chronic atrial fibrillation.Which statements about dabigatran are true? (Select all that apply.)

A patient has had recent mechanical heart valve surgery and is receiving anticoagulant therapy.While monitoring the patient's laboratory work,the nurse interprets that the patient's international normalized ratio (INR) level of 3 indicates that: