Question 1

A nurse has just obtained a unit of packed red blood cells from the blood bank.The nurse carefully plans care of the client so that the blood transfusion is hung within how many minutes of being signed out of the blood bank?

Accepted Answer

The blood transfusion should be hung within 30 minutes of being signed out of the blood bank. This is because after 30 minutes, the risk of bacterial contamination and growth increases, which can cause harm to the patient. It is important for nurses to plan ahead and ensure that the necessary equipment and staff are available to start the transfusion promptly.

Question 2

The nurse is initiating an intravenous infusion of anistreplase (Eminase).The nurse would assess the client for which of the following signs of allergic reaction during the early minutes of the infusion?

Accepted Answer

Anistreplase (Eminase) is a thrombolytic agent used to dissolve blood clots. During the early minutes of the infusion, the nurse should monitor the client closely for signs of an allergic reaction, which include dyspnea and wheezing. Muscle aches, sudden rise in blood pressure, and dizziness and confusion are not typical signs of an allergic reaction to anistreplase.

Question 3

A client is due to receive a scheduled dose of enoxaparin (Lovenox).The nurse should do which of the following to administer this drug correctly?

Accepted Answer

Enoxaparin (Lovenox) should be administered subcutaneously into the abdomen, and the injection site should be rotated systematically to prevent tissue damage or irritation. Using a smaller gauge needle (25-30) is recommended to minimize discomfort and bruising. There is no need to aspirate before injecting, and massaging the site after injection is not recommended as it can increase the risk of hematoma formation.

Question 4

A client has just completed intravenous thrombolytic therapy.The nurse places a sign above the client's head of bed reminding caregivers not to give drugs by which route for at least 24 hours?

Accepted Answer

After intravenous thrombolytic therapy, it is important to avoid intramuscular injections for at least 24 hours due to the increased risk of bleeding. Thrombolytic therapy dissolves blood clots and significantly increases the risk of bleeding, making intramuscular injections potentially dangerous during this period.

Question 5

The client with a history of heart failure has an order to receive one unit of packed red blood cells.If the nurse hangs the unit at 10:00 AM,the infusion must be completed absolutely no later than

Accepted Answer

Blood transfusions should be completed within 4 hours of removal from refrigeration to prevent bacterial growth, so if started at 10:00 AM, it must be completed by 2:00 PM.

Question 6

The nurse would pretreat the client with acetaminophen (Tylenol)according to protocol orders if the client has a history of which of the following transfusion reactions?

Accepted Answer

The nurse would pretreat the client with acetaminophen (Tylenol) according to protocol orders if the client has a history of febrile nonhemolytic transfusion reaction. This is because a febrile nonhemolytic transfusion reaction often presents with a fever and chills, and acetaminophen can help to reduce these symptoms. Acetaminophen would not be effective for other types of transfusion reactions such as allergic or anaphylactic reactions, or immune-mediated hemolytic reactions.

Question 7

The nurse is preparing to administer a blood product to an assigned client.The nurse checks the client's intravenous catheter to make sure that it is no smaller than which of the following sizes?

Accepted Answer

A 19 gauge needle is typically the smallest size recommended for administering blood products to ensure that the blood cells are not damaged during the transfusion and to allow for an appropriate flow rate.

Question 8

The nurse preparing to hang a unit of blood for an assigned client would select which of the following intravenous solutions to prime the blood tubing before administration?

Accepted Answer

0.9% Sodium chloride is the standard solution used to prime blood tubing before administration as it is isotonic and compatible with blood products.

Question 9

The nurse overhears the prescriber tell a client that drug therapy with dalteparin (Fragmin)will be started.The nurse plans to teach the client that this drug will be administered by which of the following routes?

Accepted Answer

Dalteparin (Fragmin) is administered by subcutaneous injection. It should not be taken orally or sublingually as it will not have a therapeutic effect. Intramuscular injection is not recommended as it may cause bleeding or hematoma formation.

Question 10

A client receiving anticoagulant therapy with heparin has an activated partial thromboplastin time in the critically high range.The nurse should ensure that which of the following drugs is on hand to use as an antidote?

Accepted Answer

Protamine sulfate is the antidote for heparin, which is the anticoagulant therapy being used in this scenario. Phytonadione (Vitamin K) is the antidote for warfarin, another type of anticoagulant therapy. Aminocaproic acid (Amicar) is used to prevent or treat excessive bleeding caused by fibrinolytic therapy or surgical complications. Anistreplase (Eminase) is a thrombolytic agent used to dissolve blood clots and is not used as an antidote for anticoagulant therapy.

Question 11

A client is starting drug therapy with clopidogrel (Plavix).The nurse evaluates that the client understands drug interactions when the client states to take which of the following drugs as an over-the-counter analgesic when needed?

Accepted Answer

Aspirin, ibuprofen, and naproxen are all nonsteroidal anti-inflammatory drugs (NSAIDs) that can increase the risk of bleeding when taken with clopidogrel. Acetaminophen does not have this effect and is considered safe to take as an analgesic with clopidogrel therapy.

Question 12

The nurse has an order to give a newly ordered dose of ticlopidine (Ticlid)to a client.The nurse checks the client's medical record to be sure the client does not have a history of which of the following?

Accepted Answer

Ticlopidine (Ticlid) can cause liver dysfunction, so the nurse should check the patient's medical history to ensure they do not have a pre-existing liver disease that could be further compromised by the medication. Pulmonary embolism and deep vein thrombosis are not contraindications for ticlopidine, while diabetes mellitus may require closer monitoring of blood glucose levels while taking ticlopidine.

Question 13

A client meets the criteria to be a candidate for drug therapy with alteplase (Activase).The nurse explains the use of this drug to the client by telling the client that the drug will

Accepted Answer

Alteplase is a thrombolytic drug that functions to dissolve the blood clot that has already formed in order to restore blood flow. It does not stabilize or prevent the breakdown of existing clots, nor does it prevent the formation of additional clots.

Question 14

A client is nearing the completion of an intravenous infusion of alteplase (Activase).The nurse prepares to hang which of the following drugs next as part of standard drug protocol?

Accepted Answer

Heparin is often used after alteplase to prevent re-occlusion of the vessel. Morphine sulfate and nitroglycerin are not routinely given after alteplase. Streptokinase, although similar to alteplase, is not typically given sequentially due to a risk of bleeding.

Question 15

The nurse is providing discharge instructions to a client who will be discharged to home while on anticoagulant therapy.The nurse would encourage the client to use which of the following as an acceptable item for self-care?

Accepted Answer

Anticoagulant therapy increases the risk of bleeding, so the client should be instructed to avoid items that can cause injury. A soft toothbrush is recommended as it is less likely to cause bleeding in the gums. Straight razors should be avoided as they can cause nicks and cuts that may bleed. Alcohol-based mouthwash can dry out the mouth and cause bleeding in the gums, and unwaxed dental floss can also cause bleeding in the gums. So, option A is the best choice.

Quiz 30: Antiplatelets,anticoagulants,fibrinolytics,and Blood Components

A nurse has just obtained a unit of packed red blood cells from the blood bank.The nurse carefully plans care of the client so that the blood transfusion is hung within how many minutes of being signed out of the blood bank?

The nurse is initiating an intravenous infusion of anistreplase (Eminase) .The nurse would assess the client for which of the following signs of allergic reaction during the early minutes of the infusion?

A client is due to receive a scheduled dose of enoxaparin (Lovenox) .The nurse should do which of the following to administer this drug correctly?

A client has just completed intravenous thrombolytic therapy.The nurse places a sign above the client's head of bed reminding caregivers not to give drugs by which route for at least 24 hours?

The client with a history of heart failure has an order to receive one unit of packed red blood cells.If the nurse hangs the unit at 10:00 AM,the infusion must be completed absolutely no later than

The nurse would pretreat the client with acetaminophen (Tylenol) according to protocol orders if the client has a history of which of the following transfusion reactions?

The nurse is preparing to administer a blood product to an assigned client.The nurse checks the client's intravenous catheter to make sure that it is no smaller than which of the following sizes?

The nurse preparing to hang a unit of blood for an assigned client would select which of the following intravenous solutions to prime the blood tubing before administration?

The nurse overhears the prescriber tell a client that drug therapy with dalteparin (Fragmin) will be started.The nurse plans to teach the client that this drug will be administered by which of the following routes?

A client receiving anticoagulant therapy with heparin has an activated partial thromboplastin time in the critically high range.The nurse should ensure that which of the following drugs is on hand to use as an antidote?

A client is starting drug therapy with clopidogrel (Plavix) .The nurse evaluates that the client understands drug interactions when the client states to take which of the following drugs as an over-the-counter analgesic when needed?

The nurse has an order to give a newly ordered dose of ticlopidine (Ticlid) to a client.The nurse checks the client's medical record to be sure the client does not have a history of which of the following?

A client meets the criteria to be a candidate for drug therapy with alteplase (Activase) .The nurse explains the use of this drug to the client by telling the client that the drug will

A client is nearing the completion of an intravenous infusion of alteplase (Activase) .The nurse prepares to hang which of the following drugs next as part of standard drug protocol?

The nurse is providing discharge instructions to a client who will be discharged to home while on anticoagulant therapy.The nurse would encourage the client to use which of the following as an acceptable item for self-care?