Question 1

After drawing up heparin from a vial,the next thing the nurse should do before giving this medication to the patient is which of the following?

Accepted Answer

Because of severe adverse effects if inaccurate doses are given,once the heparin is drawn into a syringe,double-check the dosage with another nurse.

Question 2

A patient is started on warfarin (Coumadin)that is adjusted with the results of the INR and/or PT.You expect the physician to start an initial dose that is which of the following ranges?

Accepted Answer

Individualized dosage is usually initiated at 2 to 5 mg/day,with dosage adjustments based on the results of INR and/or PT.

Question 3

Anticoagulant therapy is used to do which of the following?

Accepted Answer

All anticoagulants prevent the formation of blood clots,or thrombi,by interfering with the complex clotting mechanism of blood and increasing the time it takes for blood to clot.

Question 4

In intermittent IV heparin therapy,the blood for the activated partial thromboplastin time (aPTT)should be drawn at which of the following times?

Accepted Answer

If intermittent IV heparin therapy is being given,blood for determination of aPTT should be drawn 30 minutes before the next dose is given.

Question 5

Laboratories commonly report the PT values with which of the following measurements?

Accepted Answer

Laboratories commonly report both numbers (PT/INR)when a PT is ordered.

Question 6

The effect of anticoagulants can be potentiated by taking which of the following?

Accepted Answer

Nonsteroidal antiinflammatory drugs (NSAIDs)will increase the risk of bleeding and hemorrhage in a patient receiving heparin.

Question 7

A 50-year-old male patient is started on aspirin (ASA)80-mg tablets once daily as an antiplatelet agent.The nurse explains to this patient that ASA is the drug of choice for reducing the risk of which of the following conditions?

Accepted Answer

In men over 50 years of age,ASA is a drug of choice for reducing the risk of ischemic stroke.It plays no role in hemorrhagic stroke.

Question 8

Which of the following statements should the nurse include when teaching a patient about anticoagulant therapy?

Accepted Answer

Pressure should be used to stop bleeding from accidental cuts or scrapes.If bleeding persists after 10 minutes,the nurse,physician,or other health care provider should be contacted.

Question 9

A patient comes into the emergency department with complaints of chest pains.An ECG reveals an acute myocardial infarction taking place.You would expect the physician to take which of the following actions?

Accepted Answer

Thrombolytic agents are used in acute myocardial infarction for lysis of thrombi blocking coronary arteries.

Question 10

A patient on anticoagulant therapy should avoid excessive amounts of which of the following vitamins?

Accepted Answer

The patient should eat a normal,balanced diet but should avoid eating excessive amounts of foods such as leafy,green vegetables high in the water-soluble vitamin K.

Question 11

Which of the following is the antidote for heparin overdose?

Accepted Answer

Protamine sulfate is a strongly basic (alkaline)protein that acts as an antagonist to neutralize (reverse)the actions of heparin.

Question 12

A patient is receiving both heparin and Coumadin (warfarin).Which of the following is most likely to be true about this case?

Accepted Answer

If anticoagulant therapy is started with heparin and a coumarin or indanedione derivative,it is recommended that both drugs be given until the PT or INR results indicate an adequate response to the coumarin or indanedione derivative.

Question 13

Once anticoagulation therapy has ended,the nurse would advise the patient to do which of the following?

Accepted Answer

After anticoagulation therapy has been stopped,the patient should use caution until the body recovers its blood-clotting abilities.

Question 14

In checking the chart of an elderly female outpatient on anticoagulant therapy,the LPN/LVN notes that the patient's lab values are off.The patient says she takes her medication as prescribed,so the nurse asks about her dietary intake.Which of the following foods might have an effect on anticoagulant therapy?

Accepted Answer

The patient should eat a normal,balanced diet but should avoid excessive amounts of foods high in vitamin K (broccoli,cabbage,green onions,dark leafy greens,beef liver,soybean oil).

Question 15

Which of the following is an early indication of anticoagulant overdose?

Accepted Answer

An early sign of overdose is bleeding from the gums while brushing teeth.

Question 16

The dosage of heparin is considered adequate when the whole blood clotting time is at approximately which of the following levels?

Accepted Answer

The dosage of heparin is considered adequate when the whole blood clotting time is approximately 2 1/2 to 3 times the control value.

Question 17

Protamine sulfate should be given by which of the following health care professionals?

Accepted Answer

Protamine sulfate should be given only by a physician.An LPN/LVN may assemble the medications but must allow the physician to draw up and administer the dose.

Question 18

Which of the following tests will the nurse evaluate after the physician makes an adjustment in a patient's heparin dose in order to determine the effect of the change?

Accepted Answer

The dose of heparin is adjusted based on the activated partial thromboplastin time (aPTT)result,determined from blood drawn 8 hours after the start of heparin infusion.

Question 19

Which of the following represents the therapeutic INR range for a patient taking Coumadin?

Accepted Answer

The specific INR goal recommendations for each clinical indication is typically 2.0 to 3.0,except in cases of cardiac valve replacement,for which it is higher.

Question 20

Thrombolytic agents have which of the following actions?

Accepted Answer

Thrombolytics convert plasminogen to the enzyme plasmin,which breaks down fibrin clots,fibrinogen,and other plasma proteins.These products are used for lysis (dissolving)of thrombi.

Quiz 20: Hematologic Products