Deck 26: Drugs for Coagulation Disorders

Question 1

The client receives enoxaparin (Lovenox) postoperatively. The nurse teaches the client about this medication and evaluates that learning has occurred when he makes which statement?

A) "It increases the flexibility of my blood cells."
B) "It increases the time it takes for me to form a clot."
C) "It dissolves small clots so I won't have a stroke."
D) "It inhibits the synthesis of prostaglandins."

Answer 1

"It increases the time it takes for me to form a clot."

Question 2

The physician orders enoxaparin (Lovenox) for the postoperative client. What is the best administration technique by the nurse?

A) Administer the medication in the abdomen, subcutaneously.
B) Ask the client where she would like the injection, and administer it subcutaneously.
C) Administer the medication via slow intravenous (IV) push in the client's Intravenous (IV) line.
D) Administer the medication in the upper arm, subcutaneously.

Answer 2

Administer the medication in the abdomen, subcutaneously.

Question 3

The nursing instructor is teaching student nurses about the process of hemostasis after an injury. What does the nursing instructor include as the initial event in this process?

A) Plasma proteins convert to active forms.
B) Platelets become sticky.
C) Von Willebrand's factor is activated.
D) The vessel spasms.

Answer 3

The vessel spasms.

Question 4

The client receives warfarin (Coumadin). The nurse notes that the client's morning international normalized ratio (INR) is 7. What are the priority nursing interventions at this time?

A) Administer vitamin K and hold the next dose of warfarin (Coumadin).
B) Hold the next dose of warfarin (Coumadin) and repeat the international normalized ratio (INR).
C) Administer protamine sulfate and hold the next dose of warfarin (Coumadin).
D) Hold the next dose of warfarin (Coumadin) and contact the physician.

Question 5

The physician orders pentoxifylline (Trental) for the client with peripheral vascular disease. The nurse has completed medication education and determines that learning has occurred when the client makes which statement(s)? Select all that apply.

A) "It changes how my liver makes clotting factors."
B) "It thins my blood so more can get to those little vessels."
C) "It decreases my platelets so my blood is less likely to clot."
D) "It makes my red blood cells (RBCs) squishy so they can go into the little blood vessels."
E) "It decreases the "stickiness" of my blood."

Question 6

The nurse is managing care for a client with a DVT (deep vein thrombosis) of the right calf. The client receives heparin intravenously (IV). What is the priority outcome for this client?

A) The client will not experience bleeding.
B) The client will comply with dietary restrictions.
C) The client will not disturb the intravenous infusion.
D) The client will keep the right leg elevated on two pillows.

Question 7

The client receives warfarin (Coumadin). The nurse plans to teach the client to avoid which foods that are served for lunch?

A) whole -wheat bread with margarine
B) fettuccine Alfredo
C) salt substitute
D) tomato salad with basil

Question 8

The nurse is managing care for a client with cirrhosis of the liver. The nurse teaches the client about how to avoid injury that may result in bleeding. The client asks the nurse why he is at risk to start bleeding. What is the best response by the nurse?

A) "Because your liver is injured and unable to manufacture platelets."
B) "Because your liver is breaking down your clotting factors too quickly."
C) "Because your liver thickens your blood so it is less likely to clot."
D) "Because your liver is injured and cannot make clotting factors."

Question 9

The client receives an appropriate dose of warfarin (Coumadin), but the international normalized ratio (INR) is in the high range. The client denies taking any aspirin products. What is the best assessment question to ask the client at this time?

A) "Are you restricting your fluids too much?"
B) "Have you been drinking too much milk?"
C) "Have you been eating much garlic?"
D) "Have you been eating a lot of salads and vegetables?"

Question 10

The client is being discharged on warfarin (Coumadin) following a valve replacement. The nurse has completed medication education and determines that learning has occurred when the client makes which statement?

A) "I must limit my intake of vitamin C while I'm on warfarin (Coumadin)."
B) "If I notice any bruising or bleeding I will need to have lab work done."
C) "I can take enteric -coated aspirin, but not plain aspirin for my arthritis."
D) "I must wear a medic alert bracelet that says I'm on warfarin (Coumadin)."

Question 11

The new mother receives heparin. She asks the nurse if she can breast -feed her baby. What is the most therapeutic response by the nurse?

A) "No, because this could alter your international normalized ratio (INR)times too much."
B) "No, because heparin will enter your breast milk."
C) "No, because it would be too difficult to regulate your heparin dose."
D) "No, because this could cause your nipples to bleed."

Question 12

A woman brings her husband to the emergency department and tells the nurse that her husband just had a stroke. The physician verifies a thrombotic cerebral vascular accident (CVA) occurred and wishes to use alteplase (Activase). What priority assessment question will the nurse ask the wife?

A) "What other medications does your husband take?"
B) "Does your husband have hypertension?"
C) "What other medical illnesses does your husband have?"
D) "What time did your husband have the stroke?"

Question 13

The client has a deep vein thrombosis (DVT) and is admitted for initial heparin therapy. Which order(s) would the nurse want to validate with the physician? Select all that apply.

A) Obtain a daily weight on the client.
B) Tylenol as needed (PRN) for headaches
C) Advil as needed (PRN) for headaches
D) low vitamin K diet
E) Heparin 1,000 units intravenous (IV) every 6 hours

Question 14

The client receives heparin. During the morning assessment of the client, the nurse notes that the client's blood pressure and red blood cell (RBC) count are low. There is no evidence of bleeding on the bed linen or the client's gown. What will the best assessment of this client reveal?

A) The client is dehydrated.
B) The client has probably formed some clots.
C) The client's activated partial thromboplastin time (aPTT) is too low.
D) The client may be bleeding internally.

Question 15

The client receives warfarin (Coumadin) and becomes pregnant. The physician changes her anticoagulant to enoxaparin (Lovenox). She asks the nurse "Why did the doctor do that"? What is the best explanation by the nurse?

A) "Because it is easier to maintain your bleeding times in a therapeutic range".
B) "Because warfarin (Coumadin) is known to cause serious cardiac defects."
C) "Because enoxaparin (Lovenox) cannot get into your baby through the placenta".
D) "Because you are less likely to have bleeding with enoxaparin (Lovenox)."