Deck 31: Drugs for Coagulation Disorders

Question 1

The nurse notes the blood pressure and red blood cell (RBC) count of a client receiving heparin is low. Which should the nurse suspect has occurred?

A) Dehydration
B) Internal bleeding
C) Decreased activated partial thromboplastin time (aPTT)
D) Clot formation

Answer 1

Internal bleeding

Question 2

Which anatomical area should the nurse display a client when providing education about the point of origin of a pulmonary embolism?

A) Right ventricle
B) Left atrium
C) Left ventricle
D) Right atrium

Answer 2

Right ventricle

Question 3

Which additional prescribed treatment should the nurse anticipate for the client prescribed heparin therapy?

A) Obtaining an aPTT
B) Weekly weights
C) Advil as needed (PRN) for headaches
D) Low vitamin K diet

Answer 3

Obtaining an aPTT

Question 4

The nurse has provided education for a client prescribed pentoxifylline (Trental). Which statements made by the client indicate an understanding of the information? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "The prescription will soften the red blood cells (RBCs) so they can fit through the smaller blood vessels."
B) "The prescription decreases the platelets so the blood is less likely to clot."
C) "The prescription decreases the 'stickiness' of the blood."
D) "The prescription affects how the liver makes clotting factors."
E) "The prescription destroys some of the clotting factors."

Question 5

Which laboratory test is used to measure the effectiveness of warfarin sodium therapy?

A) Complete blood count
B) Platelet count
C) aPTT
D) International normalized ratio (INR)

Question 6

Which route of administration should the nurse anticipate to use for a client's prescribed enoxaparin (Lovenox)?

A) Administer the prescription orally.
B) Administer the prescription into the abdomen, subcutaneously.
C) Administer the prescription via slow intravenous (IV) push.
D) Administer the prescription intramuscularly into the thigh.

Question 7

Which laboratory study is used to evaluate the proper dosage for heparin therapy?

A) aPTT
B) Serum heparin levels
C) Complete blood count
D) Sedimentation rate

Question 8

The nurse notes a client's warfarin (Coumadin) level is 7 mcg/mL. Which action should the nurse take?

A) Continue the treatment and monitor the client.
B) Administer protamine sulfate and hold the next dose of warfarin (Coumadin).
C) Hold the next dose of warfarin (Coumadin) and contact the healthcare provider.
D) Hold the next dose of warfarin (Coumadin) and request an international normalized ratio (INR).

Question 9

A client with cirrhosis of the liver asks the nurse why they are at risk for bleeding. Which response should the nurse provide the client?

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

Question 10

The nurse is reviewing the process of hemostasis after an injury with a client. Which should the nurse identify as the initial event in this process?

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

Question 11

Which priority question should the nurse ask a client suspected of experiencing a stroke that is prescribed alteplase (Activase).

A) "Do you take any other prescriptions?"
B) "Are you currently being treated for hypertension?"
C) "Do you have any other medical conditions?"
D) "Do you know what time the stroke occurred?"

Question 12

The nurse has provided discharge education for a client prescribed an anticoagulant. Which statement made by the client indicates an understanding of the information?

A) "I should wear a medical alert bracelet that says I'm on an anticoagulant."
B) "I need to eat more protein while I am taking this medication."
C) "I can take enteric-coated aspirin but not plain aspirin for my arthritis."
D) "I must limit my intake of vitamin C while I'm on warfarin (Coumadin)."

Question 13

The nurse is caring for a client with a DVT (deep vein thrombosis) receiving heparin intravenously (IV). Which is the priority outcome for the client?

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

Question 14

The nurse has provided a client education about enoxaparin (Lovenox). Which statement made by a client indicates an understanding of the information?

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

Question 15

Which should the client be instructed to avoid when prescribed an anticoagulant? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Citrus fruits
B) Alcohol
C) Contact sports
D) Prolonged sitting
E) Hard toothbrush

Question 16

Which describes the purpose of fibrinolysis?

A) Stop blood flow
B) Remove a blood clot
C) Produce enzymes
D) Increase blood flow

Question 17

The nurse is preparing to assess a client with von Willebrand's disease (vWD). Which priority question should the nurse ask the client?

A) "Do you have any other medical conditions?"
B) "Do you have heavy menstrual periods?"
C) "Have you ever been pregnant?"
D) "What are you currently using for birth control?"

Question 18

Which describes the primary action of anticoagulant therapy?

A) Increase the number of platelets
B) Prevent the formation of blood clots
C) Decrease the prothrombin time
D) Dissolve blood clots

Question 19

The nurse notes that a client receiving warfarin (Coumadin) has a high international normalized ratio (INR). Which question should the nurse include in the assessment?

A) "Do you eat a lot of garlic?"
B) "Have you been eating a lot of salads and vegetables?"
C) "Do you drink a lot of milk?"
D) "Are you restricting your fluids?"

Question 20

Which food should the nurse instruct the client prescribed warfarin (Coumadin) to avoid?

A) Tomato salad with kale and basil
B) Whole-wheat bread with margarine
C) Salt substitute
D) Fettuccine Alfredo

Question 21

Which prescription should the nurse anticipate for a client that has overdosed on Clopidogrel (Plavix)?

A) Whole blood transfusion
B) Platelet transfusion
C) Vitamin K
D) Protamine sulfate

Question 22

Which prescription should the nurse prepare to administer for a client experiencing a warfarin sodium overdose?

A) Aspirin
B) Heparin
C) Vitamin K
D) Protamine sulfate

Question 23

The nurse is preparing to provide education for a client prescribed Clopidogrel (Plavix) after a myocardial infarction and stent placement. Which statements should the nurse use to explain the action of Clopidogrel? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Clopidogrel will dissolve any clots that might form in your stent."
B) "Clopidogrel will make the platelets in your blood less sticky."
C) "Clopidogrel will change the way your platelets work."
D) "Clopidogrel decreases your blood's ability to clot."
E) "Clopidogrel works just like the heparin you were prescribed when in the hospital."

Question 24

Which classification of prescriptions does the nurse anticipate for the client being treated for a thromboembolic disorder? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Hemostatics
B) Thrombolytics
C) Anticoagulants
D) Antiplatelet agents
E) Clotting factor concentrates

Question 25

Which describes the action of thrombolytic prescriptions?

A) Convert plasmin to plasminogen.
B) Prevent the liver from making fibrin.
C) Prevent thrombus formation.
D) Digest and remove preexisting clots.

Question 26

Which describes the mechanism of action for Clopidogrel (Plavix)?

A) Decreases platelet production
B) Prevents platelets from adhering to the injured tissue
C) Stimulates platelet production
D) Prevents the platelets from sticking together

Question 27

Which describes the mechanism of action of anticoagulant prescriptions?

A) Alteration of plasma membrane and platelets
B) Conversion of plasminogen to plasmin
C) Prevention of fibrin from dissolving
D) Inhibition of thrombi formation.

Question 28

Which information should the nurse include in the teaching for a client prescribed heparin? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Self-administration of subcutaneous injections
B) Symptoms of deep vein thrombosis
C) Required laboratory tests
D) Signs of abnormal bleeding
E) Scheduled administration times with meals

Question 29

Which adverse effect should the nurse instruct the client to monitor for while receiving warfarin sodium?

A) Bleeding
B) Pain
C) Headache
D) Rash

Question 30

Which statements should the nurse include in the teaching for a client prescribed warfarin (Coumadin) therapy? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Inform your dentist you are taking warfarin prior to any procedures."
B) "Report to the lab for testing of activated partial thromboplastin time (aPTT)."
C) "Avoid strenuous activities."
D) "Place ice at the injection site if stinging or burning occurs."
E) "Take nonsteroidal anti-inflammatories (NSAIDs) for minor pain relief."