Edmunds: Introduction to Clinical Pharmacology, 8th Edition

Chapter 17: Hematologic Products - TEST

MULTIPLE CHOICE

1. Anticoagulant therapy is used to do which of the following?

a. Thin the blood

b. Lyse existing clots

c. Increase viscosity of the blood

d. Prevent new clot formation

2. 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?

a. Check the syringe size and needle again.

b. Look at the color of the solution.

c. Let another nurse check the dosage.

d. Check the order one more time.

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

a. Abdominal pain

b. Bleeding gums

c. Low blood pressure

d. Pallor

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

a. Vitamin K

b. Thiazide diuretics

c. Nonsteroidal antiinflammatory analgesics

d. Vitamin C

5. 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?

a. Hemorrhagic stroke

b. Ischemic stroke

c. Gastric inflammation

d. Cellular formation

6. 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?

a. aPTT

b. PT

c. INR

d. DIC panel

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

a. The physician has made an error.

b. The patient is being weaned from Coumadin.

c. The patient will soon be taken off heparin.

d. The patient may be experiencing a paradoxical effect to one of the medications.

8. 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?

a. Broccoli

b. Eggplant

c. Oranges

d. Grapes

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

a. 1.0 to 2.0

b. 2.0 to 3.0

c. 3.0 to 4.0

d. 4.0 to 5.0

10. 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?

a. 2 to 5 mg

b. 0.5 to 1 mg

c. 6 to 8 mg

d. 8 to 9 mg

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

a. "If you are cut and bleeding persists after 10 minutes, call the doctor."

b. "Over-the-counter medications may be taken with this drug."

c. "A diet high in green, leafy vegetables is recommended."

d. "Black, tarry stools are common with this medication."

12. Which of the following is the antidote for heparin overdose?
a. Aspirin
b. Packed red blood cells
c. Vitamin K
d. Protamine sulfate

13. Thrombolytic agents have which of the following actions?

a. They prevent clot formation.

b. They lyse existing clots.

c. They increase the blood's viscosity.

d. They thin the blood.

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

a. A physician

b. A trained IV nurse

c. An OR nurse

d. Any trained medical professional

15. 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?

a. Send the patient directly to the cardiac unit for follow-up care.

b. Give the patient one aspirin and repeat the ECG.

c. Administer a thrombolytic agent for lysis of thrombi.

d. Administer heparin only to prevent potential bleeding of coronary arteries.

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

a. Vitamin C

b. Vitamin D

c. Vitamin E

d. Vitamin K

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

a. Go back to using a razor for shaving as before therapy.

b. Use caution for a while after therapy has ended.

c. Remove the Medic-Alert bracelet at the end of therapy.

d. Resume alcohol consumption after therapy has ended.

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

a. 2 1/2 to 3 times the control value

b. 0.1 to 1 1/2 times the control value

c. 1 to 2 times the control value

d. 0.5 to 1 1/2 times the control value

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

a. ISI

b. PTT

c. DIC

d. INR

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

a. 1 hour before the next dose

b. 2 hours after the last dose

c. 30 minutes before the next dose

d. 2 1/2 hours before the next dose

21. Heparin therapy is based on the patient's body weight in kilograms. Which of the following represents the rate used for an IV bolus infusion?

a. 80 units/kg

b. 65 units/kg

c. 5 units/kg

d. 18 units/kg

22. Aside from excessive bleeding, heparin therapy may increase the risk of a patient developing which of the following conditions?

a. A decrease in urination

b. An increase in thirst

c. An increase in hypertension

d. A decrease in visual acuity

23. To reduce the risk of gastrointestinal bleeding in older adult patients, the nurse must be aware of giving anticoagulants with which of the following drugs?

a. Tylenol

b. Ibuprofen

c. Vitamin C

d. Vitamin E

24. Which of the following is a heparin antagonist?

a. Vitamin D

b. Vitamin E

c. Folic acid

d. Protamine sulfate

MULTIPLE RESPONSE

1. Thrombolytic agents are used in which of the following conditions? (Select all that apply.)

a. Acute pulmonary embolism

b. Ischemic stroke

c. Cellular damage

d. Hypotensive crisis

2. Which of the following drugs are used to prevent myocardial infarction in men? (Select all that apply.)

a. Vitamin K (AquaMEPHYTON)

b. Dipyridamole (Persantine)

c. Ticlopidine (Ticlid)

d. Clopidogrel (Plavix)