Pharmacology III Unit 3

C. 1.5-2.5 times the normal value range

A patient is receiving continuous IV Heparin. In order for this medication to have a therapeutic effect on the patient, the aPTT should be? A. 0.5-2.5 times the normal value range. B. 2-3 times the normal value range C. 1.5-2.5 times the normal value range D. 1-3.5 times the normal value range

D. Hold the infusion for 1 hour and decrease the rate per protocol because the aPTT is too high.

A patient who is receiving continuous IV Heparin, has an aPTT of 105 seconds. What is your next nursing action per protocol? A. Continue with the infusion because no change is needed based on this aPTT B. Increase the drip rate per protocol because the aPTT is too low. C. Re-draw the aPTT stat. D. Hold the infusion for 1 hour and decrease the rate per protocol because the aPTT is too high.

B. An aPTT twice the usual value

An older adult with cerebral arteriosclerosis is admitted with atrial fibrillation and is started on a continuous heparin infusion. What clinical finding enables the nurse to conclude that the anticoagulation therapy is effective? A. A reduction in confusion B. An aPTT twice the usual value C. An absence of ecchymotic areas D. A decreased viscosity of the blood.

C. increase in red blood cell count

Which laboratory result would indicate that the prescription for epoetin alfa is having the desired therapeutic effect? A. increase in platelet count B. increase in white blood cell count C. increase in red blood cell count D. increase in iron level

D. Liver

Which organ is most likely to become enlarged as a result of severe anemia? A. Gallbladder B. Kidneys C. Colon D. Liver

A. A 55 year old male patient who is post-op day 1 from brain surgery. C. A 36 year old male patient with active peptic ulcer disease

Which patients below would be at a HIGH risk for developing adverse effects of Heparin drug therapy? Select all that apply: A. A 55 year old male patient who is post-op day 1 from brain surgery. B. A 45 year old female patient with a pulmonary embolism C. A 36 year old male patient with active peptic ulcer disease D. A 43 year old female with uncontrolled atrial fibrillation.

B. Epistaxis

Which specifically should the nurse monitor when a client is receiving a platelet aggregation inhibitor such as clopidogrel (Plavix)? A. Nausea B. Epistaxis C. Chest pain D. Elevated temperature

D. It enhances the activation of antithrombin III, which prevents the activation of thrombin and the conversion of fibrinogen to fibrin.

Which statement below BEST describes how Heparin works as an anticoagulant? A. It inhibits clotting factors from synthesizing Vitamin K B. It inactivates the extrinsic pathways of coagulation C. It prevents Factor Xa from activating prothrombin to fibrinogen D. It enhances the activation of antithrombin III, which prevents the activation of thrombin and the conversion of fibrinogen to fibrin.

A. Patient shows no signs/symptoms of a blood clot.

While reviewing the patient's medication list, the nurse notes that the patient is receiving parenteral enoxaparin. Which outcome statement reflects the goal of the enoxaparin therapy? A. Patient shows no signs/symptoms of a blood clot. B. Patient reports a decrease in fatigue and dizziness. C. Patient shows no signs/symptoms of infection. D. Patient reports no shortness of breath on exertion.

B. Hyponatremia D. Diabetes insipidus E. Severe renal disease

A client has been prescribed medication to increase platelet aggregation. Which medical diagnosis should the nurse recognize as a contraindication for this medication therapy? Select all that apply A. Hypertension B. Hyponatremia C. Cystic fibrosis D. Diabetes insipidus E. Severe renal disease

A. INR

A client is receiving warfarin. Which test result should the nurse use to determine whether the daily dose of this anticoagulant is therapeutic? A. INR B. aPTT C. Bleeding time D. Sedimentation rate

A. Take the vital signs, verify the blood product with another nurse against the client's ID bracelet, and monitor the vital signs according to agency policy.

A client who is pale and moaning is diagnosed with esophageal varices and is admitted to the hospital. The health care provider orders a blood transfusion. What nursing actions should be taken? A. Take the vital signs, verify the blood product with another nurse against the client's ID bracelet, and monitor the vital signs according to agency policy. B. Because the vital signs were recorded during admission, hand the blood and monitor the client's vital signs every 15 minutes until the transfusion is absorbed. C. Record the vital signs in accordance with facility policy and check the blood product against the client's ID bracelet in the presence of the nursing supervisor. D. Take the vital signs after hanging the blood because the client is pale and moaning and is in critical condition; return in 15 minutes to monitor the vital signs.

C. Iron Salts

A client with upper gastrointestinal (GI) bleeding develops mild anemia. What should the nurse expect to be prescribed for this client? A. Epogen B. Dextran C. Iron Salts D. Vitamin B12

A. Pulmonary embolism B. Myocardial infarction E. Stroke

A deficiency in any of the anticlotting factors, such as protein C, protein S, and antithrombin III increases the patient's risk for which disorder(s)? Select all that apply. A. Pulmonary embolism B. Myocardial infarction C. Iron deficient anemia D. Pernicious anemia E. Stroke F. Hemolytic anemia

C. monthly, for the rest of my life.

A nurse determines that teaching regarding vitamin B12 injections to treat pernicious anemia is understood when a client states, "I must take the drug: A. When feeling fatigued." B. until my symptoms subside." C. monthly, for the rest of my life." D. during exacerbations of anemia."

C. Elevation in hematocrit level

A nurse is evaluating the results of treatment with erythropoietin (Epogen). Which client response is considered significant? A. Elevation in liver panel B. Increase in WBC counts C. Elevation in hematocrit level D. Decrease in Kaposi sarcoma lesions

C. Systolic blood pressure is lower than normal

A patient is diagnosed with iron deficiency anemia. Which assessment finding is the nurse most likely to observe in this patient? A. Neck veins are distended and edema is present. B. Lower extremities show signs of phlebitis C. Systolic blood pressure is lower than normal D. Palpation of ribs or sternum elicits tenderness

A. Hematuria B. decreasing platelets D. Low hemoglobin and hematocrit E. positive stool guaiac test.

A patient is on a continuous IV Heparin drip. As the nurse you are monitoring for any adverse reactions. Select all the signs and symptoms that would indicate this patient is having an adverse reaction to this medication: A. Hematuria B. decreasing platelets C. Increased blood glucose D. Low hemoglobin and hematocrit E. positive stool guaiac test.

B. Weight

A patient is ordered to start an IV continuous Heparin drip. Prior to starting the medication, the nurse would ensure what information is gathered correctly before initiating the drip? A. Vital signs B. Weight C. PT/INR level D. EKG

B. Ibuprofen

Which drug disrupts platelet action? A. Vitamin K B. Ibuprofen C. Penicillin V D. Morphine

False- anticoagulants are used to prevent clots

Anticoagulants are used to destroy clots. True or False

2 mL

Cyanocobalamin (Vitamin B12) 0.2 mg IM is prescribed for a client with pernicious anemia. A vial of the drug labeled "1 mL = 100 mcg" is available. How many milliliters should the nurse administer?

B. Indirect thrombin inhibitors

Heparin is an anticoagulant. What family of anticoagulant medications does this drug belong to? A. Direct thrombin inhibitors B. Indirect thrombin inhibitors C. Vitamin K antagonists D. Factor Xa inhibitors

A. Heparin can be used during pregnancy B. Heparin has a short half-life C. Heparin works to affect the intrinsic pathways of clotting

Select all the TRUE statements about the medication Heparin: A. Heparin can be used during pregnancy B. Heparin has a short half-life C. Heparin works to affect the intrinsic pathways of clotting D. Heparin can be administered orally, intravenously, or subcutaneously.

B. Platelet inhibitor

The home health nurse notices that new medications were prescribed for a patient during a recent hospitalization. In addition, the patient reports taking daily low-dose aspirin, but aspirin is not on the medication reconciliation list. Because of the aspirin , the nurse is most likely to call the prescribing health care provider for clarification of which type of medication? A. Vitamin supplement B. Platelet inhibitor C. Antihypertensive D. Erythrocyte stimulating agent

A. Fatigue

The nurse is interviewing a patient who has iron deficiency anemia. Which symptom is the patient most likely to report? A. Fatigue B. Night sweats C. Calf pain D. Blood in urine

C. Iron

The nurse notes that a 45-year-old woman has a low hemoglobin level. The nurse would perform a dietary assessment to identify a possible deficiency in which nutrient? A. Calcium B. Vitamin K C. Iron D. Vitamin D

C. Document the result because it is within normal range and continue to monitor patient.

The nurse notes that the patient's platelet count is 400,000/mm3. What action is the nurse most likely to take? A. Immediately inform the health care provider because of possible spontaneous bleeding. B. Instruct unlicensed assistive personnel to handle patient gently to minimize bruising C. Document the result because it is within normal range and continue to monitor patient. D. Initiate protective isolation and monitor for signs/symptoms of systemic infection.

B. bruising and bleeding at venipuncture sites

The patient is admitted for a chronic liver disorder and will be receiving vitamin K to address one of the problems associated with the disorder. Which clinical manifestation is the nurse most likely to observe before vitamin K is initiated? A. Sore throat and a smooth tongue B. Bruising and bleeding at venipuncture sites C. Fever and increased white blood cell count D. Calf swelling due to deep vein thrombosis

A. "It is contraindicated because bleeding will increase."

The spouse of a client with an intracranial hemorrhage asks the nurse, " Why aren't they administering an anticoagulant?" How should the nurse respond? A. "It is contraindicated because bleeding will increase." B. "If necessary it will be started to enhance circulation." C. "If necessary it will be started to prevent pulmonary thrombosis." D. "It is inadvisable because it masks the effects of the hemorrhage."

A. Protamine sulfate

What is the antidote for Heparin? A. Protamine sulfate B. Vitamin K C. Flumazenil D. Narcan

C. 30-40 seconds

What is the approximate NORMAL level range for an activated partial thromboplastin time (aPTT)? A. 20-25 seconds B. 2-3 seconds C. 30-40 seconds D. 60-80 seconds

B. The patient injects the needle 1 inch away from the umbilicus.

Your patient is being discharged home and will be required to self-administer injectable Heparin. You are observing the patient administer their scheduled dose of Heparin to confirm that the patient knows how to do it correctly. What action by the patient requires you to re-educate them about how to administer Heparin? A. The patient injects the needle into the fatty tissue of the abdomen. B. The patient injects the needle 1 inch away from the umbilicus. C. The patient rotated the injection site from the previous dose of Heparin. D. The patient does not massage the injection site after administering the medication.

D. Collect an aPTT level in 6 hours per protocol

Your patient is started on a Heparin drip. You administer a bolus of Heparin and start the drip per protocol as ordered by the physician. What will be your next important nursing action? A. Collect a PT level in 6 hours per protocol B. Collect an INR level in 4 hours per protocol C. Collect a Troponin level in 6 hours per protocol D. Collect an aPTT level in 6 hours per protocol