Pharmacology Ch 52 Online Questions (Exam 2)
Which instruction about clopidogrel [Plavix] should the nurse include in the discharge teaching for a patient who has received a drug-eluting coronary stent?
"Check with your healthcare provider before taking any over-the-counter medications for gastric acidity."
The nurse is caring for a patient who takes warfarin [Coumadin] for prevention of deep vein thrombosis. The patient has an international normalized ratio (INR) of 1.2. Which action by the nurse is most appropriate?
Call the healthcare provider to increase the dose.
The nurse knows that which statement is accurate for enoxaparin [Lovenox]?
It reduces the activity of factor Xa more than the activity of thrombin.
The nurse is caring for a patient receiving clopidogrel [Plavix] to prevent blockage of coronary artery stents. Which other drug on the patient's medication administration record may reduce the antiplatelet effects of clopidogrel?
Omeprazole [Prilosec]
Fondaparinux [Arixtra] is not approved for use in which circumstance?
Prevention of ischemic complications in patients with unstable angina
The nurse is caring for a group of patients taking warfarin [Coumadin]. Which patients are at moderate to high risk for harm as a result of warfarin therapy? (Select all that apply.)
-A patient with variant genes that code for VKORC1 and CYP2CP -A woman with a new onset of symptoms of a pulmonary embolus -A patient with a prosthetic heart valve, for whom an interacting drug is being deleted from the regimen
The nurse is monitoring a patient receiving a heparin infusion for the treatment of pulmonary embolism. Which assessment finding most likely relates to an adverse effect of heparin?
Discolored Urine
A patient with nonvalvular atrial fibrillation is to be discharged on dabigatran etexilate [Pradaxa]. Which statement should the nurse include in the discharge teaching?
"The medication must be stored in the manufacturer-supplied bottle."
The healthcare provider prescribes heparin 900 units/hr. The label on the IV bag reads Heparin 10,000 units in 500 mL D5W. How many mL/hr will deliver the correct dose? (Fill in the blank and record your answer.)
1.45 mL
The patient's heparin is infusing at 11 mL/hr. The bag of fluid is mixed 25,000 units of heparin in 250 mL D5W. What hourly dose is the patient receiving? (Fill in the blank and record your answer.)
1100 units/hr
The patient's heparin is infusing at 28 mL/hr. The bag of fluid is mixed 20,000 units of heparin in 500 mL D5W. What hourly dose is the patient receiving? (Fill in the blank and record your answer.)
1120 units/hr
A patient with an acute myocardial infarction is prescribed an intravenous (IV) bolus of tenecteplase [TNKase]. The patient weighs 160 lb. The nurse will administer what dosage?
40 mg
The nurse is ready to begin a heparin infusion for a patient with evolving stroke. The baseline activated partial thromboplastin time (aPTT) is 40 seconds. Which aPTT value indicates that a therapeutic dose has been achieved?
70
A patient presents to the emergency department with symptoms of acute myocardial infarction. After a diagnostic workup, the healthcare provider prescribes a 15-mg IV bolus of alteplase (tPA), followed by 50 mg infused over 30 minutes. In monitoring this patient, which finding by the nurse most likely indicates an adverse reaction to this drug?
Decreasing level of consciousness
A patient with deep vein thrombosis receiving an intravenous (IV) heparin infusion asks the nurse how this medication works. What is the nurse's best response?
Heparin suppresses coagulation by helping antithrombin perform its natural functions.
A patient admitted with deep vein thrombosis (DVT) and subsequent pulmonary embolism (PE) requires immediate anticoagulation. What medication would be appropriate for this patient who has a history of heparin-induced thrombocytopenia (HIT)?
Lepirudin [Refludan]
The laboratory calls to report a drop in the platelet count to 90,000/mm3 for a patient receiving heparin for the treatment of postoperative deep vein thrombosis. Which action by the nurse is the most appropriate?
Notify the healthcare provider to discuss the reduction or withdrawal of heparin
A patient is receiving continuous heparin infusion for venous thromboembolism treatment. Which laboratory results should the nurse monitor? (Select all that apply.)
-Platelets -Activated partial thromboplastin time (aPTT)
A patient is being discharged from the hospital on warfarin [Coumadin] for deep vein thrombosis prevention. Which instructions should the nurse include in the patient's discharge teaching plan? (Select all that apply.)
-Wear a medical alert bracelet. -Check all urine and stool for discoloration. -Do not start any new medication without first talking to your healthcare provider.
A patient diagnosed with a pulmonary embolism is receiving a continuous heparin infusion at 1000 units/hr. Of which findings should the nurse immediately notify the healthcare provider? (Select all that apply.)
-aPTT of 40 seconds -Nosebleeds -aPTT of 100 seconds
The healthcare provider prescribes heparin 2500 units subcutaneous daily. The drug is available in 10,000 units per mL. How may milliliters will the nurse give? (Fill in the blank and record your answer using one decimal place.)
0.25mL
Which needle length and gauge should the nurse choose to administer subcutaneous heparin?
⅝ inch; 25 gauge