RNSG - Pre-Lecture Quizzes (9)

Which factor is an absolute contraindication to receiving a thrombolytic? Ischemic stroke Pregnancy Appendectomy 2 years ago Controlled hypertension

Pregnancy Rationale: Contraindications for thrombolytics include pregnancy, recent gastrointestinal bleed, hemorrhagic stroke, a known bleeding disorder, recent major surgery or trauma, history of intracranial vessel malformation, and uncontrolled hypertension. Ischemic stroke, appendectomy in the past, and controlled hypertension are not contraindications for thrombolytic administration.

During heparin therapy, the aPTT should be maintained at approximately 3.0 times the control or baseline value. TRUE FALSE

FALSE

Heparin is absorbed from the gastrointestinal (GI) tract. TRUE FALSE

FALSE

Dosage of LMWHs should be reduced in clients with severe abnormal kidney function. TRUE FALSE

TRUE

Which drugs administered for coagulation disorders are therapeutic drug monitoring not necessary? Warfarin and apixaban Dabigatran and rivaroxaban Apixaban and rivaroxaban Dabigatran and edoxaban

Apixaban and rivaroxaban Rationale: Therapeutic drug monitoring is not necessary for apixaban, edoxaban, and rivaroxaban. When warfarin therapy begins, daily evaluation of INR is necessary until a stable daily dose is reached. Prescribers use aPTT to regulate heparin dosage.

A patient is on a heparin infusion. Which lab value is used to titrate this medication? Activated partial thromboplastin clotting time (aPTT)

Activated partial thromboplastin clotting time (aPTT) Rationale: aPTT is used to guide titration in patients receiving heparin. PT and INR are monitored in patients receiving warfarin. Hemoglobin is monitored with all anticoagulants but does not impact titration.

Which drug is classified as a direct factor Xa inhibitor? Clopidogrel Apixaban Aspirin Dabigatran sulfate

Apixaban Rationale: Apixaban is classified as a direct factor Xa inhibitor. Clopidogrel and aspirin are antiplatelet drugs. Dabigatran sulfate is a direct thrombin inhibitor.

Which medication is an example of an antiplatelet? Atropine Clopidogrel Warfarin Alteplase

Clopidogrel Rationale: Clopidogrel is an example of an antiplatelet, as is aspirin. Atropine is for symptomatic bradycardia, warfarin is an anticoagulant, and alteplase is a thrombolytic.

Which drug is an antiplatelet? Rivaroxaban Alteplase Warfarin Clopidogrel

Clopidogrel Rationale: Clopidogrel is an antiplatelet drug. Alteplase is a thrombolytic drug. Warfarin and rivaroxaban are anticoagulant drugs.

What drugs have no reversing agents? Clopidogrel and aspirin Heparin and clopidogrel Warfarin and heparin Warfarin and aspirin

Clopidogrel and aspirin Rationale: Clopidogrel and aspirin have no reversing agents. Idarucizumab is the reversing agent for dabigatran. Vitamin K is the reversing agent for warfarin

Which food should be avoided because it increases the effect of warfarin? Cabbage Broccoli Garlic Lettuce

Garlic Rationale: Garlic should be avoided when taking warfarin as it increases its effect. Broccoli, cabbage, and lettuce should also be avoided, but it decreases the effect of warfarin.

Which intervention should be implemented for patients on any medications that increase the risk of bleeding? Utilize basic razors. Encourage intramuscular (IM) injections. Monitor for dark stools. Disregard fall precautions.

Monitor for dark stools. Rationale: For patients on medications that increase the risk for bleeding, the patient should be alert for signs of bleeding, which may include bleeding gums, bruising, dark stools. Other interventions include maintaining fall precautions, avoiding IM injections, and using electric razors.

Plasmin (also called fibrinolysin) is an enzyme that breaks down the fibrin meshwork that stabilizes a clot. TRUE FALSE

TRUE

Thrombogenesis may be lifesaving when it occurs as a response to hemorrhage. TRUE FALSE

TRUE

How do anticoagulants work? Thin the blood to prevent clots and stop clots from getting bigger. Prevent platelets from sticking to stents. Dissolve clots. Decrease bleeding times.

Thin the blood to prevent clots and stop clots from getting bigger. Rationale: Anticoagulants work by thinning the blood to prevent clots and to stop them from getting bigger. Antiplatelets prevent platelets from sticking to stents, and thrombolytics dissolve clots.