Exam 4 Evolve
A patient is started on warfarin therapy while also receiving intravenous heparin. The patient is concerned about the risk for bleeding. What will the nurse tell the patient?
A patient is started on warfarin therapy while also receiving intravenous heparin. The patient is concerned about the risk for bleeding. What will the nurse tell the patient?
A patient with an acute myocardial infarction is prescribed an intravenous (IV) bolus of tenecteplase. The patient weighs 160 pounds (approximately 73 kg). What dosage should the nurse administer?
40
Which needle length and gauge should the nurse choose to administer subcutaneous heprain
5/8 inch, 25 gauge
Which drug is the most effective for lowering low-density lipoprotein (LDL) cholesterol?
Atorvastatin
The nurse is reviewing laboratory date before initiating a patients heparin infusion. Which finding requires immediate action?
platelets 95,000/mm3
The nurse is monitoring a patient receiving alteplase for treatment of a massive pulmonary embolism. Which finding indicates that the therapy is effective
pulse oxygen saturation increased
The nurse is caring for a patient with hypercholesterolemia who is taking 20 mg of simvastatin as prescribed. After a few days, the patient's urinalysis reports indicated the presence of myoglobin. What instruction would the nurse receive from the primary health care provider?
"Discontinue administering the medication."
The nurse is assessing a patient with diabetes who has hyperlipidemia. The patient asks the nurse to suggest either an herbal medication or a dietary modification to reduce cholesterol levels. Which suggestion given by the nurse would be most beneficial to the patient?
"Eat foods rich in omega-3 fatty acids."
What is the mechanism of action of ezetimibe?
It inhibits absorption of dietary and biliary cholesterol in the small intestine.
The nurse is caring for a newly admitted patient who will begin heparin therapy. While documenting the patient's history, the nurse notes that the patient is currently undergoing treatment with enoxaparin. What is the nurse's highest priority?
Notify the provider that the patient should not be started on heparin.
The nurse is caring for a patient who is being treated wiht one of the coagulation modifier drugs. The patient tells the nurse the he has developed a rash. What is the nurse's highest priority action?
Notify the provider, the medication will need to be discontinued
A patient with nonvalvular atrial fibrillation is to be discharged on dabigatran etexilate. Which statement should the nurse include in the discharge teaching?
The medication must be stored in the manufacturer supplied bottle
The nurse is caring for a patient who is being treated with fondaparinux and notes a platelet count of 80,000/mm3. Based on this information, the nurse anticipates which change to the medication regimen?
The medication will be stopped completely
A patient with hyperlipidemia is treated with atorvastatin. On the follow-up visit, the nurse discovers that the patient has had no improvement in cholesterol levels. What could be the reason for this?
The patient is taking the medication in the morning
The nurse is monitoring a patient receiving reteplase therapy. Which assessment finding requires the most immediate action?
change in mental state
The patient asks the nurse to explain the difference between dalteparin and heparin. Which response by the nurse is accurate
dalteparin is a low molecular weight heparin that is more predictable in its effect and has a lower risk of bleeding
The nurse is monitoring a patient receiving a heparin infusion for the treatment of pulmonary embolism. Which assessment finding most likey relates to an adverse effect of heparin.
discolored uring
The patient is receiving warfarin therpy, and the nurse finds the international normalized ratio to be 4.0. How will the nurse interpret this finding?
The level is outside the expected target therapeutic level of anticoagulation. It is too high.
A patient who has been taking warfarin is admitted with coffee-ground emesis. What can the nurse anticipate being prescribed for this patient?
Vitamin K
The nurse is caring for a patient who has hypercholesterolemia and newly prescribed atorvastatin. Which instruction will the nurse receive from the primary health care provider for the safe administration of the medication?
"Administer 100 mg of atorvastatin orally."
When teaching the nursing student about coronary heart disease, which statement will the nurse include in the session?
"Coronary heart disease occurs because of the formation of atherosclerotic plaques."
Which statement made by the patient indicates to the nurse that understanding of the discharge instructions on antihyperlipidemic medications has occurred?
"I will continue to modify my diet and keep exercising to help increase my high-density lipoprotein serum levels."
Which statement indicates the patient understands discharge instructions regarding cholestyramine?
"I will take cholestyramine with water, fruit juice, or soup."
The nurse is teaching a group of nursing students about statin drugs and asks about the mechanism of action of lovastatin. Which response from the students indicates understanding?
"It inhibits hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase to reduce the biosynthesis of cholesterol in the liver."
Which discharge instructions should the nurse include for a patient prescribed cholestyramine?
"Mix the drug with water or juice."
The nurse is teaching a group of patients about dietary approaches to reduce cholesterol levels. Which statement is most important to include in the teaching?
"Read food labels and reduce your intake of saturated fats."
A patient receiving atorvastatin therapy to reduce high cholesterol levels calls the clinic and reports, "I am experiencing severe pain in both my legs." What is the nurse's best response?
"Stop taking the drug and visit the clinic immediately."
A patient is prescribed a therapeutic lifestyle change (TLC) diet. The patient understands the diet when he states which of the following?
"The TLC diet was prescribed to help me reduce my low-density lipoproteins (LDL) cholesterol and maintain a healthy weight."
The health care provider prescribes lovastatin for a patient discharged from the hospital after a myocardial infarction. Which instructions are most appropriate for the nurse to include in the patient's teaching plan? Select all that apply.
-"Lower the total fat and saturated fat in your diet by increasing your intake of fresh fruits and vegetables and whole grains." -"Do not start any new medications without first talking to your health care provider." -"Before starting this medication a blood test will be done to check your total cholesterol level and measure liver enzymes."
Which therapeutic lifestyle changes are shown to reduce low-density lipoprotein (LDL) cholesterol? Select all that apply.
-active exercise fro 30-60 minutes five days a week -reduction of saturated fat intake -weight loss with metabloic syndrome
The nurse is assessing a patient who has been prescribed cholestyramine. The nurse finds that the patient has decreased peristalsis and bloating. Which intervention should the nurse perform to relieve the symptoms? Select all that apply.
-provide a diet rich in fiber -increase the intake of fluid
The nurse is ready to begin a heparin infusion for a patient with evolving stroke. The baseline activated partial thromboplastin time is 40 seconds. Which aPTT value indicates that a therapeutic dose has been achieved
70
In which patient would a low-dose aspirin be contraindicted?
A patient with a hemorrhagic stroke
A patient is receiving an intravenous heparin drip. Which lab value requires immediate action by the nurse
Activated partial thromboplastin time of 120 seconds
A patient is prescribed omega 3-acid ethyl esters and simvastatin for hyperlipidemia. The nurse is looking at the patient's medication history and expresses concern over which medication?
Aspirin
Which nursing intervention is essential for a patient experiencing myocardial infarction who is receiving alteplase?
Assess for dysrhythmias
A patient with warfarin toxicity is prescribed phytoanadione. Which nursing assessment ensures patient safety?
Assess the prothrombin time
On assessment of a patient with hyperlipidemia, the nurse learns that the patient has recently undergone liver transplantation. Which antihyperlipidemic drug does the nurse expect to be excluded from the patient's prescription?
Atorvastatin
How does simvastatin exert its action?
By inhibiting the enzyme hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase
A patient diagnosed with hypercholesterolemia is prescribed lovastatin. Based on this medication order, the nurse will contact the health care provider about which reported condition in the patient's history?
Hepatic disease
The nurse is caring for a patient who has undergone kidney transplantation. The patient's laboratory reports show hyperlipidemia. Which antihyperlipidemic drug would be most beneficial for the patient?
Colesevelam
The nurse is caring for a patient who takes multiple cholesterol-lowering drugs. Which drug is least likely to cause systemic side effects?
Colesevelam
Which drug is approved for hyperlipidemia and to help control hyperglycemia in patients with type 2 diabetes?
Colesevelam
The nurse is caring for a patient who is being treated with warfarin and who is scheduled to be placed on phenytoin. The nurse anticipates which effect will occur when the phenytoin is administered?
Decreased effect of the warfarin
Which assessment finding in a patient taking a hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor will the nurse act on immediately?
Elevated liver function tests
A patient who was admitted with deep vein thrombophlebitis is com;laining of difficulty breathing and chest pain. What is the most likely cause of these symptoms?
Embolus to the lungs
The nurse provides teaching to a patient who will take atorvastatin at home. Which patient teaching is most likely to help maintain the antilipemic medication dosage at the lowest level possible?
Engage in moderate exercise.
The patient is being treated with a continuous intravenous (IV) infusion of heparin. What is the nurse's highest priority?
Ensure that protamine sulfate is readily available at all times.
Which antilipemic medication reduces serum cholesterol by inhibiting its absorption in the small intestine?
Ezetimibe
The nurse is caring for a patient who has elevated triglyceride levels and is unresponsive to HMG-CoA reductase inhibitors. What does the nurse expect the primary health care provider to prescribe to the patient?
Gemfibrozil
A patient with deep vein thrombosis receiving an intravenous 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 funtions
The nurse is caring for a patient who has coronary heart disease (CHD). The nurse tells the patient, "Your cholesterol levels are abnormal; you are at a high risk of having a heart attack." What did the nurse discover regarding the lipoprotein levels in the patient's blood report?
High levels of low-density lipoproteins (LDLs)
The nurse determines that the patient has understood the discharge teaching regarding warfarin based on which of the patients statements?
I should use a soft toothbrush for dental hygiene
A patient receiving warfarin for a chronic condition. Which patient statement requires immediate action by the nurse?
I will increase dark green, leafy vegetables in my diet
The nurse is caring for a patient who takes warfarin for prevention of deep vein thrombosis. The patient has an international normalized ratio (INR) of 1.2. How should the nurse interpret this finding?
INR is too low; the dose may need to be increased.
When will the nurse administer hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins)?
In the evening
The nurse understands that cholesterol is carried through the blood by lipoproteins. Which lipoprotein is most closely associated with coronary atherosclerosis?
Low-density lipoprotein (LDL)
A patient is taking pravastatin sodium. Which assessment finding requires immediate action by the nurse?
Muscle pain
A patient with cardiovascular disease is taking rosuvastatin. Which finding would indicate a potential adverse effect of this drug?
Muscle pain and tenderness
A patient with hyperlipidemia has been prescribed simvastatin. While caring for the patient, the nurse unknowingly administers niacin along with simvastatin. Which complication may the patient have due to the drugs' interaction?
Myopathy
A patient has overdosed on warfarin. Which substance will the nurse administer to reverse the effect of warfarin?
Phytoadione
a patient who is receiving heparin therapy has bruises covering the abdomen as well as red-colored urine. What does the nurse need to assess?
Platelet level
A patient who has been receiving an infusion of heparin has an activated partial thromboplastin time of 120 seconds.. what is the nurses first action?
Shut off the heparin drip
The nurse is teaching a medication regimen to a patient who has type II hyperlipoproteinemia and who has been prescribed cholestyramine. Of what will the nurse inform the patient during the teaching?
Take other medications 1 hour before or 4 hours after the administration of cholestyramine.
The nurse assesses the patients prothrombin time to determine the effectiveness of anticoagulant therapy and notes that it is 32 seconds. How will the nurse interpret this value
The PT is significantly elevated
The nurse assess the patient's activated partial thromboplastin time to determine the effectiveness of the heparin regimen and notes that is is 35 seconds. How will the nurse interpret this values
The aPTT is significantly decreased
The nurse is caring for a patient who is scheduled to begin warfarin treatment and is currently being treated with amiodarone. Based on this information, the nurse anticipates which change will be made to the medication regimen?
The dosage of the warfarin will be decreased
The nurse is caring for a patient who has hyperlipidemia and who has been prescribed gemfibrozil. On reviewing the medical history of the patient, the nurse learns that the patient is taking warfarin. What does the nurse anticipate after reviewing the patient's medical history?
The patient has an increased risk of bleeding.
Laboratory reports indicate that a patient's serum cholesterol concentration is 250 mg/dL and triglyceride levels are 450 mg/dL. The health care provider prescribes gemfibrozil to lower cholesterol levels. What is the desired effect of the drug on the patient's lipoprotein levels?
There would be a decrease in low-density lipoprotein (LDL) levels.
The nurse is administering tenecteplase therapy to a patient experiencing an acute myocardial infarction. What will the nurse teach the patient about this therapy?
This therapy will dissolve the clot that cause the heart attack
A bleeding patient receiving warfarin has an international normalized ratio of 6. What is the nurse's best course of action?
administer phytonadione
A nurse is preparing to administer enoxaprin sodium to a patient for prevention of deep vein thrmosis. which is an essential nursing intervention
administer the medication into subcutaneous tissue of the abdomen
The nurse is teaching a patient about therapy with anitcoagulants. What is essential information to include in the teaching plan?
anticoagulants prevent clots from forming
The patient is scheduled to receive argotroban. Which is the correct route by which to administer the drug?
intravenous
The patient has been placed on aspirin as an antiplatelet drug. Which side effect is the patient most likely to experience
nausea
The lab 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
The patient is being treated with heparin. The nurse assess the patients lab test results and finds that the platelet count has dropped to 75,000mm3. What action will the nurse perform next
notify the primary healthcare provider of this finding
Which best describes the mechanism of action of an anticoagulant
reduces the formation of fibrin
