Chapter 15: Drugs Affecting the Hematologic System
MULTIPLE CHOICE
1. An older patient who takes a daily NSAID for arthritis pain has been prescribed aspirin as an
antiplatelet agent. What information regarding risks associated with aspirin use should be
included in this teaching plan?
a. The risk for urinary retention
b. The risk for cognitive decline
c. The risk for gastrointestinal bleeding
d. The risk for peripheral arterial disease ANS: C
Most drugs that affect the blood clotting system, such as antiplatelet drugs, have the potential to
cause bleeding, especially in older patients.
DIF: Cognitive Level: Applying REF: p. 281
2. You are teaching a patient who has recently undergone a coronary artery stent placement, and
has now been prescribed clopidogrel. Which statement made by this patient informs you that the
patient requires further teaching?
a. “I will need to take this drug every day for 3 months to prevent clogging of the stent.”
b. “I will report any abnormal bleeding.”
c. “I will avoid herbal supplements while taking this drug.”
d. “I will take this drug with food.” ANS: A
For patients who have had a stent placed into the coronary artery because of severe narrowing or
blockage of the artery, clopidogrel prevents platelets from sticking to the stent mesh. For these
, Visovsky: Introduction to Clinical Pharmacology, 10th Edition 17
patients, clopidogrel must be taken daily for a year or longer to prevent clots from developing and
plugging up the stent.
DIF: Cognitive Level: Applying REF: p. 280
3. A female patient taking aspirin as an antiplatelet drug calls you to report she may be having
an allergic reaction to the drug. Which statement made by the patient alerts you to a possible
adverse reaction to the drug?
a. “I am having nausea after my meals.”
b. “I am experiencing itching and hives on my back and abdomen.”
c. “My visual acuity has decreased.”
d. “I am having increased urination throughout the night.” ANS: B
Allergic reactions to aspirin and NSAIDs generally occur within a few hours of taking the drug.
Symptoms of allergic reactions include itching, hives, and runny nose, with more severe reactions
causing swelling of the lips, tongue, or face.
DIF: Cognitive Level: Applying REF: p. 281
4. You are taking the drug history of a 47-year-old male patient who is recovering from a
myocardial infarction, and will be starting on an antiplatelet drug. Which of the following
statements made by the patient alerts you to a potential drug interaction with antiplatelet drugs?
a. “I am taking a beta blocker for hypertension.”
b. “I am taking furosemide for fluid retention.”
c. “I take an antacid daily for my reflux.”
d. “I take an inhaled corticosteroid for my asthma.” ANS: C
Antacids interfere with the action of antiplatelet drugs, and should be taken 1 to2 hours before
taking an antiplatelet drug.
, Visovsky: Introduction to Clinical Pharmacology, 10th Edition 17
DIF: Cognitive Level: Applying REF: p. 281
5. A patient prescribed an anticoagulant asks you about potential drug interactions with this
new drug. Which of the following drugs would you advise this patient to avoid while taking
anticoagulants?
a. Vitamin C
b. Thiazide diuretics
c. Potassium supplements
d. Nonsteroidal anti-inflammatory analgesics ANS: D
Nonsteroidal anti-inflammatory drugs (NSAIDs) will increase the risk of bleeding and
hemorrhage in a patient receiving anticoagulants.
DIF: Cognitive Level: Applying REF: p. 281
6. You are reviewing the laboratory values of an outpatient who is on anticoagulant therapy. The
laboratory tests show a less than desired level of anticoagulation. The patient states that the drug
has been taken as prescribed. You suspect the issue may be related to the patient’s dietary intake.
Which foods would you advise the patient to avoid while on anticoagulant therapy?
a. Spinach and broccoli
b. Peaches and plums
c. Carrots and celery
d. Sweet potatoes and white rice ANS: A
The patient should avoid excessive amounts of foods high in vitamin K (spinach, broccoli,
cabbage, kale, dark leafy greens, and asparagus).
DIF: Cognitive Level: Applying REF: p. 281
MULTIPLE CHOICE
1. An older patient who takes a daily NSAID for arthritis pain has been prescribed aspirin as an
antiplatelet agent. What information regarding risks associated with aspirin use should be
included in this teaching plan?
a. The risk for urinary retention
b. The risk for cognitive decline
c. The risk for gastrointestinal bleeding
d. The risk for peripheral arterial disease ANS: C
Most drugs that affect the blood clotting system, such as antiplatelet drugs, have the potential to
cause bleeding, especially in older patients.
DIF: Cognitive Level: Applying REF: p. 281
2. You are teaching a patient who has recently undergone a coronary artery stent placement, and
has now been prescribed clopidogrel. Which statement made by this patient informs you that the
patient requires further teaching?
a. “I will need to take this drug every day for 3 months to prevent clogging of the stent.”
b. “I will report any abnormal bleeding.”
c. “I will avoid herbal supplements while taking this drug.”
d. “I will take this drug with food.” ANS: A
For patients who have had a stent placed into the coronary artery because of severe narrowing or
blockage of the artery, clopidogrel prevents platelets from sticking to the stent mesh. For these
, Visovsky: Introduction to Clinical Pharmacology, 10th Edition 17
patients, clopidogrel must be taken daily for a year or longer to prevent clots from developing and
plugging up the stent.
DIF: Cognitive Level: Applying REF: p. 280
3. A female patient taking aspirin as an antiplatelet drug calls you to report she may be having
an allergic reaction to the drug. Which statement made by the patient alerts you to a possible
adverse reaction to the drug?
a. “I am having nausea after my meals.”
b. “I am experiencing itching and hives on my back and abdomen.”
c. “My visual acuity has decreased.”
d. “I am having increased urination throughout the night.” ANS: B
Allergic reactions to aspirin and NSAIDs generally occur within a few hours of taking the drug.
Symptoms of allergic reactions include itching, hives, and runny nose, with more severe reactions
causing swelling of the lips, tongue, or face.
DIF: Cognitive Level: Applying REF: p. 281
4. You are taking the drug history of a 47-year-old male patient who is recovering from a
myocardial infarction, and will be starting on an antiplatelet drug. Which of the following
statements made by the patient alerts you to a potential drug interaction with antiplatelet drugs?
a. “I am taking a beta blocker for hypertension.”
b. “I am taking furosemide for fluid retention.”
c. “I take an antacid daily for my reflux.”
d. “I take an inhaled corticosteroid for my asthma.” ANS: C
Antacids interfere with the action of antiplatelet drugs, and should be taken 1 to2 hours before
taking an antiplatelet drug.
, Visovsky: Introduction to Clinical Pharmacology, 10th Edition 17
DIF: Cognitive Level: Applying REF: p. 281
5. A patient prescribed an anticoagulant asks you about potential drug interactions with this
new drug. Which of the following drugs would you advise this patient to avoid while taking
anticoagulants?
a. Vitamin C
b. Thiazide diuretics
c. Potassium supplements
d. Nonsteroidal anti-inflammatory analgesics ANS: D
Nonsteroidal anti-inflammatory drugs (NSAIDs) will increase the risk of bleeding and
hemorrhage in a patient receiving anticoagulants.
DIF: Cognitive Level: Applying REF: p. 281
6. You are reviewing the laboratory values of an outpatient who is on anticoagulant therapy. The
laboratory tests show a less than desired level of anticoagulation. The patient states that the drug
has been taken as prescribed. You suspect the issue may be related to the patient’s dietary intake.
Which foods would you advise the patient to avoid while on anticoagulant therapy?
a. Spinach and broccoli
b. Peaches and plums
c. Carrots and celery
d. Sweet potatoes and white rice ANS: A
The patient should avoid excessive amounts of foods high in vitamin K (spinach, broccoli,
cabbage, kale, dark leafy greens, and asparagus).
DIF: Cognitive Level: Applying REF: p. 281
