NU308 EXAM 4 GUIDE WITH
COMPLETE SOLUTION
A nurse is caring for a pt who has thrombophlebitis & is receiving heparin by
cont. IV infusion. The pt asks the nurse how long it will take for the heparin
to dissolve the clot. Which of the following responses should the nurse give?
a. "It usually takes heparin at least 2-3 days to reach a therapeutic blood
level."
b. "A pharmacist is the person to answer that question."
c. "Heparin does not dissolve clots, It stops new clots from forming."
d. "The oral med you will take after this IV will dissolve the clot." - ANSWER c
A client with DVT is receiving an infusion of heparin & will be starting on
warfarin soon. While the pt is receiving heparin, what lab test will provide the
nurse with info about its therapeutic effects?
a. Prothrombin time (PT)
b. International normalized ration (INR)
c. Activated partial thromboplastin time (aPTT)
d. Platelet count - ANSWER c
A nurse is preparing to admin heparin to a pt. Which of the following actions
should the nurse plan to take?
a. Use a 22-gauge needle to inject the med
,b. Use a 1-in. needle to inject the med
c. Inject the med into the abdomen above the level of the iliac crest
d. Massage the injection site after admin of the med - ANSWER c -
subcutaneous, do not massage!
A nurse is caring for a pt who has thrombophlebitis & is receiving a
continuous heparin infusion. Which of the following meds should the nurse
have available to reverse heparin's effects?
a. Vitamin K
b. Protamine sulfate
c. Acetylcysteine
d. Defarasirox - ANSWER b - vit K reverses warfarin
A nurse is caring for a pt who has DVT & has been on heparin continuous
infusion for 5 days. The provider prescribes warfarin PO without
discontinuing the heparin. The pt asks the nurse why both anticoagulants are
necessary. Which of the following statements should the nurse make?
a. "Warfarin takes several days to work, so the IV heparin will be used until
the warfarin reaches a therapeutic level."
b. "I will call the provider to get a prescription for discontinuing the IV
heparin today."
c. "Both heparin & warfarin work together to dissolve the clot."
d. "The IV heparin increases the effects of the warfarin & decreases the
length of your hospital stay." - ANSWER a
,A nurse is caring for a pt who is prescribed warfarin therapy for an artificial
heart valve. Which of the following lab values should the nurse monitor for a
therapeutic effect of warfarin?
a. Hemoglobin (Hgb)
b. Prothrombin time (PT)
c. Bleeding time
d. Activated partial thromboplastin time (aPTT) - ANSWER b
A nurse is providing discharge teaching for a pt who has a new prescription
for warfarin. Which of the following instructions should the nurse include in
the teaching?
a. Mild nosebleeds are common during initial Tx
b. Use an electric razor while on this med
c. If a dose of the med is missed, double the dose at the scheduled time.
d. Increase fiber intake to reduce the adverse effect of constipation -
ANSWER b
A nurse in a clinic is caring for a pt who has recently began taking warfarin.
The nurse is reviewing potential drug & food interaction risks and should
instruct the pt to avoid which of the following?
a. Cabbage
b. Cantaloupe
c. Green beans
d. White beans - ANSWER a
, What pt education should be included for a pt receiving enoxaprin
(Lovenox)? (select all that apply)
a. Teach the pt or family to give SC injections at home
b. Teach the pt or family not to take any OTC drugs without first consulting
with the PCP
c. Teach the pt to observe for unexplained bleeding such as pink, red, or dark
brown urine or bloody gums.
d. Teach the pt to monitor the development of DVT.
e. Teach the pt about the importance of drinking grapefruit juice daily. -
ANSWER a,b,c,d
Aspirin causes its anticoagulant effect by inhibiting which of the following?
a. Plasminogen
b. Prothrombin
c. Thromboxane 2
d. Glycoprotein IIb/IIIa - ANSWER c
A client has started clopidogrel (Plavix) after experiencing angina. What is
the desired therapeutic effect of this drug?
a. Anti-inflammatory & antipyretic drugs
b. To reduce the risk of an MI from a blood clot
c. Analgesic as well as clot-dissolving effects
d. To stop clots from becoming emboli - ANSWER b
COMPLETE SOLUTION
A nurse is caring for a pt who has thrombophlebitis & is receiving heparin by
cont. IV infusion. The pt asks the nurse how long it will take for the heparin
to dissolve the clot. Which of the following responses should the nurse give?
a. "It usually takes heparin at least 2-3 days to reach a therapeutic blood
level."
b. "A pharmacist is the person to answer that question."
c. "Heparin does not dissolve clots, It stops new clots from forming."
d. "The oral med you will take after this IV will dissolve the clot." - ANSWER c
A client with DVT is receiving an infusion of heparin & will be starting on
warfarin soon. While the pt is receiving heparin, what lab test will provide the
nurse with info about its therapeutic effects?
a. Prothrombin time (PT)
b. International normalized ration (INR)
c. Activated partial thromboplastin time (aPTT)
d. Platelet count - ANSWER c
A nurse is preparing to admin heparin to a pt. Which of the following actions
should the nurse plan to take?
a. Use a 22-gauge needle to inject the med
,b. Use a 1-in. needle to inject the med
c. Inject the med into the abdomen above the level of the iliac crest
d. Massage the injection site after admin of the med - ANSWER c -
subcutaneous, do not massage!
A nurse is caring for a pt who has thrombophlebitis & is receiving a
continuous heparin infusion. Which of the following meds should the nurse
have available to reverse heparin's effects?
a. Vitamin K
b. Protamine sulfate
c. Acetylcysteine
d. Defarasirox - ANSWER b - vit K reverses warfarin
A nurse is caring for a pt who has DVT & has been on heparin continuous
infusion for 5 days. The provider prescribes warfarin PO without
discontinuing the heparin. The pt asks the nurse why both anticoagulants are
necessary. Which of the following statements should the nurse make?
a. "Warfarin takes several days to work, so the IV heparin will be used until
the warfarin reaches a therapeutic level."
b. "I will call the provider to get a prescription for discontinuing the IV
heparin today."
c. "Both heparin & warfarin work together to dissolve the clot."
d. "The IV heparin increases the effects of the warfarin & decreases the
length of your hospital stay." - ANSWER a
,A nurse is caring for a pt who is prescribed warfarin therapy for an artificial
heart valve. Which of the following lab values should the nurse monitor for a
therapeutic effect of warfarin?
a. Hemoglobin (Hgb)
b. Prothrombin time (PT)
c. Bleeding time
d. Activated partial thromboplastin time (aPTT) - ANSWER b
A nurse is providing discharge teaching for a pt who has a new prescription
for warfarin. Which of the following instructions should the nurse include in
the teaching?
a. Mild nosebleeds are common during initial Tx
b. Use an electric razor while on this med
c. If a dose of the med is missed, double the dose at the scheduled time.
d. Increase fiber intake to reduce the adverse effect of constipation -
ANSWER b
A nurse in a clinic is caring for a pt who has recently began taking warfarin.
The nurse is reviewing potential drug & food interaction risks and should
instruct the pt to avoid which of the following?
a. Cabbage
b. Cantaloupe
c. Green beans
d. White beans - ANSWER a
, What pt education should be included for a pt receiving enoxaprin
(Lovenox)? (select all that apply)
a. Teach the pt or family to give SC injections at home
b. Teach the pt or family not to take any OTC drugs without first consulting
with the PCP
c. Teach the pt to observe for unexplained bleeding such as pink, red, or dark
brown urine or bloody gums.
d. Teach the pt to monitor the development of DVT.
e. Teach the pt about the importance of drinking grapefruit juice daily. -
ANSWER a,b,c,d
Aspirin causes its anticoagulant effect by inhibiting which of the following?
a. Plasminogen
b. Prothrombin
c. Thromboxane 2
d. Glycoprotein IIb/IIIa - ANSWER c
A client has started clopidogrel (Plavix) after experiencing angina. What is
the desired therapeutic effect of this drug?
a. Anti-inflammatory & antipyretic drugs
b. To reduce the risk of an MI from a blood clot
c. Analgesic as well as clot-dissolving effects
d. To stop clots from becoming emboli - ANSWER b
