Pharm: A Patient-Centered Nursing
Process Approach CH: 40 Exam 2024
Questions & Answers 100% Accurate!!
The nurse is caring for a postoperative patient. The nurse will anticipate administering which
medication to this patient to help prevent thrombus formation caused by slow venous blood flow?
a. Alteplase (Activase)
b. Aspirin
c. Clopidogrel (Plavix)
d. Low-molecular-weight heparin - ANSWER ANS: D
Low-molecular-weight heparin is an anticoagulant, which is used to inhibit clot formation and is used
prophylactically to prevent postoperative deep vein thrombosis. Alteplase is a thrombolytic, which is
used to break down clots after they form; alteplase is contraindicated in any patient with recent
surgery. Aspirin and clopidogrel are antiplatelet drugs and are used to prevent arterial thrombosis.
A nursing student asks why the anticoagulant heparin is given to patients who have disseminated
intravascular coagulation (DIC) and are at risk for excessive bleeding. The nurse will explain that
heparin is used in this case for which reason?
a. To decrease the risk of venous thrombosis
b. To dissolve blood clots as they form
c. To enhance the formation of fibrous clots
d. To preserve platelet function - ANSWER ANS: A
The primary use of heparin for patients with DIC is to prevent venous thrombosis, which can lead to
pulmonary embolism or stroke. Heparin does not break down blood clots, enhance the formation of
fibrous clots, or preserve platelet function.
A patient has been receiving intravenous heparin. When laboratory tests are drawn, the nurse has
difficulty stopping bleeding at the puncture site. The patient has bloody stools and is reporting
abdominal pain. The nurse notes elevated partial thromboplastin time (PTT) and activated PPT
(aPTT). Which action will the nurse perform?
a. Ask for an order for oral warfarin (Coumadin).
b. Obtain an order for protamine sulfate.
c. Request an order for vitamin K.
, d. Suggest that the patient receive subcutaneous heparin. - ANSWER ANS: B
Protamine sulfate is given as an antidote to heparin when patient's clotting times are elevated. Oral
warfarin will not stop the anticoagulant effects of heparin. Vitamin K is used as an antidote for
warfarin. Administering heparin by another route is not indicated when there is a need to reverse
the effects of heparin.
The nurse is teaching a patient who will begin taking warfarin (Coumadin) for atrial fibrillation. Which
statement by the patient indicates understanding of the teaching?
a. "I should eat plenty of green, leafy vegetables while taking this drug."
b. "I should take a nonsteroidal anti-inflammatory drug (NSAID) instead of acetaminophen for pain or
fever."
c. "I will take cimetidine (Tagamet) to prevent gastric irritation and bleeding."
d. "I will tell my dentist that I am taking this medication."
. - ANSWER ANS: D
Patients taking warfarin should tell their dentists that they are taking the medication because of the
increased risk for bleeding. Patients should avoid foods high in vitamin K, which can decrease the
effects of warfarin. Patients should not take NSAIDs or cimetidine (Tagamet) because they can
displace warfarin from protein-binding sites.
The nurse is assessing a patient who takes warfarin (Coumadin). The nurse notes a heart rate of 92
beats per minute and a blood pressure of 88/78 mm Hg. To evaluate the reason for these vital signs,
the nurse will assess the patient's
a. gums, nose, and skin.
b. lung sounds and respiratory effort.
c. skin turgor and oral mucous membranes.
d. urine output and level of consciousness. - ANSWER ANS: A
An increased heart rate followed by a decreased systolic pressure can indicate a fluid volume deficit
caused by internal or external bleeding. The nurse should examine the patient's mouth, nose, and
skin for bleeding. These vital signs do not indicate a pulmonary problem. Skin turgor and mucous
membranes as well as urine output and level of consciousness may be assessed to determine the
level of fluid deficit, but finding the source of blood loss is more important. Signs of gastrointestinal
bleeding should also be assessed.
A patient who has recently had a myocardial infarction (MI) will begin taking clopidogrel (Plavix) to
prevent a second MI. Which medication will the nurse expect the provider to order as adjunctive
therapy for this patient?
a. Aspirin
Process Approach CH: 40 Exam 2024
Questions & Answers 100% Accurate!!
The nurse is caring for a postoperative patient. The nurse will anticipate administering which
medication to this patient to help prevent thrombus formation caused by slow venous blood flow?
a. Alteplase (Activase)
b. Aspirin
c. Clopidogrel (Plavix)
d. Low-molecular-weight heparin - ANSWER ANS: D
Low-molecular-weight heparin is an anticoagulant, which is used to inhibit clot formation and is used
prophylactically to prevent postoperative deep vein thrombosis. Alteplase is a thrombolytic, which is
used to break down clots after they form; alteplase is contraindicated in any patient with recent
surgery. Aspirin and clopidogrel are antiplatelet drugs and are used to prevent arterial thrombosis.
A nursing student asks why the anticoagulant heparin is given to patients who have disseminated
intravascular coagulation (DIC) and are at risk for excessive bleeding. The nurse will explain that
heparin is used in this case for which reason?
a. To decrease the risk of venous thrombosis
b. To dissolve blood clots as they form
c. To enhance the formation of fibrous clots
d. To preserve platelet function - ANSWER ANS: A
The primary use of heparin for patients with DIC is to prevent venous thrombosis, which can lead to
pulmonary embolism or stroke. Heparin does not break down blood clots, enhance the formation of
fibrous clots, or preserve platelet function.
A patient has been receiving intravenous heparin. When laboratory tests are drawn, the nurse has
difficulty stopping bleeding at the puncture site. The patient has bloody stools and is reporting
abdominal pain. The nurse notes elevated partial thromboplastin time (PTT) and activated PPT
(aPTT). Which action will the nurse perform?
a. Ask for an order for oral warfarin (Coumadin).
b. Obtain an order for protamine sulfate.
c. Request an order for vitamin K.
, d. Suggest that the patient receive subcutaneous heparin. - ANSWER ANS: B
Protamine sulfate is given as an antidote to heparin when patient's clotting times are elevated. Oral
warfarin will not stop the anticoagulant effects of heparin. Vitamin K is used as an antidote for
warfarin. Administering heparin by another route is not indicated when there is a need to reverse
the effects of heparin.
The nurse is teaching a patient who will begin taking warfarin (Coumadin) for atrial fibrillation. Which
statement by the patient indicates understanding of the teaching?
a. "I should eat plenty of green, leafy vegetables while taking this drug."
b. "I should take a nonsteroidal anti-inflammatory drug (NSAID) instead of acetaminophen for pain or
fever."
c. "I will take cimetidine (Tagamet) to prevent gastric irritation and bleeding."
d. "I will tell my dentist that I am taking this medication."
. - ANSWER ANS: D
Patients taking warfarin should tell their dentists that they are taking the medication because of the
increased risk for bleeding. Patients should avoid foods high in vitamin K, which can decrease the
effects of warfarin. Patients should not take NSAIDs or cimetidine (Tagamet) because they can
displace warfarin from protein-binding sites.
The nurse is assessing a patient who takes warfarin (Coumadin). The nurse notes a heart rate of 92
beats per minute and a blood pressure of 88/78 mm Hg. To evaluate the reason for these vital signs,
the nurse will assess the patient's
a. gums, nose, and skin.
b. lung sounds and respiratory effort.
c. skin turgor and oral mucous membranes.
d. urine output and level of consciousness. - ANSWER ANS: A
An increased heart rate followed by a decreased systolic pressure can indicate a fluid volume deficit
caused by internal or external bleeding. The nurse should examine the patient's mouth, nose, and
skin for bleeding. These vital signs do not indicate a pulmonary problem. Skin turgor and mucous
membranes as well as urine output and level of consciousness may be assessed to determine the
level of fluid deficit, but finding the source of blood loss is more important. Signs of gastrointestinal
bleeding should also be assessed.
A patient who has recently had a myocardial infarction (MI) will begin taking clopidogrel (Plavix) to
prevent a second MI. Which medication will the nurse expect the provider to order as adjunctive
therapy for this patient?
a. Aspirin
