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NUR 219 Exam 4 Practice Questions and Complete Solutions

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A patient is receiving an intravenous infusion of heparin to treat a pulmonary embolism. What laboratory value will you monitor to evaluate treatment with this medication? A. Activated partial thromboplastin time (aPTT) B. Prothrombin time (PT) C. Platelet count D. Hemoglobin and hematocrit A. activated partial thromboplastin time (aPTT) Which of the following patients needs an increased dose of warfarin [Coumadin] to have the same anticoagulant effect? A. Patient taking acetaminophen [Tylenol] for back pain B. Patient taking cimetidine [Tagamet] to prevent gastric ulcers C. Patient taking oral contraceptives to prevent pregnancy D. Patient taking prednisone [Deltasone] for rheumatoid arthritis C. patient taking oral contraceptives to prevent pregnancy What is the antidote for heparin? A. Ferrous sulfate B. Atropine sulfate C. Protamine sulfate D. Magnesium sulfate C. protamine sulfate Your patient diagnosed with a DVT has been started on intravenous heparin and oral warfarin. The patient asks you why two medications are necessary. Your best response is: A. "Heparin will start to dissolve the clot and warfarin will prevent any more clots from forming." B. "Because of the potential for complications, it is important for you to take more than one anticoagulant." C. "The heparin will work immediately, but the warfarin takes several days to have an effect on blood coagulation." D. "Administration of two anticoagulants reduces the risk for recurrent deep vein thrombosis." C. "The heparin will work immediately, but the warfarin takes several days to have an effect on blood coagulation."

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NUR 219 Exam 4 Practice Questions and
Complete Solutions
A patient is receiving an intravenous infusion of heparin to treat a pulmonary embolism.
What laboratory value will you monitor to evaluate treatment with this medication?

A. Activated partial thromboplastin time (aPTT)
B. Prothrombin time (PT)
C. Platelet count
D. Hemoglobin and hematocrit ✅A. activated partial thromboplastin time (aPTT)

Which of the following patients needs an increased dose of warfarin [Coumadin] to have
the same anticoagulant effect?

A. Patient taking acetaminophen [Tylenol] for back pain
B. Patient taking cimetidine [Tagamet] to prevent gastric ulcers
C. Patient taking oral contraceptives to prevent pregnancy
D. Patient taking prednisone [Deltasone] for rheumatoid arthritis ✅C. patient taking
oral contraceptives to prevent pregnancy

What is the antidote for heparin?

A. Ferrous sulfate
B. Atropine sulfate
C. Protamine sulfate
D. Magnesium sulfate ✅C. protamine sulfate

Your patient diagnosed with a DVT has been started on intravenous heparin and oral
warfarin. The patient asks you why two medications are necessary. Your best response
is:

A. "Heparin will start to dissolve the clot and warfarin will prevent any more clots from
forming."
B. "Because of the potential for complications, it is important for you to take more than
one anticoagulant."
C. "The heparin will work immediately, but the warfarin takes several days to have an
effect on blood coagulation."
D. "Administration of two anticoagulants reduces the risk for recurrent deep vein
thrombosis." ✅C. "The heparin will work immediately, but the warfarin takes several
days to have an effect on blood coagulation."

, To protect against widespread coagulation, the body must inactivate clotting factors
which stray way from the injured vessel. Inactivation of clotting factors is accomplished
by:
A. Factor XII (Hageman Factor)
B. Tissue Thromboplastin
C. Anti-thrombin
D. Plasminogen ✅C. Anti-thrombin

What is the antidote for warfarin (Coumdin) overdose?
A. Protamine Sulfate
B. Vitamin K
C. Vitamin C
D. Magnesium Sulfate ✅B. Vitamin K

Which of the following lab tests will be ordered to confirm a deep vein thrombosis (DVT)
in a patient complaining of lower leg pain?
A. Prothrombin Time (PT)
B. Bleeding Time
C. Partial Thromboplastin Time (PTT)
D. D-Dimer ✅D. D-Dimer

A patient arrive in the Emergency Room with complaints of inability to move his left arm.
His symptoms began one hour prior to admission. Diagnostic testing reveals that the
patient has suffered a CVA (stroke) caused by an embolism (blood clot). Which of the
following medications is most appropriate to use to treat this patient at this time?
A. Altepase (Activase)
B. Dibigatran Etexilate (Pradaxa)
C. Warfarin (Coumadin)
D. Clopidogrel (Plavix) ✅A. Altepase (Activase)

Which of the following patients is MOST AT RISK for developing a clotting disorder?
A. Patient A who suffers from chronic kidney disease
B. Patient B who suffers from chronic osteoporosis
C. Patient C who suffers from congestive heart failure
D. Patient D who suffers from chronic liver disease ✅D. Patient D who suffers from
chronic liver disease

A nurse is educating a patient who is prescribed warfarin. The nurse advises the patient
to avoid taking aspirin and explains that taking both drugs together may cause a
phenomenon called increased adverse effects, which would result in which outcome?
A. excessive bleeding
B. formation of blood clots
C. increase in saliva production
D. decrease in total urine output ✅A. excessive bleeding
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