Chapter 14: Drugs Affecting the Hematologic System
Visovsky: Introduction to Clinical Pharmacology, 9th Edition
MULTIPLE CHOICE
1. A patient with a clotting disorder is prescribed an anticoagulant and asks you to explain the
purpose of anticoagulant therapy. What is your best response?
a. Anticoagulants are used to lyse existing clots.
b. Anticoagulants are used to increase the flow of blood.
c. Anticoagulants are used to prevent new clot formation.
d. Anticoagulants are used to thin the viscosity of the blood.
ANS: C
Anticoagulants are drugs that interfere with the clotting process, so they are used to reduce
existing clots or to prevent new clots from forming.
DIF: Cognitive Level: Remembering REF: p.266
2. 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.268
3. Which statement made by a patient with a recent coronary artery stent placement who is
taking clopidogrel informs you that the patient requires further teaching about this drug?
a. “I will avoid herbal supplements while taking this drug.”
b. “I will need to take this drug every day for 3 months.”
c. “I will report any abnormal bleeding.”
d. “I will take this drug with food.”
ANS: B
For patients who have had a stent placed into the coronary artery as a result of severe
narrowing or blockage of the artery, clopidogrel prevents platelets from sticking to the stent
mesh. For these 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.268
4. Which symptom when reported by a patient taking aspirin alerts you to a possible adverse
reaction to the drug?
, a. Nausea
b. Itching and hives
c. Decreased vision
d. Increased urination
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.268
5. You are taking the drug history of a patient who will be starting on an anticoagulant. Which
of the following drug categories from this patients’ drug list would potentially interfere with
an anticoagulant?
a. Beta blockers
b. Loop diuretics
c. Oral contraceptives
d. Inhaled corticosteroids
ANS: C
Oral contraceptives decrease the effects of anticoagulants.
DIF: Cognitive Level: Knowing REF: p.269
6. 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. Proton pump inhibitor
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.269
7. 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. Which food would you advise the patient to avoid
while on anticoagulant therapy?
a. Spinach
b. Bananas
c. Tomatoes
d. Sweet potatoes
ANS: A
The patient should avoid excessive amounts of foods high in vitamin K (spinach, broccoli,
cabbage, kale, dark leafy greens, and asparagus).
Visovsky: Introduction to Clinical Pharmacology, 9th Edition
MULTIPLE CHOICE
1. A patient with a clotting disorder is prescribed an anticoagulant and asks you to explain the
purpose of anticoagulant therapy. What is your best response?
a. Anticoagulants are used to lyse existing clots.
b. Anticoagulants are used to increase the flow of blood.
c. Anticoagulants are used to prevent new clot formation.
d. Anticoagulants are used to thin the viscosity of the blood.
ANS: C
Anticoagulants are drugs that interfere with the clotting process, so they are used to reduce
existing clots or to prevent new clots from forming.
DIF: Cognitive Level: Remembering REF: p.266
2. 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.268
3. Which statement made by a patient with a recent coronary artery stent placement who is
taking clopidogrel informs you that the patient requires further teaching about this drug?
a. “I will avoid herbal supplements while taking this drug.”
b. “I will need to take this drug every day for 3 months.”
c. “I will report any abnormal bleeding.”
d. “I will take this drug with food.”
ANS: B
For patients who have had a stent placed into the coronary artery as a result of severe
narrowing or blockage of the artery, clopidogrel prevents platelets from sticking to the stent
mesh. For these 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.268
4. Which symptom when reported by a patient taking aspirin alerts you to a possible adverse
reaction to the drug?
, a. Nausea
b. Itching and hives
c. Decreased vision
d. Increased urination
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.268
5. You are taking the drug history of a patient who will be starting on an anticoagulant. Which
of the following drug categories from this patients’ drug list would potentially interfere with
an anticoagulant?
a. Beta blockers
b. Loop diuretics
c. Oral contraceptives
d. Inhaled corticosteroids
ANS: C
Oral contraceptives decrease the effects of anticoagulants.
DIF: Cognitive Level: Knowing REF: p.269
6. 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. Proton pump inhibitor
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.269
7. 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. Which food would you advise the patient to avoid
while on anticoagulant therapy?
a. Spinach
b. Bananas
c. Tomatoes
d. Sweet potatoes
ANS: A
The patient should avoid excessive amounts of foods high in vitamin K (spinach, broccoli,
cabbage, kale, dark leafy greens, and asparagus).
