NSG 318 COMPREHENSIVE EXAM 2026/2027
QUESTIONS AND ANSWERS RATED A+
✔✔warfarin action - ✔✔depresses hepatic synthesis of Vitamin K clotting factors
✔✔Warfarin route of administration - ✔✔oral
✔✔warfarin 1/2 life - ✔✔20-80hrs
✔✔Warfarin contraindications - ✔✔pregnancy, hematologic disorders, head trauma
caution w DM, leukemia, peptic ulcer
✔✔antidote for warfarin - ✔✔Vitamin K
✔✔drugs that inc effects of warfarin - ✔✔-Aspirin, NSAIDs, sulfas, thyroid drugs
-Allopurinol, histamine blockers, oral hypoglycemic
-Diuretics, oral antibiotics, vitamin E
✔✔drugs that dec effect of warfarin - ✔✔-Barbiturates, laxatives, phenytoin, oral
contraceptives
-Vitamin C and K
✔✔warfarin food interactions - ✔✔foods rich in vitamin K (avoid-blocks action)
✔✔warfarin side effects/adverse effects - ✔✔alopecia, GI distress, fever, PURPLE TOE
SYNDROME, bone fx, hypotension, elevated hepatic enzymes
✔✔warfarin interventions - ✔✔-have pt use soft toothbrush and shave with electric razor
-examine mouth, urine, stool, and skin for bleed
-monitor INR and platelet counts
✔✔warfarin CAM interactions - ✔✔-Feverfew, garlic, ginger, green tea, chamomile tea,
gingko: inc bleeding
-Excessive doses of anise: interfere with anticoagulation
-Ginsend, goldenseal, valerian: dec effects of warfarin
-Goldenseal: dec effects of heparin
-Hawthorne: inc action of anticoagulants
✔✔clopidogrel class - ✔✔Antiplatelet
✔✔clopidogrel use - ✔✔prevent thrombosis associated with unstable angina, acute MI,
stroke, TIAs
, ✔✔clopidogrel action - ✔✔inhibits platelet aggregation and prevent ADP from binding
with ADP platelet receptors
✔✔clopidogrel contraindications - ✔✔intracranial hemorrhage, GI bleed
caution w hepatic/renal disease, surgery, bleed from trauma, purpura
✔✔Clopidogrel Side Effects/Adverse Reactions - ✔✔flulike symptoms, GI distress,
pruritus, bronchospasm, elevated hepatic enzymes, peptic ulcer, agranulocytosis,
aplastic anemia, thrombocytopenia, stevens johnson
✔✔what drugs may inc bleeding with clopidogrel - ✔✔-NSAIDs, anticoagulants,
omeprazole, azole antifungals
-SSRIs, barbituates
✔✔clopidogrel interferes with the metabolism of - ✔✔phenytoin, warfarin, NSAIDs, Ca
channel blockers, and morphine
✔✔Clopidogrel food interactions - ✔✔dec effects with grapefruit juice
✔✔clopidogrel CAM interactions - ✔✔-Ginger, garlic, gingko, feverfew, green tea: inc
bleeding
✔✔alteplase class - ✔✔thrombolytic
✔✔alteplase use - ✔✔promote fibrinolysis associated with thrombosis, acute MI, PE,
ischemic stroke and occluded IV catheter
✔✔alteplase action - ✔✔promotes conversion of plasminogen to plasmin (enzyme that
digests fibrin matrix of clots)
initiates fibrinolysis
✔✔alteplase contraindications - ✔✔bleeding disorders, surgery, recent CVS, bacterial
endocarditis, severe uncontrolled HTN
caution w cardiac dysrhythmias, peptic ulcer disease, CABG, diabetic retinopathy,
pregnancy, older adults
✔✔alteplase side effects/adverse reactions - ✔✔bleeding, hypotension, GI distress,
infection, anaphylactic reaction, laryngeal edema, HTN, rhabdomyolysis, PE
✔✔alteplase drug interactions - ✔✔-Anticoagulants, NSAIDs, SNRIs, SSRIs,
cephalosporins: inc bleeding
✔✔alteplase CAM interactions - ✔✔-Gingko, garlic, feverfew, ginger, green tea, omega-
3 fatty acids: inc bleeding
QUESTIONS AND ANSWERS RATED A+
✔✔warfarin action - ✔✔depresses hepatic synthesis of Vitamin K clotting factors
✔✔Warfarin route of administration - ✔✔oral
✔✔warfarin 1/2 life - ✔✔20-80hrs
✔✔Warfarin contraindications - ✔✔pregnancy, hematologic disorders, head trauma
caution w DM, leukemia, peptic ulcer
✔✔antidote for warfarin - ✔✔Vitamin K
✔✔drugs that inc effects of warfarin - ✔✔-Aspirin, NSAIDs, sulfas, thyroid drugs
-Allopurinol, histamine blockers, oral hypoglycemic
-Diuretics, oral antibiotics, vitamin E
✔✔drugs that dec effect of warfarin - ✔✔-Barbiturates, laxatives, phenytoin, oral
contraceptives
-Vitamin C and K
✔✔warfarin food interactions - ✔✔foods rich in vitamin K (avoid-blocks action)
✔✔warfarin side effects/adverse effects - ✔✔alopecia, GI distress, fever, PURPLE TOE
SYNDROME, bone fx, hypotension, elevated hepatic enzymes
✔✔warfarin interventions - ✔✔-have pt use soft toothbrush and shave with electric razor
-examine mouth, urine, stool, and skin for bleed
-monitor INR and platelet counts
✔✔warfarin CAM interactions - ✔✔-Feverfew, garlic, ginger, green tea, chamomile tea,
gingko: inc bleeding
-Excessive doses of anise: interfere with anticoagulation
-Ginsend, goldenseal, valerian: dec effects of warfarin
-Goldenseal: dec effects of heparin
-Hawthorne: inc action of anticoagulants
✔✔clopidogrel class - ✔✔Antiplatelet
✔✔clopidogrel use - ✔✔prevent thrombosis associated with unstable angina, acute MI,
stroke, TIAs
, ✔✔clopidogrel action - ✔✔inhibits platelet aggregation and prevent ADP from binding
with ADP platelet receptors
✔✔clopidogrel contraindications - ✔✔intracranial hemorrhage, GI bleed
caution w hepatic/renal disease, surgery, bleed from trauma, purpura
✔✔Clopidogrel Side Effects/Adverse Reactions - ✔✔flulike symptoms, GI distress,
pruritus, bronchospasm, elevated hepatic enzymes, peptic ulcer, agranulocytosis,
aplastic anemia, thrombocytopenia, stevens johnson
✔✔what drugs may inc bleeding with clopidogrel - ✔✔-NSAIDs, anticoagulants,
omeprazole, azole antifungals
-SSRIs, barbituates
✔✔clopidogrel interferes with the metabolism of - ✔✔phenytoin, warfarin, NSAIDs, Ca
channel blockers, and morphine
✔✔Clopidogrel food interactions - ✔✔dec effects with grapefruit juice
✔✔clopidogrel CAM interactions - ✔✔-Ginger, garlic, gingko, feverfew, green tea: inc
bleeding
✔✔alteplase class - ✔✔thrombolytic
✔✔alteplase use - ✔✔promote fibrinolysis associated with thrombosis, acute MI, PE,
ischemic stroke and occluded IV catheter
✔✔alteplase action - ✔✔promotes conversion of plasminogen to plasmin (enzyme that
digests fibrin matrix of clots)
initiates fibrinolysis
✔✔alteplase contraindications - ✔✔bleeding disorders, surgery, recent CVS, bacterial
endocarditis, severe uncontrolled HTN
caution w cardiac dysrhythmias, peptic ulcer disease, CABG, diabetic retinopathy,
pregnancy, older adults
✔✔alteplase side effects/adverse reactions - ✔✔bleeding, hypotension, GI distress,
infection, anaphylactic reaction, laryngeal edema, HTN, rhabdomyolysis, PE
✔✔alteplase drug interactions - ✔✔-Anticoagulants, NSAIDs, SNRIs, SSRIs,
cephalosporins: inc bleeding
✔✔alteplase CAM interactions - ✔✔-Gingko, garlic, feverfew, ginger, green tea, omega-
3 fatty acids: inc bleeding
