Chapter 48- Drugs Affecting Blood Coagulation My Nursing Test Banks
A patient is admitted to the hospital with deep vein thrombosis. A 10,000-unit dose of heparin is administered
subcutaneously. What drug does the nurse keep on hand to reverse the effects of heparin if the patient begins to
1. bleed?
A) Antithrombin (Thrombate III)
B) Desirudin (Iprivask)
C) Protamine sulfate
D) Vitamin K
Ans: C
Feedback:
The antidote for heparin is protamine sulfate.
2. Prior to beginning anticoagulant therapy, the nurse will question the female patient about what?
A) Last menstrual period
B) Peptic ulcers
C) Urinary tract infection
D) Weight
Ans: B
The nurse is caring for a female patient who is nursing her 3-month-old infant. What will the nurse instruct the
3. patient to do prior to starting heparin to treat venous thrombosis?
A) Wait an hour after taking the anticoagulant before feeding the infant.
B) Push fluids to clear the drug from her system before feeding the infant.
C) Find another method of feeding the infant while taking this drug.
D) Continue breast-feeding because heparin does not enter breast milk.
Ans: D
The nurse receives a patient having an acute myocardial infarction (MI) to the emergency department. What drug
4. will the nurse administer before transferring the patient to a larger facility?
A) Anagrelide (Agrylin)
B) Clopidogrel (Plavix)
C) Ticlopidine (Ticlid)
D) Tenecteplase (TNKase)
, Ans: D
Feedback:
Arrange to administer tenecteplase to reduce mortality associated with acute MI as soon as possible after the onset of
symptoms because the timing for the administration of tenecteplase is critical to resolve the clot before permanent
damage occurs to the myocardial cells.
A nurse is preparing to discharge a patient newly prescribed warfarin (Coumadin). While assessing the patients
5. knowledge of the drug, what would indicate that the patient needs further instruction concerning drug therapy?
A) I love to eat homegrown tomatoes in the summer.
B) I take aspirin for my arthritis.
C) I walk 2 miles a day.
D) I drink a glass of wine about once a week.
Ans: B
Feedback:
Increased bleeding can occur if a salicylate is taken in combination with warfarin. The nurse will instruct the patient
to stop taking aspirin.
The nurse is caring for a patient with a fever and severe diarrhea in addition to thrombophlebitis. How will this
6. patients condition impact the clotting process?
A) Depleted production of Hageman factor
B) Increased production of thrombin
C) Activation of plasminogen
D) Reduced production of fibrinolysin
Ans: C
Feedback:
Plasminogen is the basis for the clot-dissolving system. It is converted to plasmin (fibrinolysin) by several factors
including Hagemans factor, which is factor XII found in circulating blood. Activated thrombin breaks down
fibrinogen to form fibrin threads, which form a clot inside the blood vessel. Patients with diarrhea or fever could
alter the normal clotting process by, respectively, loss of vitamin K from the intestine or activation of plasminogen.
The nurse is caring for a patient who received protamine sulfate in error. The patient is not receiving, and has never
7. received, heparin. What effect does the nurse assess for in this patient?
A) Coagulation effects
B) No effect
C) Anticoagulant effects
D) Antiplatelet effects
Ans: C
Paradoxically, if protamine is given to a patient who has not received heparin, it has anticoagulant effects.
8. A patient is being discharged home on warfarin. The discharge teaching by the nurse should include a warning to
A patient is admitted to the hospital with deep vein thrombosis. A 10,000-unit dose of heparin is administered
subcutaneously. What drug does the nurse keep on hand to reverse the effects of heparin if the patient begins to
1. bleed?
A) Antithrombin (Thrombate III)
B) Desirudin (Iprivask)
C) Protamine sulfate
D) Vitamin K
Ans: C
Feedback:
The antidote for heparin is protamine sulfate.
2. Prior to beginning anticoagulant therapy, the nurse will question the female patient about what?
A) Last menstrual period
B) Peptic ulcers
C) Urinary tract infection
D) Weight
Ans: B
The nurse is caring for a female patient who is nursing her 3-month-old infant. What will the nurse instruct the
3. patient to do prior to starting heparin to treat venous thrombosis?
A) Wait an hour after taking the anticoagulant before feeding the infant.
B) Push fluids to clear the drug from her system before feeding the infant.
C) Find another method of feeding the infant while taking this drug.
D) Continue breast-feeding because heparin does not enter breast milk.
Ans: D
The nurse receives a patient having an acute myocardial infarction (MI) to the emergency department. What drug
4. will the nurse administer before transferring the patient to a larger facility?
A) Anagrelide (Agrylin)
B) Clopidogrel (Plavix)
C) Ticlopidine (Ticlid)
D) Tenecteplase (TNKase)
, Ans: D
Feedback:
Arrange to administer tenecteplase to reduce mortality associated with acute MI as soon as possible after the onset of
symptoms because the timing for the administration of tenecteplase is critical to resolve the clot before permanent
damage occurs to the myocardial cells.
A nurse is preparing to discharge a patient newly prescribed warfarin (Coumadin). While assessing the patients
5. knowledge of the drug, what would indicate that the patient needs further instruction concerning drug therapy?
A) I love to eat homegrown tomatoes in the summer.
B) I take aspirin for my arthritis.
C) I walk 2 miles a day.
D) I drink a glass of wine about once a week.
Ans: B
Feedback:
Increased bleeding can occur if a salicylate is taken in combination with warfarin. The nurse will instruct the patient
to stop taking aspirin.
The nurse is caring for a patient with a fever and severe diarrhea in addition to thrombophlebitis. How will this
6. patients condition impact the clotting process?
A) Depleted production of Hageman factor
B) Increased production of thrombin
C) Activation of plasminogen
D) Reduced production of fibrinolysin
Ans: C
Feedback:
Plasminogen is the basis for the clot-dissolving system. It is converted to plasmin (fibrinolysin) by several factors
including Hagemans factor, which is factor XII found in circulating blood. Activated thrombin breaks down
fibrinogen to form fibrin threads, which form a clot inside the blood vessel. Patients with diarrhea or fever could
alter the normal clotting process by, respectively, loss of vitamin K from the intestine or activation of plasminogen.
The nurse is caring for a patient who received protamine sulfate in error. The patient is not receiving, and has never
7. received, heparin. What effect does the nurse assess for in this patient?
A) Coagulation effects
B) No effect
C) Anticoagulant effects
D) Antiplatelet effects
Ans: C
Paradoxically, if protamine is given to a patient who has not received heparin, it has anticoagulant effects.
8. A patient is being discharged home on warfarin. The discharge teaching by the nurse should include a warning to
