NURS 358 Test 3 Questions With
Guaranteed Pass Solutions.
What one of the following is the mechanism of action of heparin?
A.
Decreases platelet aggregation
B.
Blocks vitamin K & prevents activation of prothrombin
C.
Binds to albumin in the plasma to prevent clotting
D.
Blocks the fibrin threads from forming a stable clot - Answer D
antiplatelets like aspirin and clopidogrel decrease platelet aggregation.
Warfarin blocks Vitamin K factors, including plasma proteins such as albumin, and prevents
prothrombin as a thrombolytic drug.
A patient diagnosed with a pulmonary embolism is receiving a continuous heparin infusion at
1000 units/hr. Which situation would warrant a call to the physician? (Select all that apply.)
A.
aPTT of 65 seconds
B.
aPTT of 40 seconds
C.
Nosebleeds
D.
aPTT of 100 seconds
E.
platelet count of 300,000/mcL - Answer CD
Any active bleeding, like nosebleeds, gum bleeds, hematuria, warrants a dose of the antidote
protamine sulfate.
An aPTT of 100 is above the therapeutic window.
An aPTT of 40 could potentially be a concern, but we would need to see the nonagram to be
,The nurse is teaching a patient about self-administration of enoxaparin (Lovenox). Which
statement will be included in this teaching session?
A.
"We will need to teach a family member how to give this drug in your arm."
B.
"This drug is given in the folds of your abdomen, but at least 2 inches away from your navel."
C.
"This drug needs to be taken at the same time every day with a full glass of water."
D.
"Be sure to massage the injection site thoroughly after giving the drug." - Answer B
patients are able to complete this shot by themselves as long as they know to stay 2 in. away
from the belly button/navel/umbilicus.
Because this med has no GI symptoms, it does not need to be taken with food or drink.
NEVER massage the injection site
The nurse is caring for a patient who takes warfarin (Coumadin) for prevention of deep vein
thrombosis. The patient has an international normalized ratio (INR) of 1.2. Which action by the
nurse is most appropriate?
A.
Prepare to administer protamine sulfate.
B.
Continue with the current prescription.
C.
Prepare to administer vitamin K.
D.
Call the healthcare provider to increase the dose. - Answer D
Because warfarin is being used to prevent DVT, the INR therapeutic range should be 2-3. Seeing
the the INR is subtherapeutic, the provider should be notified of the lab value and an increased
dose requested.
You are going over discharge paperwork with your patient who is being sent home on
dabigatran (Pradaxa). What would you want to include in your discharge teaching?
a.
,c.
Crush this tablet and dissolve in water to decrease GI symptoms
d.
You will always have the same dose, so there's no need to monitor labs - Answer B
This drug is has significant GI effects which can be controlled by taking with food and a proton
pump inhibitor.
These meds should never be crushed or chewed.
The antidote is Praxbind
The dose is dependent on kidney function, so labs will need to be monitored appropriately
As a nurse at the ED, you know that alteplase will be given if:
Select all that apply
a.
Patient's PT and INR are within range
b.
A CT rules out any hemorrhage
c.
As long as aspirin has been given in the last 24 hrs
d.
The onset of the symptoms was within 2-4 hrs
e.
It can be administered subcutaneously - Answer A, B, D
A) If PT > 15 seconds or INR > 1.7, it would not be given
B) A CT should always be done to rule out hemorrhage
C) You would hold if an antiplatelet has been given recently
D) The onset of symptoms needs to be within 2-4 hrs for it to be effective
E) It cannot be administered subcutaneously
On assessment, your patients vitals are: BP:175/111, HR: 90 and regular rate, RR: 20, Temp:97.9,
Pulse ox: 98%. Your priority is to
a.
Document the vitals
, Lower the head of the bed
d.
Retake the blood pressure and notify physician if still high - Answer D
You need to retake the BP and notify the physician - alteplase can't be given with such a high
BP- you'll likely need to give the patient a quick acting antihypertensive - like nitroglycerine
Your patient has been given nitroglycerine to lower the blood pressure before administration of
alteplase. They are complaining of a headache. What do you anticipate giving them?
a.
Aspirin
b.
Ibuprofen
c.
Acetaminophen
d.
Tramadol - Answer C
Tylenol is always the safest option.
You CANNOT give an NSAID or antiplatelet (A and B)
Tramadol is a controlled substance - and too heavy for what you need (D)
As you educate your patient for discharge on warfarin/coumadin, which statement will require
your immediate action?
a.
"I will avoid contact sports."
b.
"I will take my medication in the early evening each day.
c.
"I will increase dark-green, leafy vegetables in my diet."
d.
"I will contact my health care provider if I develop excessive bruising." - Answer C
You don't want to increase foods with vitamin K (OR decrease them) just keep a consistent level
You SHOULD avoid contact sports ( A)
Guaranteed Pass Solutions.
What one of the following is the mechanism of action of heparin?
A.
Decreases platelet aggregation
B.
Blocks vitamin K & prevents activation of prothrombin
C.
Binds to albumin in the plasma to prevent clotting
D.
Blocks the fibrin threads from forming a stable clot - Answer D
antiplatelets like aspirin and clopidogrel decrease platelet aggregation.
Warfarin blocks Vitamin K factors, including plasma proteins such as albumin, and prevents
prothrombin as a thrombolytic drug.
A patient diagnosed with a pulmonary embolism is receiving a continuous heparin infusion at
1000 units/hr. Which situation would warrant a call to the physician? (Select all that apply.)
A.
aPTT of 65 seconds
B.
aPTT of 40 seconds
C.
Nosebleeds
D.
aPTT of 100 seconds
E.
platelet count of 300,000/mcL - Answer CD
Any active bleeding, like nosebleeds, gum bleeds, hematuria, warrants a dose of the antidote
protamine sulfate.
An aPTT of 100 is above the therapeutic window.
An aPTT of 40 could potentially be a concern, but we would need to see the nonagram to be
,The nurse is teaching a patient about self-administration of enoxaparin (Lovenox). Which
statement will be included in this teaching session?
A.
"We will need to teach a family member how to give this drug in your arm."
B.
"This drug is given in the folds of your abdomen, but at least 2 inches away from your navel."
C.
"This drug needs to be taken at the same time every day with a full glass of water."
D.
"Be sure to massage the injection site thoroughly after giving the drug." - Answer B
patients are able to complete this shot by themselves as long as they know to stay 2 in. away
from the belly button/navel/umbilicus.
Because this med has no GI symptoms, it does not need to be taken with food or drink.
NEVER massage the injection site
The nurse is caring for a patient who takes warfarin (Coumadin) for prevention of deep vein
thrombosis. The patient has an international normalized ratio (INR) of 1.2. Which action by the
nurse is most appropriate?
A.
Prepare to administer protamine sulfate.
B.
Continue with the current prescription.
C.
Prepare to administer vitamin K.
D.
Call the healthcare provider to increase the dose. - Answer D
Because warfarin is being used to prevent DVT, the INR therapeutic range should be 2-3. Seeing
the the INR is subtherapeutic, the provider should be notified of the lab value and an increased
dose requested.
You are going over discharge paperwork with your patient who is being sent home on
dabigatran (Pradaxa). What would you want to include in your discharge teaching?
a.
,c.
Crush this tablet and dissolve in water to decrease GI symptoms
d.
You will always have the same dose, so there's no need to monitor labs - Answer B
This drug is has significant GI effects which can be controlled by taking with food and a proton
pump inhibitor.
These meds should never be crushed or chewed.
The antidote is Praxbind
The dose is dependent on kidney function, so labs will need to be monitored appropriately
As a nurse at the ED, you know that alteplase will be given if:
Select all that apply
a.
Patient's PT and INR are within range
b.
A CT rules out any hemorrhage
c.
As long as aspirin has been given in the last 24 hrs
d.
The onset of the symptoms was within 2-4 hrs
e.
It can be administered subcutaneously - Answer A, B, D
A) If PT > 15 seconds or INR > 1.7, it would not be given
B) A CT should always be done to rule out hemorrhage
C) You would hold if an antiplatelet has been given recently
D) The onset of symptoms needs to be within 2-4 hrs for it to be effective
E) It cannot be administered subcutaneously
On assessment, your patients vitals are: BP:175/111, HR: 90 and regular rate, RR: 20, Temp:97.9,
Pulse ox: 98%. Your priority is to
a.
Document the vitals
, Lower the head of the bed
d.
Retake the blood pressure and notify physician if still high - Answer D
You need to retake the BP and notify the physician - alteplase can't be given with such a high
BP- you'll likely need to give the patient a quick acting antihypertensive - like nitroglycerine
Your patient has been given nitroglycerine to lower the blood pressure before administration of
alteplase. They are complaining of a headache. What do you anticipate giving them?
a.
Aspirin
b.
Ibuprofen
c.
Acetaminophen
d.
Tramadol - Answer C
Tylenol is always the safest option.
You CANNOT give an NSAID or antiplatelet (A and B)
Tramadol is a controlled substance - and too heavy for what you need (D)
As you educate your patient for discharge on warfarin/coumadin, which statement will require
your immediate action?
a.
"I will avoid contact sports."
b.
"I will take my medication in the early evening each day.
c.
"I will increase dark-green, leafy vegetables in my diet."
d.
"I will contact my health care provider if I develop excessive bruising." - Answer C
You don't want to increase foods with vitamin K (OR decrease them) just keep a consistent level
You SHOULD avoid contact sports ( A)
