Chapter 45: Anticoagulants, Antiplatelets, and Thrombolytics

Chapter 45: Anticoagulants, Antiplatelets, and Thrombolytics

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse is caring for a postoperative patient. The nurse will anticipate administering which medication to this patient to help prevent thrombus formation caused by slow venous blood flow?

a.	Alteplase (Activase)
b.	Aspirin
c.	Clopidogrel (Plavix)
d.	Low–molecular-weight heparin

 

 

ANS:  D

Low–molecular-weight heparin is an anticoagulant, which is used to inhibit clot formation and is used prophylactically to prevent postoperative deep vein thrombosis. Alteplase is a thrombolytic, which is used to break down clots after they form; alteplase is contraindicated in any patient with recent surgery. Aspirin and clopidogrel are antiplatelet drugs and are used to prevent arterial thrombosis.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 652

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. A nursing student asks why the anticoagulant heparin is given to patients who have disseminated intravascular coagulation (DIC) and are at risk for excessive bleeding. The nurse will explain that heparin is used in this case for which reason?

a.	To decrease the risk of venous thrombosis
b.	To dissolve blood clots as they form
c.	To enhance the formation of fibrous clots
d.	To preserve platelet function

 

 

ANS:  A

The primary use of heparin for patients with DIC is to prevent venous thrombosis, which can lead to pulmonary embolism or stroke. Heparin does not break down blood clots, enhance the formation of fibrous clots, or preserve platelet function.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension)    REF:   Page 655

TOP:   NURSING PROCESS: Assessment

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. A patient has been receiving intravenous heparin. When laboratory tests are drawn, the nurse has difficulty stopping bleeding at the puncture site. The patient has bloody stools and is reporting abdominal pain.The nurse notes elevated partial thromboplastin time (PTT) and activated partial thromboplastin time (aPTT). Which action will the nurse perform?

a.	Ask for an order for oral warfarin (Coumadin).
b.	Obtain an order for protamine sulfate.
c.	Request an order for vitamin K.
d.	Suggest that the patient receive subcutaneous heparin.

 

 

ANS:  B

Protamine sulfate is given as an antidote to heparin when patient’s clotting times are elevated. Oral warfarin will not stop the anticoagulant effects of heparin. Vitamin K is used as an antidote for warfarin. Administering heparin by another route is not indicated when there is a need to reverse the effects of heparin.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 656

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. A patient who has received heparin after previous surgeries will be given enoxaparin sodium (Lovenox) after knee-replacement surgery. The patient asks how this drug is different from heparin. The nurse will explain that enoxaparin

a.	decreases the need for laboratory tests.
b.	has a shorter half-life than heparin.
c.	increases the risk of hemorrhage.
d.	may be taken orally instead of subcutaneously.

 

 

ANS:  A

Enoxaparin is a low–molecular-weight heparin, which produces more stable responses at lower doses, thus reducing the need for frequent lab monitoring. It has a longer half-life than heparin. It decreases the risk of hemorrhage because it is more stable at lower doses. It is given subcutaneously.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 652

TOP:   NURSING PROCESS: Nursing Intervention: Patient Teaching

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies