Question

The patient has been started on warfarin (Coumadin) for deep vein thrombosis. The patient asks when the medication will break up the clots. The nurse's best response would be:

Answer 1

Correct Answers:

"This medication will not break down clots but will make it less likely that the clot will get larger."

Rationale :

Warfarin is an anticoagulant, not a thrombolytic agent. It prevents new clot formation and stops existing clots from growing but does not dissolve clots. Clot breakdown occurs naturally over time via the body’s fibrinolytic system.

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Answer 2

Correct Answers:

Labeling is not always reliable and herbal products should be used with caution.

Rationale :

Herbal supplements are not regulated as strictly as prescription drugs, and labeling may not always accurately reflect contents or dosage. Education is vital because these products can have side effects and interact with medications. Nurses should emphasize caution and encourage patients to report use.

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Answer 3

Correct Answers:

Signs and symptoms of bruising and bleeding.

Rationale :

Enoxaparin is a low molecular weight heparin that increases bleeding risk. The nurse should monitor for signs like bruising, nosebleeds, and blood in urine or stool. It is used to prevent clots, not dissolve them.

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Answer 4

Correct Answers:

Platelets

Rationale :

Platelets are the first responders in hemostasis. They adhere to injured blood vessels and clump together to form a temporary plug. This action is critical to prevent blood loss.

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Answer 5

Correct Answers:

Monitor the client tor black, tarry stools.

Rationale :

Clopidogrel inhibits platelet aggregation and increases bleeding risk. Black, tarry stools are a sign of gastrointestinal bleeding and must be reported. Nurses should teach clients to watch for these signs.

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Answer 6

Correct Answers:

2

Rationale :

To give 0.25 mg using 0.125 mg tablets, the nurse must administer 2 tablets. Safe calculation and rounding to the nearest whole number are essential for patient safety.

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Answer 7

Correct Answers:

Protamine sulfate

Rationale :

Protamine sulfate is the specific antidote for heparin overdose. It binds with heparin to neutralize its anticoagulant effects. Vitamin K is for warfarin, not heparin.

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Answer 8

Correct Answers:

Hold the next dose of heparin and contact the physician

Rationale :

Hematuria is a sign of bleeding, which can result from heparin over-anticoagulation. The nurse should stop the drug and notify the provider for further instructions. Administering more heparin would worsen the bleeding.

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Answer 9

Correct Answers:

Prothrombin time (PT)

Rationale :

PT and INR are used to monitor warfarin effectiveness. aPTT is used for heparin. PT reflects the extrinsic clotting pathway affected by warfarin.

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Answer 10

Correct Answers:

"The anticoagulant effect of a single dose of aspirin can last for as long as a week."

Rationale :

Aspirin irreversibly inhibits platelet function, and platelets live for about 7 days. The anticoagulant effect persists until new platelets are made. This is why aspirin is stopped before surgery.

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RN Pharmacology #25E

No.

1 : The patient has been started on warfarin (Coumadin) for deep vein thrombosis. The patient asks when the medication will break up the clots. The nurse's best response would be:

2 : It is important that nurses ensure that their patients receive education regarding herbal products because:

3 : The patient is receiving enoxaparin (Lovenox) subcutaneously every 12 hours following knee replacement surgery. The patient is monitored for?

4 : Which of the following clump and adhere to the wall of the injured blood vessel to begin the process of hemostasis?

5 : A nurse is caring for a client who has a prescription for clopidogrel. Which of the following actions should the nurse plan to take?

6 : A nurse is preparing to administer digoxin 0.25 mg PO to a client. The amount available is digoxin 0.125 mg tablets. How many tablets should the nurse administer to the client? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

7 : A nurse is caring for a client who has thrombophlebitis and is receiving a continuous heparin infusion. Which of the following medications should the nurse have available to reverse heparin's effects?

8 : A patient has been taking heparin for three days and has developed hematuria. The most appropriate action for the nurse is to:

9 : A nurse is caring for a client who has a new prescription for warfarin. The nurse should use the results of which of the following diagnostic tests to monitor the effect of this therapy?

10 : A client is taking aspirin (ASA) and asks the nurse how long the anticoagulant effect of a single dose of aspirin can last. The nurse replies:

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