Holland/Adams/Brice, Core Concepts in Pharmacology 5th Edition Test Bank
Chapter 24

Question 1

Type: MCSA

What is the medical term for stopping of blood flow, an essential mechanism protecting the body from both external and internal injury?

1. Thrombolytic
2. Coagulation
3. Hemostasis
4. Fibrinolysis

Cognitive Level: Remembering

Client Need: Physiological Integrity

Page Number: 375

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 24-1 Explain the importance of hemostasis.

Question 2

Type: MCSA

What is the term for a complex series of steps that begins when the injured cells release a chemical called prothrombin activator, or prothrombinase?

1. Hemostatics
2. Clotting factors
3. The coagulation cascade
4. Hemostasis

Cognitive Level: Remembering

Client Need: Physiological Integrity

Page Number: 376

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 24-1 Explain the importance of hemostasis.

Question 3

Type: MCMA

A client asks the nurse to describe conditions that require coagulation-modifying medications. Which conditions should the nurse include in the explanation? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Deep vein thrombosis (DVT)
2. Angina
3. Myocardial infarction
4. Headache
5. Hyperglycemia

Cognitive Level: Applying

Client Need: Physiological Integrity

Page number: 375

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 24-1 Explain the importance of hemostasis.

Question 4

Type: MCSA

A client has been prescribed an anticoagulant, and asks the nurse to explain why this medication has been prescribed. Which response by the nurse is the most appropriate?

1. “These medications are used to prevent the formation of clots.”
2. “These medications inhibit the normal removal of fibrin, thus keeping the clot in place for a longer period of time.”
3. “These medications are used to dissolve life-threatening clots.”
4. “These medications are used to prevent clot formation in arteries.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 378

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-4 Explain the primary mechanism by which anticoagulants act.

Question 5

Type: MCSA

A client has been prescribed a thrombolytic, and asks the nurse to explain why this medication has been prescribed. Which reply by the nurse is the most appropriate?

1. “These medications are used to prevent the formation of clots.”
2. “These medications inhibit the normal removal of fibrin, thus keeping the clot in place for a longer period of time.”
3. “These medications are used to dissolve life-threatening clots.”
4. “These medications are used to prevent clotting action of platelets.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 378

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-6 Describe indications for the administration of thrombolytics.

Question 6

Type: MCSA

A client has been prescribed an antiplatelet drug, and asks the nurse to explain why this medication has been prescribed. Which response by the nurse is the most appropriate?

1. “These medications are used to dissolve life-threatening clots.”
2. “These medications are used to prevent clotting action of platelets.”
3. “These medications are used to prevent the formation of clots.”
4. “These medications inhibit the normal removal of fibrin, thus keeping the clot in place for a longer period of time.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 377

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-5 Explain the primary mechanism by which antiplatelet drugs act.

Question 7

Type: MCSA

The client is receiving heparin (Hep-Lock). The nurse will monitor which laboratory results to evaluate therapeutic response?

1. INR
2. aPTT
3. BNP
4. PT

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 380

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-4 Explain the primary mechanism by which anticoagulants act.

Question 8

Type: MCSA

The client is receiving warfarin (Coumadin). Which laboratory result will the nurse monitor to evaluate the therapeutic response?

1. WBC
2. PT and INR
3. BNP
4. aPTT

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 381

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-4 Explain the primary mechanism by which anticoagulants act.

Question 9

Type: MCSA

A client is receiving heparin (Hep-Lock) therapy, and serious hemorrhage occurs. Which medication should the nurse administer to reverse the effects of heparin (Hep-Lock)?

1. Vitamin K
2. Desirudin (Iprivask)
3. Potassium chloride
4. Protamine sulfate

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 378

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-4 Explain the primary mechanism by which anticoagulants act.

Question 10

Type: MCSA

A client receiving warfarin (Coumadin) therapy has an INR of 5.6. Which medication would the nurse expect the physician to order to reverse the warfarin (Coumadin)?

1. Potassium chloride
2. Vitamin K
3. Desirudin (Iprivask)
4. Protamine sulfate

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 375

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-4 Explain the primary mechanism by which anticoagulants act.

Question 11

Type: MCSA

The nurse caring for a client receiving heparin (Hep-Lock) monitors the patient for what serious complication that occurs in up to 30% of patients taking the drug?

1. Tachycardia
2. Hypotension
3. Angioedema
4. Heparin-induced thrombocytopenia (HIT)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 380

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-4 Explain the primary mechanism by which anticoagulants act.

Question 12

Type: MCSA

A client taking warfarin (Coumadin) should be instructed to avoid herbal supplements such as green tea, ginkgo, feverfew, garlic, cranberry, chamomile, and ginger. The client asks the nurse why these items should be avoided. The nurse bases her response on what knowledge?

1. These items increase the risk of bleeding.
2. These items cause severe hypotension.
3. These items decrease the effect of the warfarin (Coumadin).
4. These items cause severe headache.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 381

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-4 Explain the primary mechanism by which anticoagulants act.

Question 13

Type: MCSA

A client is taking aspirin (ASA), and asks the nurse how long the anticoagulant effect of a single dose of aspirin can last. Which reply by the nurse is the most appropriate?

1. “The anticoagulant effect of a single dose of aspirin can last for as long as a week.”
2. “The anticoagulant effect of a single dose of aspirin can last for as long as a day.”
3. “The anticoagulant effect of a single dose of aspirin can last for as long as 12 hours.”
4. “The anticoagulant effect of a single dose of aspirin can last for as long as a month.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 384

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-5 Explain the primary mechanism by which antiplatelet drugs act.

Question 14

Type: MCMA

A client has been prescribed clopidogrel (Plavix). The nurse instructs the client that which types of drugs can increase the risk for bleeding? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Anticoagulants
2. Protein pump inhibitors
3. Thrombolytic agents
4. Antibiotics
5. Aspirin

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 384

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-5 Explain the primary mechanism by which antiplatelet drugs act.

Question 15

Type: MCSA

The nurse is preparing to administer alteplase (Activase). In order for this medication to be effective in treating a thrombolytic stroke, when must the medication be administered?

1. 6 hours prior to symptoms
2. 3 hours prior to symptoms
3. 24
4. 12

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 385

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-6 Describe indications for the administration of thrombolytics.

Question 16

Type: MCSA

Which classification of medications is used to prevent and treat excessive bleeding following surgical procedures?

1. Thrombolytics
2. Anticoagulants
3. Hemostatics
4. Antiplatelets

Cognitive Level: Remembering

Client Need: Physiological Integrity

Page Number: 385

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 24-7 Describe indications for the administration of hemostatics.

Question 17

Type: MCSA

A client has been ordered a thrombolytic medication. Why is it important for the nurse to obtain a comprehensive medication history for this client?

1. Many patients are allergic to this medication.
2. Thrombolytics cannot be given to a patient with a history of asthma.
3. Thrombolytics will stop bleeding.
4. Thrombolytics are contraindicated in patients with active bleeding or with a history of recent trauma.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 385

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-6 Describe indications for the administration of thrombolytics. .

Question 18

Type: MCSA

The client is caring for a client who is prescribed a thrombolytic drug. Which item in the client’s history does not support the use of this medication?

1. Pulmonary embolism
2. Acute MI
3. Postoperative bleeding
4. Cerebrovascular accident (CVA)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 385

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-6 Describe indications for the administration of thrombolytics.

Question 19

Type: MCMA

What are the primary classes of antiplatelet agents? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Thrombolytics
2. Aspirin (ASA)
3. Adenosine diphosphate (ADP) receptor blockers
4. Glycoprotein IIb/IIIa receptor blockers
5. Antipyretic agents

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 383

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-5 Explain the primary mechanism by which antiplatelet drugs act.

Question 20

Type: MCMA

The nurse is caring for a client receiving an ADP receptor blocker. Which medications does the nurse anticipate may be included on the MAR? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Heparin (Hep-Lock)
2. Ticlopidine (Ticlid)
3. Clopidogrel (Plavix)
4. Warfarin (Coumadin)
5. Ibuprofen (Advil)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 383

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-5 Explain the primary mechanism by which antiplatelet drugs act.

Question 21

Type: MCMA

A client states that the physician is going to prescribe an antiplatelet agent. The nurse knows which medications are antiplatelet agents? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Heparin (Hep-Lock)
2. Dipyridamole (Persantine)
3. Warfarin (Coumadin)
4. Cilostazol (Pletal)
5. Acetaminophen (Tylenol)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 383

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-5 Explain the primary mechanism by which antiplatelet drugs act.

Question 22

Type: MCSA

A client asks the nurse what the most common side effect of anticoagulant therapy is. What is the best response by the nurse?

1. “Bleeding.”
2. “Ataxia.”
3. “Headache.”
4. “Hypotension.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 378

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-4 Explain the primary mechanism by which anticoagulants act.

Question 23

Type: MCSA

A nurse is reviewing the laboratory data of a hospitalized client. The nurse recognizes that the white blood cell (WBC) count is lower than expected. The nurse anticipates the prescriber to order which medication?

1. Epoetin alfa (Epogen)

2. Filgrastim (Neupogen)

3. Dalteparin (Fragmin)

4. Warfarin (Coumadin)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 387

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-8 Explain reasons for administering hematopoietic growth factors.

Question 24

Type: MCSA

A client asks the nurse what is, if any, common adverse effect of epoetin alfa (Procrit). What is the best response by the nurse?

1. “Bleeding.”

2. “Ataxia.”

3. “Headache.”

4. “Hypertension.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 388

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-8 Explain reasons for administering hematopoietic growth factors.

Question 25

Type: MCSA

A nurse understands that certain medications can boost the production of red blood cells, white blood cells, or platelets in patient. What is the name of this group of medications?

1. Colony stimulating factors

2. Hematopoietic growth factors

3. Anticoagulants

4. Hemostatics

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 387

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-8 Explain reasons for administering hematopoietic growth factors.

Question 26

Type: MCSA

Which medication may be prescribed for a client who recently had surgery and has a small amount of oozing and bleeding from the surgery site?

1. Thrombin (Evithrom)

2. Warfarin (Coumadin)

3. Enoxaparin (Lovenox)

4. Aspirin

Cognitive Level: Remembering

Client Need: Physiological Integrity

Page Number: 386

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 24-7 Describe indications for the administration of hemostatics.

Question 27

Type: SEQ

Which are the steps in hemostasis?

1. Platelets adhere to injury site

2. Vessel spasms

3. Vessel injury

4. Insoluble fibrin strands form and coagulate

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 376

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-3 Construct a diagram that illustrates how drugs are used to modify the coagulation process.

Question 28

Type: MCSA

A nurse is discussing the use of a thrombolytic. The client tells the nurse that they thought blood clots are very important to the body. Which is the nurse’s best response?

1. “Yes clotting is very important.”

2. “A balance of blood fluidity and coagulation is important to functioning of blood.”

3. “Let’s call the prescriber to explain.”

4. “By maintaining a proper diet with a variety of electrolytes can restore blood coagulation.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 375

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-2 Identify the importance of removing blood clots to the restoration of blood circulation.

Question 29

Type: MCSA

A nurse is reviewing laboratory report of a client and realizes the liver function tests are elevated. The client should be monitored for which potential complication?

1. Abnormal coagulation

2. Electrolyte imbalance

3. Respiratory issues

4. Reduced cardiac output

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 376

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-2 Identify the importance of removing blood clots to the restoration of blood circulation.