1.
The nurse admits a client with an acute pulmonary embolism and is instructed to start heparin. Which of the following tests can the nurse best use to adjust the dose of heparin?
-
Partial thromboplastin time (PTT)
-
International normalized ratio (INR)
-
Complete blood count (CBC)
-
Prothrombin time (PT)
2.
A client who received heparin developed uncontrollable bleeding. What medication is the provider most likely to use as an antidote to the heparin?
-
Protamine
-
Phytonadione
-
Idarucizumab
-
Andexanet alfa
3.
The nurse is answering the client’s question about the risk for heparin-induced thrombocytopenia (HIT). Which of the following information should be included in the discussion?
-
The condition increases the risk for bleeding.
-
The platelet count rises above normal initially.
-
The condition is immune mediated.
-
The skin rash is the most reliable diagnostic indicator.
4.
A client is admitted to the emergency department with an acute myocardial infarction. Which medication does the nurse anticipate being ordered to dissolve the clot in the coronary artery?
-
Vitamin K
-
Alteplase
-
Warfarin
-
Enoxaparin
5.
The nurse is teaching a client with a pulmonary embolism about their new medication, heparin. What will the nurse tell the client about the purpose of heparin?
-
It will dissolve the blood clot quickly.
-
It will prevent platelet-to-platelet adhesion.
-
It will enhance clotting.
-
It will prevent further clot formation.
6.
A nurse is teaching a client about warfarin dietary considerations. Which of the following statements by the client indicates understanding of the restrictions?
-
“I should eat a lot of spinach every day due to increased vitamin K needs.”
-
“I can eat a lot of extra broccoli with a meal as long as it is only occasionally due to decreased vitamin K needs.”
-
“I should avoid eating fruit like bananas due to excess vitamin K content.”
-
“I should eat a consistent amount of vitamin K–containing foods in my diet.”
7.
A nurse admits a client who has been started on warfarin for a pulmonary embolism. Which test will the nurse monitor to assess warfarin’s effect?
-
Partial thromboplastin time (PTT)
-
International normalized ratio (INR)
-
Complete blood count (CBC)
-
Anti-factor Xa level
8.
The nurse is monitoring for medication-related adverse effects in a client receiving heparin. Which of the following would indicate that the client should be assessed for heparin-induced thrombocytopenia (HIT)?
-
A decrease in platelet count and concomitant gastrointestinal bleed
-
A decrease in platelet count and concomitant deep vein thrombosis
-
An increase in platelet count and concomitant intracranial hemorrhage
-
An increase in platelet count and concomitant pulmonary embolism
9.
Which of the following direct-acting oral anticoagulant drugs must be taken with food for effective absorption?
-
Endoxaban
-
Dabigatran
-
Rivaroxaban
-
Apixaban
10.
An emergency department nurse is assessing a client with an acute ischemic stroke prior to administering alteplase. Which finding will the nurse need to discuss with the provider prior to administering alteplase therapy?
-
Total knee replacement surgery 6 months ago
-
Blood pressure of 197/110 mm Hg
-
Glucose level of 168 mg/dL
-
Past medical history of gastroesophageal reflux disease (GERD)