Nokea
A nurse is caring for a client receiving the anticoagulant drug warfarin. Which assessment would be most appropriate before administering the drug?
- A. Observe for signs of thrombus formation.
- B. Assess prothrombin time (PT) and INR.
- C. Assess for signs of bleeding.
- D. Monitor for hypersensitivity reaction.
Correct Answer: B
Rationale: The nurse should assess the prothrombin time (PT) and INR before administering the anticoagulant drug warfarin to the client.
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A client is being discharged from the hospital with a prescription for clopidogrel. The nurse would instruct the client about which of the following as a possible adverse reaction? Select all that apply.
- A. Skin rash
- B. Bleeding
- C. Heart palpitations
- D. Nausea
- E. Constipation
Correct Answer: A,B,C,E
Rationale: The most common adverse reactions associated with clopidogrel are skin rash, dizziness, bleeding, palpitations, and constipation.
A nurse is reviewing a journal article about antiplatelet agents. Which of the following would the nurse expect to be discussed? Select all that apply.
- A. Heparin
- B. Warfarin
- C. Abciximab
- D. Anagrelide
- E. Dipyridamole
Correct Answer: C,D,E
Rationale: Abciximab, anagrelide, and dipyridamole are antiplatelet agents. Heparin and warfarin are anticoagulants.
A client is prescribed an anticoagulant. In which of the following situations would the nurse hold the drug and notify the physician? Select all that apply.
- A. PT exceeds 1.5 times the control value.
- B. PT is less than 1.5 times the control value.
- C. There is evidence of bleeding.
- D. INR is less than 3.0.
- E. INR is greater than 3.0.
Correct Answer: A,C,E
Rationale: The nurse should withhold the drug and contact the physician if any of the following occur: the PT exceeds 1.5 times the control value, there is evidence of bleeding, or the INR is greater than 3.0.
When teaching a class about parenterally administered heparin, which of the following would the nurse include? Select all that apply.
- A. Onset of action is almost immediate.
- B. Maximum effect occurs within 10 minutes.
- C. It is preferably given intramuscularly.
- D. Clotting time returns to normal within 4 hours.
- E. It causes fewer adverse reactions than the oral form.
Correct Answer: A,B,D
Rationale: Parenteral heparin results in an almost immediate onset of action with a maximum effect within 10 minutes, but clotting returns to normal within 4 hours unless subsequent doses are given. It is preferably given subcutaneously or intravenously.
Protamine is used to treat overdose of which of the following medications? Select all that apply.
- A. Clopidogrel (Plavix)
- B. Heparin
- C. Enoxaparin (Lovenox)
- D. Alreplase (Activase)
- E. Warfarin (Coumadin)
Correct Answer: B,C
Rationale: Protamine is used to treat overdose of heparin and low-molecular-weight heparins (LMWHs).