Test 5 CH 15 Flashcards
An older patient who takes a daily NSAID for arthritis pain has been prescribed aspirin as an antiplatelet agent. What information regarding risks associated with aspirin use should be included in this teaching plan?
a. The risk for urinary retention
b. The risk for cognitive decline
c. The risk for gastrointestinal bleeding
d. The risk for peripheral arterial disease
ANS: C
You are teaching a patient who has recently undergone a coronary artery stent placement, and has now been prescribed clopidogrel. Which statement made by this patient informs you that the patient requires further teaching?
a. “I will need to take this drug every day for 3 months to prevent clogging of the stent.”
b. “I will report any abnormal bleeding.”
c. “I will avoid herbal supplements while taking this drug.”
d. “I will take this drug with food.”
ANS: A
A female patient taking aspirin as an antiplatelet drug calls you to report she may be having an allergic reaction to the drug. Which statement made by the patient alerts you to a possible adverse reaction to the drug?
a. “I am having nausea after my meals.”
b. “I am experiencing itching and hives on my back and abdomen.”
c. “My visual acuity has decreased.”
d. “I am having increased urination throughout the night.”
ANS: B
You are taking the drug history of a 47-year-old male patient who is recovering from a myocardial infarction, and will be starting on an antiplatelet drug. Which of the following statements made by the patient alerts you to a potential drug interaction with antiplatelet drugs?
a. “I am taking a beta blocker for hypertension.”
b. “I am taking furosemide for fluid retention.”
c. “I take an antacid daily for my reflux.”
d. “I take an inhaled corticosteroid for my asthma.”
ANS: C
A patient prescribed an anticoagulant asks you about potential drug interactions with this new drug. Which of the following drugs would you advise this patient to avoid while taking anticoagulants?
a. Vitamin C
b. Thiazide diuretics
c. Potassium supplements
d. Nonsteroidal anti-inflammatory analgesics
ANS: D
You are reviewing the laboratory values of an outpatient who is on anticoagulant therapy. The laboratory tests show a less than desired level of anticoagulation. The patient states that the drug has been taken as prescribed. You suspect the issue may be related to the patient’s dietary intake. Which foods would you advise the patient to avoid while on anticoagulant therapy?
a. Spinach and broccoli
b. Peaches and plums
c. Carrots and celery
d. Sweet potatoes and white rice
ANS: A
You are taking a drug history from a patient who is taking an anticoagulant. The patient informs you that the herbal supplement St. John’s wort is taken daily for depression. What should you teach the patient about the use of this and other herbal supplements with anticoagulant therapy?
a. Herbal drugs may decrease clotting times.
b. Herbal drugs may increase the risk of bleeding.
c. There are no risks associated with this drug combination.
d. They are safe to take together if you take them an hour apart.
ANS: B
A patient with atrial fibrillation has been prescribed the drug dabigatran (Pradaxa). The patient asks you what the advantage of this drug may be over warfarin (Coumadin). What is your best response?
a. “This drug is taken only once daily.”
b. “This drug does not carry a risk for excessive bleeding.”
c. “This drug does not require frequent laboratory testing.”
d. “This drug does not interact with other drugs you may be taking.”
ANS: C
You are caring for a patient who is taking the indirect thrombin inhibitor clopidogrel following cardiac surgery. What laboratory value should you monitor for possible adverse effects of this therapy?
a. Platelet count
b. Potassium level
c. Serum calcium level
d. White blood cell count
ANS: A
A 52-year-old male patient who has been taking a direct thrombin inhibitor for several months tells you he is going on vacation. He asks what specific advice he should follow related to this specific class of drugs while he is traveling?
a. “Keep this drug in its original bottle while traveling.”
b. “Stop this drug while on vacation to avoid the risk of bleeding.”
c. “Take this drug every other day to prevent adverse events while on vacation.”
d. “Make sure you eat plenty of green vegetables while on vacation.”
ANS: A
You are caring for a 35-year-old female patient who has been prescribed apixaban (Eliquis). She reports that she experienced unusually heavy bleeding during her menstrual period. What is your best response?
a. “This bleeding is expected during the first month of taking the drug.”
b. “I will let your healthcare provider know right away.”
c. “There is no need for concern, this side effect is expected.”
d. “I will document this finding in my notes and check with you next month.”
ANS: D
What category of anticoagulant drugs works by increasing the amount of the protein antithrombin III?
a. Fibrinolytics
b. Vitamin K antagonists
c. Direct thrombin inhibitors
d. Indirect thrombin inhibitors
ANS: D
A patient with a history of deep vein thrombosis is prescribed subcutaneous heparin before surgery. The patient asks you if the heparin can be taken orally instead of by injection. What is your best response?
a. “Oral heparin is quite expensive, and not covered by insurance.”
b. “Heparin is given by injection because it cannot be absorbed orally.”
c. “Heparin is given by injection before surgery because it works faster.”
d. “Heparin cannot be given orally because you are fasting for your surgery.”
ANS: B
You are reviewing the laboratory values of a patient whose heparin dose has been changed by the healthcare provider. Which laboratory value will inform you about effect of the dose change on this patient’s anticoagulant therapy?
a. PT
b. INR
c. aPTT
d. DIC panel
ANS: C
A patient is suspected of having an overdose of heparin. What drug should you prepare for the healthcare provider to give?
a. Naloxone
b. Warfarin
c. Acetylcysteine
d. Protamine sulfate
ANS: D
