A nursing student who is preparing to care for a postoperative patient with deep vein thrombosis asks the nurse why the patient must take heparin rather than warfarin. Which response by the nurse is correct?
The onset of warfarin is delayed.
Warfarin prevents platelet aggregation.
Heparin has fewer adverse effects.
Heparin has a longer half-life.
The Correct Answer is A
Choice A reason:
The onset of warfarin is delayed, meaning it takes longer to achieve a therapeutic effect. Warfarin requires several days to adjust to effective anticoagulation levels because it works by inhibiting the synthesis of clotting factors that are already present and active in the bloodstream. In contrast, heparin has an immediate anticoagulant effect when administered, which is crucial for patients with acute conditions like deep vein thrombosis.
Choice B reason:
Warfarin does not prevent platelet aggregation. Instead, it works by inhibiting vitamin K-dependent clotting factors, which are essential for blood coagulation. Platelet aggregation is primarily inhibited by antiplatelet drugs like aspirin or clopidogrel, not anticoagulants like warfarin.
Choice C reason:
Heparin does not necessarily have fewer adverse effects compared to warfarin. Both anticoagulants have their specific risks and side effects. Heparin is preferred in acute settings due to its rapid onset of action, but it can cause complications like heparin-induced thrombocytopenia (HIT), which requires careful monitoring.
Choice D reason:
Heparin does not have a longer half-life than warfarin. In fact, heparin's half-life is relatively short, which is why it is often administered via continuous infusion or frequent subcutaneous injections. Warfarin has a longer half-life, but its delayed onset of action makes it less suitable for immediate anticoagulation needs.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice D reason: The backup of pancreatic enzymes is the initial trigger for tissue damage in pancreatitis. When these enzymes become activated within the pancreas, they begin to digest pancreatic tissue, leading to inflammation and damage.
Choice A reason: Insulin toxicity is not a cause of tissue damage in pancreatitis. Insulin is a hormone that regulates blood sugar levels and does not play a role in the initial damage seen in pancreatitis.
Choice B reason: Autoimmune destruction of the pancreas is associated with conditions like type 1 diabetes, not pancreatitis. Pancreatitis is primarily caused by the premature activation of digestive enzymes within the pancreas.
Choice C reason: Hydrochloric acid reflux into the pancreatic duct is not a known cause of pancreatitis. The condition is related to the digestive enzymes produced by the pancreas itself, not stomach acid.
Correct Answer is C
Explanation
Choice A reason:
Left ventricular heart failure can cause severe chest pain and elevated cardiac enzymes but is not as directly associated with elevated cardiac troponin levels as a myocardial infarction. The presence of elevated troponin levels specifically indicates myocardial cell injury, which is most consistent with an MI.
Choice B reason:
Unstable angina involves chest pain that is not relieved by rest and may indicate a higher risk for an MI. However, it typically does not result in elevated cardiac troponin levels unless there is actual myocardial damage. Elevated troponin is a marker for myocardial infarction rather than just unstable angina.
Choice C reason:
Myocardial infarction (MI) is the correct answer. Elevated levels of cardiac troponin are a key indicator of myocardial infarction as they reflect heart muscle damage. The patient's severe chest pain and elevated troponin levels strongly suggest that an MI has occurred.
Choice D reason:
Prinzmetal angina, or variant angina, is characterized by chest pain caused by coronary artery spasms. While it can cause significant pain, it does not typically lead to elevated cardiac troponin levels unless it results in myocardial damage, which is less common than in an MI.
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