Review ATI Pharmacology Quiz #1 25E

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ATI Pharmacology Quiz #1 25E

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Total Questions : 44

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Question 1:

The patient has been started on warfarin (Coumadin) for deep vein thrombosis. The patient asks when the medication will break up the clots. The nurse's best response would be:

A. "This medication will not break down clots but will make it less likely that the clot will get larger." B. "It will break down the clot within 8 to 12 hours of administration." C. "It will take 7 to 10 days for the clot to break down." D. "You will need to be on this medication for a long time before it will break down the clot."

Answer and Explanation

Choice A:

"This medication will not break down clots but will make it less likely that the clot will get larger." Warfarin (Coumadin) is an anticoagulant medication that works by inhibiting the synthesis of certain clotting factors in the liver. It does not directly break down existing clots but prevents the formation of new clots and the extension of existing ones. This response provides accurate information about the mechanism of action of warfarin.

Choice B:

"It will break down the clot within 8 to 12 hours of administration." This statement is incorrect. Warfarin does not have an immediate effect on existing clots. Its action is primarily preventive, reducing the risk of further clot formation and allowing the body's natural processes to gradually break down existing clots over time.

Choice C:

"It will take 7 to 10 days for the clot to break down." While the body's natural processes may start breaking down the clot within this timeframe, warfarin itself does not directly cause the dissolution of clots. This response is partially accurate in terms of the timeline for the body's natural clot resolution but does not specify that warfarin itself is not responsible for clot breakdown.

Choice D:

"You will need to be on this medication for a long time before it will break down the clot." This statement is misleading. Warfarin's role is to prevent the formation of new clots and further extension of existing ones rather than directly breaking down clots. Additionally, the duration of warfarin therapy is typically determined based on the individual's risk factors for clot formation, and it may not necessarily correlate with the time it takes for existing clots to resolve.

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Question 2:

It is important that nurses ensure that their patients receive education regarding herbal products because:

A. Labeling is not always reliable and herbal products should be used with caution. B. Herbal products are approved under strict FDA regulations. C. There are so few side effects, and they can be purchased without a prescription. D. The manufacturer has repeatedly demonstrated effectiveness.

Answer and Explanation

Choice A:

Labeling is not always reliable and herbal products should be used with caution. Herbal products are not subject to the same rigorous regulations and testing as pharmaceutical drugs. Therefore, their labeling may not always be accurate or comprehensive. Patients need to be aware of potential risks, interactions, and variations in potency associated with herbal products. Education helps patients make informed decisions and use these products safely.

Choice B:

Herbal products are approved under strict FDA regulations. This statement is false. Unlike pharmaceutical drugs, herbal products are regulated as dietary supplements in the United States and are not subject to the same level of scrutiny and approval processes by the FDA. While the FDA regulates the manufacturing and labeling of dietary supplements, including herbal products, the standards are not as strict as those for prescription or over-the-counter medications.

Choice C:

There are so few side effects, and they can be purchased without a prescription. This statement is misleading and potentially dangerous. Herbal products can indeed have side effects and interactions with medications, and their safety profiles vary widely. Additionally, the availability of herbal products without a prescription does not necessarily imply safety. Patients need education to understand potential risks and benefits associated with herbal product use.

Choice D:

The manufacturer has repeatedly demonstrated effectiveness. This statement is unsubstantiated and may not be true for all herbal products. Unlike pharmaceutical drugs, herbal products often lack extensive scientific evidence supporting their effectiveness for specific indications. While some manufacturers may conduct studies to support their products' efficacy, the evidence may be limited or inconclusive. Patients need education to critically evaluate claims of effectiveness and make informed decisions about herbal product use.

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Question 3:

The patient is receiving enoxaparin (Lovenox) subcutaneously every 12 hours following knee replacement surgery. The patient is monitored for.

A. Clotting at the incision site. B. Increased pain. C. Gingival hyperplasia. D. Signs and symptoms of bruising and bleeding.

Answer and Explanation

Choice A:

Clotting at the incision site. Enoxaparin (Lovenox) is an anticoagulant medication used to prevent blood clots, particularly deep vein thrombosis (DVT) and pulmonary embolism (PE), which are common complications following orthopedic surgeries like knee replacement. Monitoring for clotting at the incision site is essential to ensure that the medication is effectively preventing excessive clot formation while also ensuring that the patient does not experience excessive bleeding.

Choice B:

Increased pain. While increased pain could be a concern postoperatively, particularly after a surgical procedure like knee replacement, it is not a specific monitoring parameter for enoxaparin administration. Pain management is typically addressed separately, and increased pain may indicate issues such as inadequate analgesia, surgical complications, or other factors unrelated to enoxaparin therapy.

Choice C:

Gingival hyperplasia. Gingival hyperplasia refers to an overgrowth of gum tissue and is not directly associated with enoxaparin therapy. This side effect is more commonly associated with certain medications such as phenytoin and cyclosporine rather than anticoagulants like enoxaparin. Monitoring for gingival hyperplasia would not be relevant in this context.

Choice D:

Signs and symptoms of bruising and bleeding. This is the correct answer. Enoxaparin is an anticoagulant medication, which increases the risk of bleeding. Therefore, monitoring for signs and symptoms of bruising and bleeding is crucial to detect any potential complications such as hemorrhage or hematoma formation. This includes assessing for unusual bruising, bleeding from the gums, nosebleeds, hematuria, melena, or any other signs of internal or external bleeding. Prompt recognition and management of bleeding complications are essential to ensure patient safety during enoxaparin therapy, especially following orthopedic surgery.

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Question 4:

Which of the following clump and adhere to the wall of the injured blood vessel to begin the process of hemostasis?

A. White blood cells B. Antibodies C. Red blood cells D. Platelets

Answer and Explanation

Choice A:

WBCs are part of the immune system and play a role in fighting infections. However, they are not directly involved in hemostasis or clot formation.

Choice B:

Antibodies are proteins produced by the immune system to recognize and neutralize foreign substances (antigens). They do not directly participate in clot formation.

Choice C:

RBCs carry oxygen and carbon dioxide but are not directly involved in clotting. They do not adhere to the vessel wall during hemostasis.

Choice D:

Platelets are small cell fragments in the blood. They clump together (aggregate) at the site of injury to form a temporary plug (platelet plug). Platelets adhere to the injured vessel wall and release chemicals that initiate clotting.

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Question 5:

A nurse is caring for a client who has a prescription for clopidogrel. Which of the following actions should the nurse plan to take?

A. Have suction equipment at the bedside. B. Monitor the client for black, tarry stools. C. Administer the medication with each meal. D. Initiate contact precautions.

Answer and Explanation

Choice A:

Have suction equipment at the bedside. Clopidogrel is an antiplatelet medication that inhibits blood clot formation. While it does not typically increase the risk of bleeding to the extent that requires constant suctioning, it's prudent to have suction equipment readily available for any patient who may be at risk of bleeding due to their underlying condition or concurrent medications. However, the administration of clopidogrel alone does not necessitate the need for constant suctioning.

Choice B:

Monitor the client for black, tarry stools. This is the correct answer. Clopidogrel, like other antiplatelet medications, increases the risk of bleeding, including gastrointestinal bleeding. Black, tarry stools can indicate gastrointestinal bleeding, which can be a serious complication of clopidogrel therapy. Therefore, monitoring for this symptom is essential for early detection of potential bleeding complications.

Choice C:

Administer the medication with each meal. Clopidogrel can be administered with or without food, as it is not significantly affected by food intake. However, there is no specific recommendation to administer it with meals. The timing of administration may vary based on the prescriber's instructions or patient preferences, but it does not need to be consistently administered with meals.

Choice D:

Initiate contact precautions. Clopidogrel therapy does not require contact precautions. Contact precautions are typically implemented for patients with contagious infections that spread via direct or indirect contact. Clopidogrel does not pose a risk of transmission to others and does not warrant contact precautions.

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Question 6:

A nurse is preparing to administer digoxin 0.25 mg PO to a client. The amount available is digoxin 0.125 mg tablets. How many tablets should the nurse administer to the client?

(Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Answer and Explanation

Correct Answer: "2" tablets

Explanation

To determine how many tablets of digoxin 0.125 mg are needed to administer a total dose of 0.25 mg, divide the desired dose by the dose per tablet:

0.25 mg (desired dose) ÷ 0.125 mg (dose per tablet) = 2 tablets

Therefore, the nurse should administer 2 tablets of digoxin 0.125 mg to the client to achieve a total dose of 0.25 mg.

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Question 7:

A nurse is caring for a client who has thrombophlebitis and is receiving a continuous heparin infusion. Which of the following medications should the nurse have available to reverse heparin's effects?

A. Vitamin K B. Deferoxamine C. Acetylcysteine D. Protamine sulfate

Answer and Explanation

Choice A:

Vitamin K: Vitamin K is the antidote for warfarin, not heparin. Warfarin works by inhibiting the synthesis of vitamin K-dependent clotting factors in the liver. Therefore, vitamin K is used to reverse the effects of warfarin in cases of over-anticoagulation. It does not reverse the effects of heparin.

Choice B:

Deferoxamine: Deferoxamine is a chelating agent used to treat iron toxicity and aluminum overload. It is not indicated for reversing the effects of heparin.

Choice C:

Acetylcysteine: Acetylcysteine is used as an antidote for acetaminophen (paracetamol) overdose. It is not indicated for reversing the effects of heparin.

Choice D:

Protamine sulfate: This is the correct answer. Protamine sulfate is the antidote for heparin. It works by binding to heparin to form a stable complex, thereby neutralizing its anticoagulant effects. Protamine sulfate is commonly used in clinical practice to reverse the effects of heparin in situations such as hemorrhage or when rapid reversal of anticoagulation is needed, such as before surgery.

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Question 8:

A patient has been taking heparin for three days and has developed hematuria. The most appropriate action for the nurse is to:

A. Insert a urinary catheter to determine the residual urine B. Hold the next dose of heparin and contact the physician C. Instruct the patient to drink adequate amounts of fluid D. Administer an additional dose of heparin subcutaneously

Answer and Explanation

Choice A:

Insert a urinary catheter to determine the residual urine. Inserting a urinary catheter may be necessary to accurately measure urinary output and assess for signs of urinary retention. However, the presence of hematuria suggests a potential bleeding complication related to heparin therapy. While monitoring urinary output is important, inserting a urinary catheter should not be the first action taken in response to hematuria. Other interventions to address the bleeding should be prioritized.

Choice B:

Hold the next dose of heparin and contact the physician. This is the correct answer. Hematuria can be a sign of a bleeding complication, which is a known side effect of heparin therapy. Holding the next dose of heparin is appropriate to prevent further bleeding, and contacting the physician ensures prompt evaluation and appropriate management of the patient's condition. The physician may decide to adjust the dose of heparin, temporarily discontinue it, or order further investigations to determine the cause of the hematuria.

Choice C:

Instruct the patient to drink adequate amounts of fluid. While maintaining hydration is important for overall health, instructing the patient to drink fluids would not directly address the underlying cause of hematuria, which may be related to a bleeding complication from heparin therapy. Holding the next dose of heparin and contacting the physician are more appropriate actions in response to hematuria.

Choice D:

Administer an additional dose of heparin subcutaneously. Administering additional heparin would exacerbate the bleeding risk and is contraindicated in the presence of hematuria. It is important to withhold further doses of heparin and seek medical guidance to address the bleeding complication.

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Question 9:

A nurse is caring for a client who has a new prescription for warfarin. The nurse should use the results of which of the following diagnostic tests to monitor the effect of this therapy?

A. White blood cell count (WBC) B. Activated partial thromboplastin time (aPTT) C. Prothrombin time (PT) D. Platelet count

Answer and Explanation

Choice A:

WBCs are part of the immune system and play a role in fighting infections. However, they are not directly involved in hemostasis or clot formation. WBCs do not adhere to the vessel wall during hemostasis.

Choice B:

aPTT measures the time it takes for blood to clot. It is primarily used to monitor heparin therapy, not warfarin. aPTT is not specific for warfarin monitoring.

Choice C:

PT measures how quickly blood clots. It is used to monitor warfarin therapy and assess clotting factors. PT is essential for monitoring warfarin effectiveness.

Choice D:

Platelets are crucial for clot formation. Platelet count helps assess platelet function. Platelets play a direct role in hemostasis.

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Question 10:

is the stopping of blood flow, an essential mechanism protecting the body from both external and internal injury.

Answer and Explanation

Explanation

a. Hemostasis: Hemostasis refers to the process of stopping bleeding or preventing excessive blood loss. It involves several steps, including vasoconstriction, platelet aggregation, and clot formation. Hemostasis is the correct answer because it directly addresses the stopping of blood flow to protect the body from injury.

b. Thrombolytics: Thrombolytics are medications used to dissolve blood clots. They are not the natural mechanism for stopping blood flow. Thrombolytics are not the correct answer in this context.

c. Hematopoiesis: Hematopoiesis is the process of forming blood cells (including red blood cells, white blood cells, and platelets) in the bone marrow. It is essential for maintaining blood cell populations but does not directly stop blood flow. Hematopoiesis is not related to stopping blood flow.

d. Anticoagulation: Anticoagulation refers to preventing blood clot formation. While it is important for certain medical conditions, it does not directly stop blood flow. Anticoagulation is not the primary mechanism for stopping bleeding.

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ATI Pharmacology Quiz #1 25E

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