NUR 140 Chapter 26 Evolve Questions and Correct Answers
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Course
NUR 140
Institution
NUR 140
The nurse would assess which laboratory value to determine the effectiveness of intravenous heparin (Hemochron)? A. Complete blood count B. Activated partial thromboplastin time (aPTT) C. Blood urea nitrogen D. Prothrombin time (PT) B. Activated partial thromboplastin time (aPTT)
Rationale: Hepari...
NUR 140 Chapter 26 Evolve Questions
and Correct Answers
The nurse would assess which laboratory value to determine the effectiveness of
intravenous heparin (Hemochron)?
A. Complete blood count
B. Activated partial thromboplastin time (aPTT)
C. Blood urea nitrogen
D. Prothrombin time (PT) ✅B. Activated partial thromboplastin time (aPTT)
Rationale: Heparin dosing is based on aPTT results. The PT is reflective of warfarin's
anticoagulant effect.
The nurse is caring for a patient admitted with gastrointestinal bleeding who is
anticoagulated with warfarin (Coumadin). Which medication should the nurse anticipate
administering?
A. Vitamin E
B. Vitamin K (Phytonadione)
C. Protamine (Protamine sulfate)
D. Calcium gluconate ✅B. Vitamin K (Phytonadione)
Rationale: Vitamin K is the antagonist for warfarin.
The nurse notes a patient's international normalized ratio (INR) value of 2.5. What is the
meaning of this reported value?
A. The patient's warfarin dose is within the therapeutic range.
B. The patient needs the subcutaneous heparin dose increased.
C. The patient is not receiving enough warfarin for a therapeutic effect.
D. The patient is receiving too much heparin and is at risk for bleeding. ✅A. The
patient's warfarin dose is within the therapeutic range.
Rationale: INR determination is a routine test to evaluate coagulation while patients are
taking warfarin, not heparin. A therapeutic INR is 2 to 3.
The nurse is giving discharge instructions to a patient prescribed warfarin (Coumadin)
for atrial fibrillation. Which statement by the patient indicates a need for further
instruction from the nurse?
A. "I will take my medication in the early evening each day."
B. "I will contact my health care provider if I develop excessive bruising."
C. "I will increase the dark green leafy vegetables in my diet."
D. "I will avoid activities that have a risk for injury such as contact sports." ✅C. "I will
increase the dark green leafy vegetables in my diet."
, Rationale: Dark green leafy vegetables are rich in vitamin K, which would antagonize
the effects of warfarin. Therefore, it is important to maintain a consistent daily intake of
vitamin K and avoid eating large amounts of these foods.
Which medication is an antiplatelet drug?
A. Clopidogrel (Plavix)
B. Alteplase (Activase)
C. Enoxaparin (Lovenox)
D. Heparin (Hemochron) ✅A. Clopidogrel (Plavix)
Rationale: Clopidogrel (Plavix) is an antiplatelet drug. Enoxaparin and heparin are
anticoagulants. Alteplase is a thrombolytic drug.
The nurse is preparing a patient with acute chest pain for an emergency angioplasty.
The nurse would anticipate administering which medication to prevent platelet
aggregation?
A. Warfarin (Coumadin)
B. Aminocaproic acid (Amicar)
C. Protamine (Protamine sulfate)
D. Tirofiban (Aggrastat) ✅D. Tirofiban (Aggrastat)
Rationale: Tirofiban is a glycoprotein IIb/IIIa inhibitor that blocks the enzyme essential
for platelet aggregation. This is given to prevent the formation of further clots and is
faster acting than warfarin. Protamine sulfate is the antagonist for heparin, not an
anticoagulant. Aminocaproic acid is an antifibrinolytic, the opposite of what is needed in
this situation.
Enoxaparin sodium (Lovenox) is an anticoagulant used to prevent and treat deep vein
thrombosis and pulmonary embolism. This medication is in which drug class?
A. Oral anticoagulant
B. Glycoprotein IIb/IIIa inhibitor
C. Low-molecular-weight heparin
D. Thrombolytic drug ✅C. Low-molecular-weight heparin
Rationale: Enoxaparin is a low-molecular-weight heparin.
The patient asks the nurse, "What is the difference between dalteparin (Fragmin) and
heparin?" What is the nurse's best response?
A. "Dalteparin is a low-molecular-weight heparin that has a more predictable
anticoagulant effect."
B. "The only difference is that the heparin dosage calculation is based on the patient's
weight."
C. "There is really no difference, but dalteparin is preferred because it is less
expensive."
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