Test Bank for Introductory
Clinical Pharmacology 12th
Edition by Susan M Ford
Chapter 36-40
C HAPTER 36: A NTICOAGULANT AND
T HROMBOLYTIC D RUGS
Ford: Introductory Clinical Pharmacology 12th Edition
Multiple Choice
1. The nurse is preparing to administer protamine emergentl y to a client per
instructions from the health care provider. The nurse concludes this is necessary
due to an adverse reaction to which drug?
A) Clopidogrel
B) Heparin
C) Alteplase
D) Warfarin
Answer: B
Rationale: An overdosage of any anticoagulant may result in uncontrolled
bleeding in the client. In most cases, discontinuation of the drug is usua ll y
sufficient to correct overdosage; however, if the bleeding is severe there are
antidotes. Protamine is used to treat overdose of heparin and low – molecular-
, weight heparins (LMWHs). Vitamin K is used to treat the overdosage of
warfarin. Alteplase and cl opidogrel do not require antidotes.
Question format: Multiple Choice
Chapter: 36
Learning Objective: 2
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Pharmacological Therapies
Integrated Process: Clinical Problem -solving Process (Nursi ng Process)
Reference: p. 468, Parenteral Anticoagulants
2. A nurse is conducting a seminar on thrombosis. The nurse should point out that
arterial thrombus can occur related to which situation?
A) Decreased blood flow
B) Injury to the vessel wall
C) Arrhythmias
D) Altered blood coagulation
Answer: C
Rationale: The nurse should mention that arterial thrombosis is caused by
atherosclerosis and arrhythmias. Decreased blood flow, injury to the vessel
wall, and altered blood flow are causes of venous thr ombosis.
Question format: Multiple Choice
Chapter: 36
Learning Objective: 1 Cognitive
Level: Understand
Client Needs: Physiological Integrit y: Physiological Adaptation
Integrated Process: Teaching/Learning
Reference: p. 3, Introduction
3. A client with intermittent claudication is prescribed cilostazol by the primary
health care provider. The nurse will administer this drug cautiousl y if the
client's history reveals which disorder?
, A) Intermittent claudication
B) Pulmonary emboli
C) M yocardial infarction
D) Pancytopenia
Answer: D
Rationale: The nurse should administer cilostazol with caution to clients with
pancytopenia. Anticoagulants are used for the prevention and treatment of
pulmonary emboli, the adjuvant treatment of m yocardial infarction, and the
treatment of intermittent cl audication.
Question format: Multiple Choice
Chapter: 36
Learning Objective: 2
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Reduction of Risk Potential
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 462, Actions and Uses
4. A client is prescribed warfarin. The client also takes a diuretic for the treatment
of cardiac problems. The nurse will monitor the client for which potential
interaction?
A) Decreased effectiveness of the anticoagulant
B) Increased effectiveness of the diuretic
C) Increased absorption of the anticoagulant
D) Increased absorption of the diuretic
Answer: A
Rationale: The nurse should monitor for decreased effectiveness of warfarin
as an effect of the interaction between the anticoagu lant and the diuretic. The
nurse need not monitor for the increased effectiveness of the diuretic, the
increased absorption of the anticoagulant, or the increased absorption of the
diuretic in the client.
Question format: Multiple Choice
, Chapter: 36
Learning Objective: 2
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Pharmacological Therapies
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 461, Precautions
5. The nurse is monitoring a client who is receiving heparin by continuous IV
infusion. Which action should the nurse prioritize?
A) Perform a complete blood count.
B) Perform baseline PT/INR.
C) Perform aPTT test 4 –6 hours after injection.
D) Perform blood coagulati on tests every 4 hours.
Answer: D
Rationale: The nurse should perform blood coagulation tests every 4 hours
for the client receiving heparin by continuous IV infusion. A blood count test
or the baseline PT/ INR test is not the right intervention for thi s client. When
administering heparin by the subcutaneous route, an aPTT test is performed
4–6 hours after the injection.
Question format: Multiple Choice
Chapter: 36
Learning Objective: 3
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: P harmacological Therapies
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 464, Ongoing Assessment
6. A nurse is preparing to administer the first dose of warfarin to a client. Which
assessment should the nurse prioritize for this client?
A) Observe for signs of thrombus formation.
B) Assess PT and INR.
C) Assess for signs of bleeding.
Clinical Pharmacology 12th
Edition by Susan M Ford
Chapter 36-40
C HAPTER 36: A NTICOAGULANT AND
T HROMBOLYTIC D RUGS
Ford: Introductory Clinical Pharmacology 12th Edition
Multiple Choice
1. The nurse is preparing to administer protamine emergentl y to a client per
instructions from the health care provider. The nurse concludes this is necessary
due to an adverse reaction to which drug?
A) Clopidogrel
B) Heparin
C) Alteplase
D) Warfarin
Answer: B
Rationale: An overdosage of any anticoagulant may result in uncontrolled
bleeding in the client. In most cases, discontinuation of the drug is usua ll y
sufficient to correct overdosage; however, if the bleeding is severe there are
antidotes. Protamine is used to treat overdose of heparin and low – molecular-
, weight heparins (LMWHs). Vitamin K is used to treat the overdosage of
warfarin. Alteplase and cl opidogrel do not require antidotes.
Question format: Multiple Choice
Chapter: 36
Learning Objective: 2
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Pharmacological Therapies
Integrated Process: Clinical Problem -solving Process (Nursi ng Process)
Reference: p. 468, Parenteral Anticoagulants
2. A nurse is conducting a seminar on thrombosis. The nurse should point out that
arterial thrombus can occur related to which situation?
A) Decreased blood flow
B) Injury to the vessel wall
C) Arrhythmias
D) Altered blood coagulation
Answer: C
Rationale: The nurse should mention that arterial thrombosis is caused by
atherosclerosis and arrhythmias. Decreased blood flow, injury to the vessel
wall, and altered blood flow are causes of venous thr ombosis.
Question format: Multiple Choice
Chapter: 36
Learning Objective: 1 Cognitive
Level: Understand
Client Needs: Physiological Integrit y: Physiological Adaptation
Integrated Process: Teaching/Learning
Reference: p. 3, Introduction
3. A client with intermittent claudication is prescribed cilostazol by the primary
health care provider. The nurse will administer this drug cautiousl y if the
client's history reveals which disorder?
, A) Intermittent claudication
B) Pulmonary emboli
C) M yocardial infarction
D) Pancytopenia
Answer: D
Rationale: The nurse should administer cilostazol with caution to clients with
pancytopenia. Anticoagulants are used for the prevention and treatment of
pulmonary emboli, the adjuvant treatment of m yocardial infarction, and the
treatment of intermittent cl audication.
Question format: Multiple Choice
Chapter: 36
Learning Objective: 2
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Reduction of Risk Potential
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 462, Actions and Uses
4. A client is prescribed warfarin. The client also takes a diuretic for the treatment
of cardiac problems. The nurse will monitor the client for which potential
interaction?
A) Decreased effectiveness of the anticoagulant
B) Increased effectiveness of the diuretic
C) Increased absorption of the anticoagulant
D) Increased absorption of the diuretic
Answer: A
Rationale: The nurse should monitor for decreased effectiveness of warfarin
as an effect of the interaction between the anticoagu lant and the diuretic. The
nurse need not monitor for the increased effectiveness of the diuretic, the
increased absorption of the anticoagulant, or the increased absorption of the
diuretic in the client.
Question format: Multiple Choice
, Chapter: 36
Learning Objective: 2
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Pharmacological Therapies
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 461, Precautions
5. The nurse is monitoring a client who is receiving heparin by continuous IV
infusion. Which action should the nurse prioritize?
A) Perform a complete blood count.
B) Perform baseline PT/INR.
C) Perform aPTT test 4 –6 hours after injection.
D) Perform blood coagulati on tests every 4 hours.
Answer: D
Rationale: The nurse should perform blood coagulation tests every 4 hours
for the client receiving heparin by continuous IV infusion. A blood count test
or the baseline PT/ INR test is not the right intervention for thi s client. When
administering heparin by the subcutaneous route, an aPTT test is performed
4–6 hours after the injection.
Question format: Multiple Choice
Chapter: 36
Learning Objective: 3
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: P harmacological Therapies
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 464, Ongoing Assessment
6. A nurse is preparing to administer the first dose of warfarin to a client. Which
assessment should the nurse prioritize for this client?
A) Observe for signs of thrombus formation.
B) Assess PT and INR.
C) Assess for signs of bleeding.
