Pharmacology - Hematological Medications.txt

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bamaguh1988
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Pharmacology - Hematological Medications.txt
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2015-01-08 17:22:03
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  1. A client is prescribed a liquid iron preparation that has the potential to stain the teeth. The nurse should instruct the client to take which action to prevent staining of the teeth?
    1. Brush the teeth before drinking the iron.
    2. Drink the iron undiluted for maximal effect.
    3. Dilute more than the amount prescribed to obtain the correct dosage.
    4. Dilute the iron in juice, drink it through a straw, and rinse the mouth afterward.
    4. Dilute the iron in juice, drink it through a straw, and rinse the mouth afterward.
  2. Ticlopidine (Ticlid) is prescribed for a client. The nurse plans to take which action before implementing this medication therapy?
    1. Taking the client's blood pressure
    2. Obtaining a prothrombin time (PT)
    3. Taking the client's apical heart rate
    4. Reviewing the results of the complete blood cell (CBC) count
    4. Reviewing the results of the complete blood cell (CBC) count
  3. Ticlopidine (Ticlid) has been prescribed for a client with a diagnosis of thrombotic stroke. The nurse provides instructions to the client and spouse regarding the medication. Which statement, if made by the client, indicates that the client understands the use of this medication?
    1. "I'll take the medicine with meals."
    2. "If I do not feel well, I should skip the medication."
    3. "I won't have another stroke if I take this medicine faithfully."
    4. "If I have any gastrointestinal side effects, I should call the health care provider (HCP)."
    1. "I'll take the medicine with meals."
  4. The home care nurse is making a monthly visit to a client with a diagnosis of pernicious anemia who has been receiving a monthly injection of cyanocobalamin (vitamin B12). Before administering the injection, the nurse evaluates the effects of the medication and determines that a therapeutic effect is occurring if the client makes which statement?
    1. "I feel really lightheaded."
    2. "I no longer have any nausea."
    3. "I have not had any pain in a month."
    4. "I feel stronger and have a much better appetite."
    4. "I feel stronger and have a much better appetite."
  5. The nurse is providing dietary instructions to the client with anemia. The client tells the nurse that the iron pills are very expensive and it will be difficult to pay for the pills and buy the proper food. What is the most appropriate nursing response?
    1. "You will have to find a way to afford both."
    2. "You will be fine as long as you take the iron pills."
    3. "Why don't you ask your family to help you out financially?"
    4. "Would you like for me to check into some other options for you?"
    4. "Would you like for me to check into some other options for you?"
  6. The nurse provides instructions to a client who has a prescription for ticlopidine (Ticlid). Which statement, if made by the client, indicates a need for further teaching?
    1. "I'll take my medicine with meals."
    2. "Blood work will be done every 2 weeks for the first 3 months."
    3. "I should not stop the medication without talking to my health care provider (HCP) first."
    4. "Food will affect the medication, so I need to take the medication on an empty stomach."
    4. "Food will affect the medication, so I need to take the medication on an empty stomach."
  7. The nurse is reviewing the health care provider's (HCP) prescriptions for a client recently admitted to the hospital and notes that the HCP has prescribed ticlopidine (Ticlid) therapy. Which finding, if noted on the client's record, would indicate a need to contact the HCP before initiating the medication prescription?
    1. Neutropenia
    2. Client history of stroke
    3. Client history of hypertension
    4. Complaints of gastrointestinal disturbances
    1. Neutropenia
  8. The nurse is monitoring a client who is receiving epoetin alfa (Epogen, Procrit) for adverse effects of the medication. Which finding indicates an adverse effect?
    1. Diarrhea
    2. Depression
    3. Bradycardia
    4. Hypertension
    4. Hypertension
  9. The nurse is evaluating the results of laboratory studies for a client receiving epoetin alfa (Epogen, Procrit). When should the nurse expect to note a therapeutic effect of this medication?
    1. Immediately
    2. 3 days after therapy
    3. 2 weeks after therapy
    4. After 1 week of therapy
    3. 2 weeks after therapy
  10. A client with chronic kidney disease is receiving ferrous sulfate (Feosol). The nurse instructs the client that which finding is a common side effect associated with this medication?
    1. Fatigue
    2. Headache
    3. Weakness
    4. Constipation
    4. Constipation
  11. A client who is due for a dose of warfarin (Coumadin) has a prothrombin time (PT) of 28 seconds. After analyzing this test result, what should the nurse do?
    1. Give double the dose.
    2. Administer the next dose.
    3. Give half of the next dose.
    4. Call the health care provider (HCP).
    4. Call the health care provider (HCP).
  12. The nurse has a prescription to give heparin sodium 5000 units subcutaneously. The nurse should plan to take which action to administer this medication?
    1. Inject via an infusion device.
    2. Inject ½ inch from the umbilicus.
    3. Massage the injection site after administration.
    4. Change the needle after withdrawing the medication from the vial.
    4. Change the needle after withdrawing the medication from the vial.
  13. A decision has just been made to give tissue plasminogen activator (t-PA) (Activase) to a client. The nurse should obtain which supply for standard use as part of safe nursing care related to this medication?
    1. Flashlight
    2. Pulse oximeter
    3. Suction equipment
    4. Occult blood test strips
    4. Occult blood test strips
  14. A client is receiving heparin sodium by continuous intravenous (IV) infusion. The nurse should notify the health care provider if ongoing nursing assessment reveals which finding?
    1. Tinnitus
    2. Ecchymoses
    3. Increased pulse rate
    4. Increased blood pressure
    2. Ecchymoses
  15. A client is being discharged to home with enoxaparin (Lovenox) for short-term therapy. What should the nurse explain to the family about the medication action?
    1. Relieves joint pain
    2. Dissolves urinary calculi
    3. Stops progression of multiple sclerosis
    4. Reduces the risk of deep vein thrombosis
    4. Reduces the risk of deep vein thrombosis
  16. The nurse is monitoring the laboratory test results for a client who is taking warfarin sodium (Coumadin). The nurse should expect the prothrombin time (PT) for this client to be at what value?
    1. 8 seconds
    2. 12 seconds
    3. 15 seconds
    4. 20 seconds
    4. 20 seconds
  17. The nurse is reviewing the laboratory results for a client who arrives at the health care clinic for follow-up assessment after insertion of a mechanical prosthetic heart valve. The international normalized ratio (INR) is analyzed because the client has been taking warfarin sodium (Coumadin) since discharge from the hospital. The nurse determines that the INR range is at an appropriate level if what value is noted on the laboratory report?
    1. 2.0
    2. 2.3
    3. 3.0
    4. 5.0
    3. 3.0
  18. The nurse is preparing to administer filgrastim (Neupogen) to a client with a diagnosis of agranulocytosis. The client asks the nurse about the purpose of the medication. The nurse explains that this medication will have which action?
    1.  Prevent bleeding.
    2.  Prolong the clotting time.
    3.  Increase the red blood cell count.
    4.  Promote the growth of neutrophils.
    4. Promote the growth of neutrophils.
  19. A home care nurse is preparing to administer filgrastim (Neupogen) to a client. The nurse plans to administer the medication by which route?
    1. Oral
    2. Subcutaneous
    3. Intramuscular
    4. Intravenous bolus
    2. Subcutaneous
  20. The nurse is reviewing the laboratory test results for a client who is receiving filgrastim (Neupogen). Which reported value would indicate an effective response to this medication?
    1. Hematocrit of 42%
    2. Blood glucose level of 120 mg/dL
    3. Platelet count of 150,000 cells/mm3
    4. Neutrophil count of 10,000 cells/mm3
    4. Neutrophil count of 10,000 cells/mm3
  21. The nurse is preparing to administer filgrastim (Neupogen) by intravenous (IV) infusion. Which nursing action is appropriate for administering this medication?
    1. Shake the solution before drawing it up.
    2. Dilute the medication in normal (0.9%) saline.
    3. Discard the medication if it has been refrigerated.
    4. Dilute the medication in 5% dextrose in water (D5W).
    4. Dilute the medication in 5% dextrose in water (D5W).
  22. A client receiving heparin sodium by continuous intravenous (IV) infusion removes the tubing from the pump to change his hospital gown. The nurse is concerned that the client received a bolus of medication. After requesting a prescription for a stat partial thromboplastin time (PTT), the nurse should check for availability of which medication in the medication cart?
    1. Vitamin K
    2. Protamine sulfate
    3. Enoxaparin (Lovenox)
    4. Aminocaproic acid (Amicar)
    2. Protamine sulfate
  23. Enoxaparin sodium (Lovenox) is prescribed for a client after hip replacement surgery. What should the nurse prepare to have available in the event that an overdose of the medication occurs?
    1. Adrenalin
    2. Vitamin K
    3. Epinephrine
    4. Protamine sulfate
    4. Protamine sulfate
  24. A client with chronic kidney disease was started on epoetin alfa (Epogen, Procrit) 2 months earlier. In evaluating the therapeutic effectiveness of the medication, the nurse should expect the client to exhibit which finding?
    1. A decrease in blood pressure
    2. An increase in white blood cells
    3. An increase in serum hematocrit
    4. A decrease in serum creatinine levels
    3. An increase in serum hematocrit
  25. Epoetin alfa (Epogen, Procrit) has been prescribed for a client with chronic kidney disease who is being cared for by a nursing student. The nursing instructor determines that the student understands the procedure for administering the medication when the student states that which route of administration is acceptable?
    1. Oral
    2. Z-track
    3. Intramuscular
    4. Subcutaneous
    4. Subcutaneous
  26. A client with a subarachnoid hemorrhage needs to have surgery delayed until a stable clinical condition is achieved. The nurse prepares to administer which medication as prescribed to prevent clot breakdown and dissolution?
    1. Alteplase (Activase)
    2. Warfarin (Coumadin)
    3. Heparin sodium (Heparin)
    4. Aminocaproic acid (Amicar)
    4. Aminocaproic acid (Amicar)
  27. When administering a subcutaneous injection of heparin sodium, the nurse should perform which action?
    1. Apply heat after the injection.
    2. Use a 21- to 23-gauge, 1-inch needle.
    3. Use a 25- to 26-gauge, ⅝-inch needle.
    4. Aspirate before injection of the medication.
    3. Use a 25- to 26-gauge, ⅝-inch needle.
  28. A client is admitted to the hospital with a diagnosis of myocardial infarction (MI). The client is started on streptokinase (Streptase) therapy. The nurse determines that teaching has been effective when the client's wife states that the purpose of the medication is to perform which action?
    1. Thin the blood.
    2. Slow the clotting of the blood.
    3. Dissolve any clots in the coronary arteries.
    4. Prevent further clots from forming in the coronary arteries.
    3. Dissolve any clots in the coronary arteries.
  29. A client is admitted to the hospital emergency department with an acute anterior wall myocardial infarction. The nurse discusses streptokinase (Streptase) therapy with the client and spouse. The spouse is concerned about the dangers of this treatment. Which statement by the nurse is appropriate?
    1. "There is no reason to worry. We use this medication all the time."
    2. "I'm certain you made the correct decision to use this medication."
    3. "You have concerns about whether this treatment is the best option."
    4. "Your loved one is very ill. The health care provider has made the best decision for you."
    3. "You have concerns about whether this treatment is the best option."
  30. The nurse has given the client with atrial fibrillation instructions to take one aspirin daily. The client says to the nurse, "Why do I need to take this? I don't get any pain with my heart rhythm." The nurse should make which response?
    1. "This will keep you from experiencing chest pain."
    2. "This will most likely keep you from ever having a heart attack."
    3. "This will prevent any inflammation from occurring on the walls of your heart."
    4. "This will help prevent clot formation in your heart as a result of your heart's rhythm."
    4. "This will help prevent clot formation in your heart as a result of your heart's rhythm."
  31. A client has a prescription to receive enoxaparin (Lovenox). The nurse should plan to administer this medication by which route?
    1. Oral
    2. Intravenous
    3. Intramuscular
    4. Subcutaneous
    4. Subcutaneous
  32. The nurse is providing discharge instructions to a client taking warfarin sodium (Coumadin). Which statement, based on health care provider (HCP) permission, is appropriate to include in client teaching for this medication?
    1. "Tylenol, rather than aspirin, needs to be taken for headache."
    2. "Alcohol can be consumed so long as it is in small amounts."
    3. "It doesn't matter what time the daily dose is taken so long as it is taken each day."
    4. "It is all right to take over-the-counter medications so long as they do not contain vitamin K."
    1. "Tylenol, rather than aspirin, needs to be taken for headache."
  33. A health care provider in the emergency department prescribes a thrombolytic medication for a client with an acute ischemic stroke. His wife asks the nurse how the medication works. How should the nurse respond about how the medication will work?
    1. Dissolve clots.
    2. Prevent ischemia.
    3. Prevent bleeding.
    4. Decrease the client's anxiety.
    1. Dissolve clots.
  34. A client admitted to the hospital with a diagnosis of myocardial infarction is about to be started on alteplase (Activase), also known as tissue plasminogen activator (TPA). In reinforcing health care provider explanations of the medication, what should the nurse tell the client and his wife that this medication will do?
    1. Slow the clotting of the blood.
    2. Keep the blood thin to prevent clotting.
    3. Dissolve any clots that are obstructing the coronary arteries.
    4. Prevent any further clots from forming anywhere in the body.
    3. Dissolve any clots that are obstructing the coronary arteries.
  35. A client is diagnosed with iron deficiency anemia, and ferrous sulfate (Feosol) is prescribed. The nurse should tell the client that it would be best to take the medication with which food?
    1. Milk
    2. Boiled egg
    3. Tomato juice
    4. Pineapple juice
    3. Tomato juice
  36. A home care nurse is visiting a client who was discharged to home with a prescription for continued administration of enoxaparin (Lovenox) subcutaneously. What is the nurse's priority assessment for this client?
    1. Constipation
    2. Fear of needles
    3. Nausea or vomiting
    4. Bleeding gums or bruising
    4. Bleeding gums or bruising
  37. The nurse is caring for a postpartum client with a diagnosis of deep vein thrombosis who is receiving a continuous intravenous infusion of heparin sodium. Which laboratory result will the nurse specifically review to determine whether an appropriate dose of heparin is being delivered?
    1. Platelet count
    2. Prothrombin time (PT)
    3. International normalized ratio (INR)
    4. Activated partial thromboplastin time (aPPT)
    4. Activated partial thromboplastin time (aPPT)
  38. The nurse is assigned to care for a client who was just admitted to the hospital for the treatment of iron overload. The nurse anticipates that the health care provider will prescribe which medication to treat the iron overload?
    1. Granisetron
    2. Ketoconazole
    3. Deferoxamine
    4. Terbinafine (Lamisil)
    3. Deferoxamine
  39. Epoetin alfa (Epogen, Procrit) by the subcutaneous route is prescribed for a client. Which is the correct action for the nurse to implement?
    1. Shake the vial before use.
    2. Freeze the medication before use.
    3. Refrigerate the medication until used.
    4. Obtain syringes with 1½-inch needles from the pharmacy.
    3. Refrigerate the medication until used.
  40. In a client receiving heparin, which laboratory finding should be the cause for greatest concern?
    1. Platelet count of 100,000 cells/mm3
    2. International normalized ratio of 1.2
    3. Red blood cell count of 4.2 million cells/mm3
    4. Activated partial thromboplastin time (aPTT) of 60 seconds
    1. Platelet count of 100,000 cells/mm3
  41. The nurse medicates a client with phytonadione (vitamin K). The nurse should assess which laboratory value 24 hours after administering vitamin K?
    1. Prothrombin time
    2. Blood ammonia level
    3. Direct serum bilirubin
    4. Serum potassium level
    1. Prothrombin time
  42. A nurse provides dietary instructions to a client who will be taking warfarin sodium (Coumadin). The nurse should tell the client to avoid which food item?
    1. Grapes
    2. Spinach
    3. Watermelon
    4. Cottage cheese
    2. Spinach
  43. A client is taking ticlopidine hydrochloride (Ticlid). The nurse should tell the client to avoid which substance while taking this medication?
    1. Vitamin C
    2. Vitamin D
    3. Acetaminophen (Tylenol)
    4. Acetylsalicylic acid (aspirin)
    4. Acetylsalicylic acid (aspirin)
  44. The nurse is providing instructions to the parent of a child with iron deficiency anemia about the administration of a liquid oral iron supplement. Which statement, if made by the parent, indicates an understanding of the administration of this medication?
    1. "I should give the iron with food."
    2. "I can mix the iron with cereal to give it."
    3. "I should add the iron to the formula in the baby's bottle."
    4. "I should use a medicine dropper and place the iron near the back of the throat."
    4. "I should use a medicine dropper and place the iron near the back of the throat."
  45. A client having a myocardial infarction is receiving alteplase (Activase) therapy. Which action should be carried out by the nurse to monitor for the most frequent adverse effect?
    1. Check for signs of bleeding.
    2. Assess for allergic reaction.
    3. Evaluate the client for muscle weakness.
    4. Monitor for signs and symptoms of infection.
    1. Check for signs of bleeding.
  46. The client in chronic kidney disease is receiving epoetin alfa (Epogen). The nurse should monitor this client for which adverse effect of this medication?
    1. Fever
    2. Depression
    3. Bradycardia
    4. Hypertension
    4. Hypertension
  47. A nurse has provided discharge instructions to a client being placed on long-term anticoagulant therapy with warfarin (Coumadin). Adequate learning would be evident if the client makes which statements? Select all that apply.
    1. "I will inform my dentist that I am taking Coumadin."
    2. "I may take over-the-counter medications as needed."
    3. "I should alternate the timing of my daily dose of Coumadin."
    4. "I should use a firm-bristled toothbrush to prevent the side effects of Coumadin."
    5. "I will have my blood levels checked as prescribed by my health care provider (HCP)."
    6. "I will report any signs of blood in my urine or stool to my health care provider (HCP)."
    • 1. "I will inform my dentist that I am taking Coumadin."
    • 5. "I will have my blood levels checked as prescribed by my health care provider (HCP)."
    • 6. "I will report any signs of blood in my urine or stool to my health care provider (HCP)."
  48. A nurse has a prescription to administer a dose of iron by a parenteral route to an assigned client. Which would the nurse implement to administer this medication correctly via the intramuscular route? Select all that apply.
    1. Use a Z-track method.
    2. Administer the medication only in the deltoid.
    3. Aspirate for blood after the needle is inserted.
    4. Use an air lock when drawing up the medication.
    5. Change the needle after drawing up the dose and before injection.
    6. Massage the injection site well after injection to hasten absorption.
    • 1. Use a Z-track method.
    • 3. Aspirate for blood after the needle is inserted.
    • 4. Use an air lock when drawing up the medication.
    • 5. Change the needle after drawing up the dose and before injection.

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