Question 1

Too much clotting can be just as deadly as too little.

Accepted Answer

A) True 
 B)False  True

Question 2

Why is heparin started in the hospital after an MI yet the patient goes home on warfarin?

Accepted Answer

Heparin interferes with the formation of thrombin, which is needed to change fibrinogen into the fibrin strands necessary to make a clot. Therefore, the patient who has had an emboli will produce less emboli. Warfarin takes a few days to work as it works on prothrombin formation, which is already circulating in the blood and it will take a few days to affect the production. It too is an anticoagulant that will lead to less clots or emboli, and thereby less events in the future. Also, heparin is injectable only while warfarin is oral tablets, making it easier for the patient to use at home.

Question 3

Heparin works on thrombin while warfarin works on prothrombin formation, which is why warfarin works immediately.

Accepted Answer

A) True 
 B)False  False

Question 4

Patients on warfarin should not eat large or inconsistent amounts of foods high in vitamin K (e.g., broccoli) because it interferes with clotting time.

Accepted Answer

A) True 
 B)False

Question 5

Taking into account the steps to achieve fibrinolysis, indicate where/how antifibrinolytics and thrombolytics work.

Accepted Answer

FIBRINOLYSIS: clot is formed --> release

Question 6

A clot within an artery that blocks blood flow to the brain is called:

Accepted Answer

A)  Myocardial infarction 
B)  Deep vein thrombosis 
C)  Cerebrovascular accident (CV
A) /stroke 
D)  Deep vein thrombosis (DVT) 
A)  Myocardial infarction 
B)  Deep vein thrombosis 
C)  Cerebrovascular accident (CV
A) /stroke 
D)  Deep vein thrombosis (DVT)

Question 7

What happens in the coagulation cascade when prothrombinase is activated after an injury?

Accepted Answer

A)  Fibrinogen changes to fibrin 
B)  Prothrombin changes to thrombin 
C)  Plasminogen changes to plasmin 
D)  Thrombin changes to prothrombin 
A)  Fibrinogen changes to fibrin 
B)  Prothrombin changes to thrombin 
C)  Plasminogen changes to plasmin 
D)  Thrombin changes to prothrombin

Question 8

Why is hemostasis important? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

A)  To protect the body from both external and internal injuries 
B)  To prevent shock and death due to bleeding from wounds 
C)  To maintain a delicate balance between blood fluidity and coagulation 
D)  To maintain body temperature in times of stress 
A)  To protect the body from both external and internal injuries 
B)  To prevent shock and death due to bleeding from wounds 
C)  To maintain a delicate balance between blood fluidity and coagulation 
D)  To maintain body temperature in times of stress

Question 9

The therapeutic effect of thrombolytics is greater when they are administered as soon as possible after clot formation occurs, preferably within 48 hours.

Accepted Answer

A) True 
 B)False

Question 10

A patient has been prescribed an antiplatelet drug, and asks the pharmacist to explain why this medication has been prescribed. Which response by the pharmacist is the most appropriate?

Accepted Answer

A)  "These medications are used to dissolve such life-threatening clots." 
B)  "These medications are used to prevent clot formation in arteries." 
C)  "These medications are used to prevent the formation of clots." 
D)  "These medications inhibit the normal removal of fibrin, thus keeping the clot in place for a longer period of time." 
A)  "These medications are used to dissolve such life-threatening clots." 
B)  "These medications are used to prevent clot formation in arteries." 
C)  "These medications are used to prevent the formation of clots." 
D)  "These medications inhibit the normal removal of fibrin, thus keeping the clot in place for a longer period of time."

Question 11

Thrombin causes the change of plasminogen to plasmin, which causes the formation of fibrin strands and a clot.

Accepted Answer

A) True 
 B)False

Question 12

A patient has been prescribed clopidogrel. The pharmacist instructs the patient that which types of drugs can increase the risk for bleeding? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

A)  Anticoagulants 
B)  Ibuprofen 
C)  Thrombolytic agents 
D)  Some antibiotics 
E)  Aspirin 
A)  Anticoagulants 
B)  Ibuprofen 
C)  Thrombolytic agents 
D)  Some antibiotics 
E)  Aspirin

Question 13

What is the rationale for a doctor prescribing a daily dosage of baby aspirin for a client with thromboembolic disease?

Accepted Answer

Aspirin is an anticoagulant (reduce bloo

Question 14

A patient has been prescribed a subcutaneous anticoagulant. Which anticoagulant can the nurse administer subcutaneously? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

A)  Lepirudin 
B)  Dalteparin 
C)  Enoxaparin 
D)  Warfarin 
E)  Insulin 
A)  Lepirudin 
B)  Dalteparin 
C)  Enoxaparin 
D)  Warfarin 
E)  Insulin

Question 15

What are the primary subclasses of antiplatelet agents? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

A)  Thrombolytics 
B)  Aspirin (AS
A)  
C)  Adenosine diphosphate (ADP) receptor blockers 
D)  Glycoprotein IIb/IIIa receptor blockers 
E)  Antipyretic agents 
A)  Thrombolytics 
B)  Aspirin (AS
A)  
C)  Adenosine diphosphate (ADP) receptor blockers 
D)  Glycoprotein IIb/IIIa receptor blockers 
E)  Antipyretic agents

Question 16

An embolism is a thrombus or clot which has moved from its origin.

Accepted Answer

A) True 
 B)False

Exam 15: Drugs for Coagulation Disorders

Too much clotting can be just as deadly as too little.

Why is heparin started in the hospital after an MI yet the patient goes home on warfarin?

Heparin works on thrombin while warfarin works on prothrombin formation, which is why warfarin works immediately.

Patients on warfarin should not eat large or inconsistent amounts of foods high in vitamin K (e.g., broccoli) because it interferes with clotting time.

Taking into account the steps to achieve fibrinolysis, indicate where/how antifibrinolytics and thrombolytics work.

A clot within an artery that blocks blood flow to the brain is called:

What happens in the coagulation cascade when prothrombinase is activated after an injury?

Why is hemostasis important? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

The therapeutic effect of thrombolytics is greater when they are administered as soon as possible after clot formation occurs, preferably within 48 hours.

A patient has been prescribed an antiplatelet drug, and asks the pharmacist to explain why this medication has been prescribed. Which response by the pharmacist is the most appropriate?

Thrombin causes the change of plasminogen to plasmin, which causes the formation of fibrin strands and a clot.

A patient has been prescribed clopidogrel. The pharmacist instructs the patient that which types of drugs can increase the risk for bleeding? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

What is the rationale for a doctor prescribing a daily dosage of baby aspirin for a client with thromboembolic disease?

A patient has been prescribed a subcutaneous anticoagulant. Which anticoagulant can the nurse administer subcutaneously? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

What are the primary subclasses of antiplatelet agents? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

An embolism is a thrombus or clot which has moved from its origin.

The Practice of Pharmacy

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