Hematologic Pharmacology – Flashcards
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You are caring for a patient who is taking warfarin (Coumadin) to prevent venous thrombosis. You should explain that taking the drug requires daily blood samples to monitor of which of the following laboratory tests? A) Fibrinogen B) PT/INR C) Platelets D) aPTT
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B) PT/INR
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You are caring for a patient who is receiving alteplase (Activase) to dissolve a thrombus. Which of the following should you include in the care plan for the patient? (Select all that apply) A) Monitor BP B) Reposition frequently C) Limit venipunctures D) Check level of consciousness E) Apply pressure to oozing sites
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A, C, D, E
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You are caring for a patient who is about to begin taking clopidogrel (Plavix) to prevent transient ischemic attacks. You should tell the patient to report which of the following adverse effects? (Select all that apply) A) Petechiae B) Tinnitus C) Diaphoresis D) Weakness E) Vision changes
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A, D, E
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You are caring for a patient who is about to begin taking oprelvekin (Neumega) for thrombocytopenia. To evaluate the potential for adverse effects, you should monitor which of the following during drug therapy? A) Liver function B) Hearing C) ECG D) Level of consciousness
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C) ECG
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A healthcare professional is caring for a patient who is about to begin taking epoetin alfa (Epogen). Which of the following laboratory values should increase with effective therapy? A) PT B) WBC C) Hgb D) Platelets
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C) Hgb
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A healthcare professional is caring for a patient who is about to begin taking oprelvekin (Neumega) to treat thrombocytopenia. The healthcare professional should tell the patient to report which of the following indications as an adverse reaction? (Select all that apply) A) Conjunctivitis B) Tinnitus C) Swollen ankles D) Jaundice E) Palpitations
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A, C, E
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A patient who is taking ferrous sulfate (Feosol) to treat iron-deficiency anemia develops severe nausea and vomiting due to iron toxicity. Which of the following drugs should the health care professional use to treat this complication? A) Flumazenil (Mazicon) B) Acetylcysteine (Acetadote) C) Naloxone D) Deferoxamine (Desferal)
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D) Deferoxamine (Desferal)
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A patient who is taking warfarin (Coumadin) arrives at the emergency department and reports rectal bleeding. Which of the following drugs should the health care professional have available? A) Filgrastin (Neuopogen) B) Deferoxamine (Desferal) C) Protamine D) Vitamin K
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D) Vitamin K
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A health care professional should assess a patient who has megalobastic anemia for indications of which of the following vitamin deficiencies? A) Vitamin B12 B) Vitamin K C) Vitamin C D) Vitamin D
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A) Vitamin B12
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A healthcare professional is caring for a patient who is about to begin taking clopidogrel (Plavix) to prevent thrombus formation. The healthcare professional should question the use of clopidogrel by a patient who has which of the following? A) Myocardial infarction B) Peptic ulcer disease C) Pancreatitis D) Myasthenia gravis
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B) Peptic ulcer disease
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A healthcare professional is caring for a patient who is about to begin taking warfarin (Coumadin). The health care professional should caution the patient about taking which of the following OTC drugs? A) Diphenhydramine B) Dimenhydrinate (Dramamine) C) Calcium carbonate (Tums) D) Ibuprofen (Motrin)
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D) Ibuprofen (Motrin)
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A healthcare professional administers epoetin alfa (Epogen) subcutaneously to a patient who has renal failure. The health care professional should monitor the patient for which of the following adverse effects? A) HTN B) Muscle pain C) Edema D) Dry mouth
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A) HTN
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A healthcare professional is caring for a patient who is about to begin taking folic acid to treat megaloblastic anemia. The health care professional should monitor which of the following laboratory values? A) Amylase level B) Reticulocyte count C) C-reactive protein D) Creatinine clearance
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B) Reticulocyte count
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A healthcare professional is caring for a patient who is undergoing bone marrow transplantation following high-dose chemotherapy. Which of the following drugs should the healthcare professional expect the primary care provider to prescribe to reduce the patient's risk of infection? A) Epoetin alfa (Erythropoietin) B) Oprelvekin (Neuomega) C) Filgrastim (Neuopogen) D) Alteplase (Activase)
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C) Filgrastim (Neuopogen)
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A healthcare professional is caring for a patient who has a known sensitivity to E-Coli derived proteins. This sensitivity is a contraindication for which of the following drugs? A) Epoetin alfa (Erythropoietin) B) Oprelvekin (Neumega) C) Filgrastim (Neuopogen) D) Alteplase (Activase)
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C) Filgrastim (Neuopogen)
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A healthcare professional is administering epoetin alfa (Epogen) subcutaneously to a patient who has renal failure. The health care professional should take which of the following actions? A) Shake the vial before using B) Insert the needle into the vial once C) Dilute the drug first with normal saline D) Save the used vial for the next dose
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B) Insert the needle into the vial once
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A health care professional is caring for a patient who is about to begin taking alteplase (Activase) to treat acute myocardial infaraction. The health care professional should understand the drug is most effective when the patient receives it A) 24 hour clot formation B) after initation of anticoagulation C) prior to clot formation D) within 3 hours of symptom onset
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D) within 3 hours of symptom onset
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A health care professional is caring for a patient who is about to begin factor VIII (Advate) therapy to treat hemophilia A. When administering factor VIII, which of the following actions should the health care professional take? A) Have emergency equipment ready B) Premedicate with aspirin (Ecotrin) C) Administer via rapid bolus D) Administer the powdered form orally
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A) Have emergency equipment ready
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A healthcare professional is caring for a patient who is about to begin taking filgrastim (Neuopogen) to treat neutropenia. The healthcare professional should assess the patient for which of the following adverse effects? A) Dusky nail beds B) Petechiae C) Enlarged spleen D) Swollen calf
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C) Enlarged spleen
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A healthcare professional is caring for a patient who is about to begin taking clopidogrel (Plavix) to prevent stent stenosis. The healthcare professional should monitor the patient for which of the following adverse effects? A) Thrombocytopenia B) Hyponatremia C) Lymphocytopenia D) Uricemia
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A) Thrombocytopenia
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A health care professional is caring for a patient who has mild hemophila A and is about to begin taking desmopressin (DDAVP) to prevent bleeding. The health care professional should monitor for which of the following adverse reactions? A) Weight loss B) Edema C) Polyuria D) Tachycardia
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B) Edema
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A healthcare professional is caring for a patient who is about to begin alteplase (Activase) therapy to treat pulmonary embolism. Which of the following drugs should the health care professional have available in the event of a severe adverse reaction? A) Vitamin K B) Aminocaproic acid (Amicar) C) Protamine D) Deferoxamine (Desferal)
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B) Aminocaproic acid (Amicar)
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A healthcare professional is caring for a patient who is about to begin taking aspirin (Ecotrin) to reduce the risk of cardiovascular event. The health care professional should understand that the drug inhibits platelet aggregation by which of the following mechanisms? A) Activating thromboxane A2 B) Blocking adenosin diphosphate receptor agnoists C) Suppressing specific clotting factors D) Inhibiting cyclooxygenase action in platelets
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D) Inhibiting cyclooxygenase action in platelets
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A health care professional is caring for a patient who is about to begin taking oprelvekin (Neumega). The health care professional should explain to the patient that the drug has which of the following effects? A) Stimulates leukocyte maturation B) Causes myelosuppression C) Increases platelet production D) Destroys blood clots
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C) Increases platelet production
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A health care professional is preparing to administer the prescribed dose of filgrastim (Neupogen) to a patient. The patient's laboratory results indicate that the patient has a WBC count of 12,000/mm3. Which of the following action should the health care professional take? A) Clarify the prescription with the provider B) Administer the drug with an analgesic C) Limit venipunctures D) Assess breath sounds
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A) Clarify the prescription with the provider
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A health care professional is caring for a patient who is about to begin taking ferrous sulfate (Feosol) to treat iron-deficiency anemia. When talking with the patient about the drug, the healthcare professional should include which of the following instructions? (Select all that apply) A) Eat iron-enriched foods B) Spread the dosage across each day C) Take the drug on an empty stomach D) Report dark green or black stools E) Increase dietary fiber intake
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A, B, C, E
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A health care professional is caring for a patient who is about to begin iron dextran (INFeD) therapy. When administering the drug IM, the health care professional should take which of the following actions? (Select all that apply) A) Administer a test dose B) Monitor BP C) Have epinephrine available D) Predicate with atropine E) Use the Z-track technique
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A, B, C, E
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A patient is about to begin therapy with recombinate factor IX (BeneFix) to treat hemophilia B. The patient asks the health care professional about the risk of disease transmission with recombinant factor IX, as compared with plasma-derived factor IX. The health care professional should explain that recombinant factor IX eliminates the risk for which of the following? A) HIV B) Cytomegalovirus C) Creutzfeldt-Jakob disease D) Anaphylasix
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C) Creutzfeldt-Jakob disease
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A health care professional is caring for a patient who is about to begin alteplase (Activase) therapy. The health care professional should monitor the patient for which of the following indications of a possible adverse effect? A) Hives B) Headache C) Edema D) HTN
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B) Headache
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A nurse is planning to administer subcutaneous enoxaparin (Lovenox) to an adult client following hip arthoplasty. Which of the following actions should the nurse plan to take? A) Choose a 22-gauge needle to administer the injection B) Use a 5/8 inch needle to administer the injection C) Administer the injection in the client's thigh D) Aspirate carefully after inserting the needle into the client's skin
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B) Use a 5/8 inch needle to administer the injection
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A nurse is caring for a hospitalized client who is receiving IV heparin for a DVT. The client begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer? A) Vitamin K1 (Phytonadione) B) Atropine C) Protamine D) Calcium gluconate
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C) Protamine Protamine reverses the anticoagulant effect of heparin
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A nurse is planning to administer IV alteplase (Activase) to a client who is demonstrating manifestations of a massive pulmonary embolism. Which of the following interventions is appropriate for the nurse to plan? A) Give IM enoxaparin along with alteplase dose B) Hold direct pressure on puncture sites for up to 30 min C) Administer aminocaproic acid (Amicar) IV prior to alteplase infusion D) Prepare to administer alteplase within 8 hr of manifestation onset
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B) Hold direct pressure on puncture sites for up to 30 min
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A nurse is monitoring a client who takes aspirin, 81 mg PO daily. Which of the following clinical manifestations are adverse effects of daily aspirin therapy? (Select all that apply) A) HTN B) Coffee-ground emesis C) Tinnitus D) Paresthesias of the extremities E) Nausea
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B, C, E
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A nurse is caring for a client who has atrial fibrillation and has a new prescription for dabigatran (Pradaxa) to prevent development of thrombosis. Which of the following medications is prescribed concurrently to treat an adverse effect of dabigatran? A) Vitamin K1 B) Protamine C) Omeprazole (Prilosec) D) Probenecid (Benemid)
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C) Omeprazole (Prilosec) Omeprazole or another proton pump inhibitor is prescribed for a client who is taking dabigatran and has abdominal pain and other GI findings that may occur as adverse side effects of dabigatran. The nurse should also advise the client who has GI effects to take dabigatran with food.
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Iron Preparations
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Ferrous Sulfate (Feosol) Iron dextran (INFeD)
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Vitamin B12
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Vitamin B12 cyanocobalamin (Nascobal, Cyanoject)
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Folic Acid
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Folic Acid (Vit B9) (Falocin)
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Factor VIII for Hemophilia A
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Plasma-derived (Hemofil-M) Recombinant factor VIII (Advate)
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Factor IX for Hemophilia B
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Plasma-derived (AlphaNine SD) Recombinant Factor IX (BeneFix)
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Desmopressin
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Desmopressin (DDAVP, Stimate)
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*Anticoagulant* Factor Xa/Thrombin inhibitors
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Heparin (factor Xa inhibitor)
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*Anticoagulant* Factor Xa inhibitor
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Enoxaparin (Lovenox) fondaparinux (Arixtra)
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*Anticoagulant* Thrombin inhibitor
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bivalirudin (Angiomax)
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*Anticoagulants* Vitamin K Inhibitor
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Warfarin (Coumadin)
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*Anti-platelets* Salicylics
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Aspirin (Ecotrin)
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*Anti-platelets* Adenosine diphosphate receptor (ADP) inhibitors
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Clopidogrel (Plavix) Ticlopidine (Ticlid)
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*Anti-platelets* Glycoprotein inhibitors
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Abciximab (ReoPro)
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*Anti-platelets* Arterial vasodilators
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Pentoxifyline (Trental)
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Thrombolytics
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Alteplase (Activase)
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Erythropoietic Growth Factor
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Epoetin alfa (Epogen, Procrit)
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Leukopoietic Growth Factor
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Filgrastim (Neupogen)
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Thrombopoietic Growth Factor
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Oprelvekin (Neumega)
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