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The nurse is caring for a client who currently has a deep vein thrombosis. Which of the following medications would be administered to lyse existing clots? (Select All that Apply.)

A.

Aspirin

B.

Heparin

C.

warfarin (Coumadin)

D.

alteplase (Activase)

E.

anistreplase (Eminase)

Question Solution

Correct Answer : D,E

A) Aspirin: While aspirin is an antiplatelet medication that can help prevent further clot formation, it does not have thrombolytic properties and does not directly lyse existing clots. Therefore, it is not appropriate for this purpose.

 

B) Heparin: Heparin is an anticoagulant used to prevent the extension of existing clots and reduce the risk of new clots forming, but it does not dissolve existing clots. It helps manage deep vein thrombosis but does not have thrombolytic activity.

 

C) Warfarin (Coumadin): Warfarin is an oral anticoagulant that is used to prevent new clot formation and the growth of existing clots. However, like heparin, it does not actively lyse or dissolve existing clots.

 

D) Alteplase (Activase): This medication is a thrombolytic agent that actively dissolves blood clots by activating plasminogen to plasmin, leading to clot breakdown. It is appropriate for use in cases of deep vein thrombosis when clot lysis is indicated.

 

E) Anistreplase (Eminase): Similar to alteplase, anistreplase is another thrombolytic agent used to lyse existing clots. It acts by converting plasminogen to plasmin, effectively breaking down fibrin in clots, making it suitable for the treatment of deep vein thrombosis.


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Correct Answer is C

Explanation

A) Migraine headache: While migraines can be uncomfortable and distressing, they are not a known serious side effect of atorvastatin. Clients may experience headaches, but this symptom does not typically require immediate reporting unless accompanied by other concerning signs.

B) Bradycardia: Bradycardia, or a slow heart rate, is not a common side effect of atorvastatin. While monitoring heart rate is important, bradycardia alone does not necessitate immediate reporting unless it leads to significant symptoms or complications.

C) Dark-red urine: Dark-red urine is a concerning finding that could indicate serious conditions, such as hematuria or rhabdomyolysis, particularly when associated with statin use. This symptom requires immediate reporting to the healthcare provider, as it may signify potential muscle breakdown or kidney issues, which are serious complications of atorvastatin therapy.

D) Elevated HDL cholesterol: Increased levels of HDL (high-density lipoprotein) cholesterol are generally considered beneficial and a positive outcome of treatment. Therefore, this finding would not necessitate immediate reporting to the healthcare provider.

Correct Answer is A

Explanation

A) Dry, non-productive cough: One of the most common side effects associated with ACE inhibitors is a dry, non-productive cough. This occurs due to the accumulation of bradykinin, a peptide that can increase in the body when ACE is inhibited. Nurses should assess for this symptom, as it may require changing the medication if it becomes bothersome to the client.

B) Nausea and vomiting: While nausea and vomiting can occur with various medications, they are not specific or common side effects of ACE inhibitors. If these symptoms do arise, they may be due to other factors and should be investigated further.

C) Hypokalemia and vomiting: ACE inhibitors are more commonly associated with hyperkalemia (elevated potassium levels) rather than hypokalemia. Monitoring potassium levels is important, but vomiting is not a typical side effect of ACE inhibitors.

D) Epistaxis and headache: Although headaches can occur with many medications, epistaxis (nosebleeds) is not a common side effect associated with ACE inhibitors. While headache assessment is appropriate, the dry cough is the more characteristic and important symptom to monitor in clients on these medications.

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