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PRACTICE NAPLEX VENO US
THROMBOEMBOLISM QUES TIONS
WITH 100% CORRECT AN SWERS |
VERIFIED | LATEST UPDATE
Question : RS is a 65-year-old woman who presents to the
emergency department complaining of some bleeding when brushing her teeth. The patient's international normalized ratio (INR) is 9.6 and she reports she may have accidentally misunderstood her new warfarin dosing regimen and has been taking a full 7.5-mg tablet of warfarin daily rather than the prescribed one-half tablet (3.75 mg) daily for the past week.Which is the most appropriate reversal agent to be used today?
Correct answer: Phytonadione
Question : A 62-year-old woman who is taking warfarin for
recurrent deep vein thrombosis (DVT) presents to her primary care physician (PCP) with polyuria and pain on urination and is diagnosed with a urinary tract infection. Which antibiotic would be expected to have the least effect on her warfarin therapy?
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Correct answer: Nitrofurantoin
Question : A patient comes to your pharmacy asking for
Boost® dietary supplement. In your discussion, she tells you that she is also taking warfarin for recurrent deep vein thrombosis (DVT). Which of the following is a likely consequence of starting this dietary supplement in someone who is receiving chronic warfarin therapy?
Correct answer: Decrease in the INR
Question : A 45-year-old man on lifelong therapy with
warfarin for recurrent deep vein thrombosis (DVT) has been prescribed metronidazole for Clostridium difficile infection.Addition of metronidazole to this patient's warfarin will likely have what effect on the international normalized ratio (INR) and by what mechanism?
Correct answer: Increase INR due to CYP2C9 inhibition
Question : Which agent has a delayed onset of anticoagulant
effect?
Correct answer: Coumadin®
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Question : 64-year-old man (95 kg) presents to the
anticoagulation clinic for routine monitoring of his warfarin.His past medical history is significant for atrial fibrillation, hypothyroidism, and osteoarthritis. He currently takes warfarin 7.5 mg daily, levothyroxine 25 mcg daily, and acetaminophen 1000 mg four times daily as needed for pain.His current laboratory values are international normalized ratio (INR) 2.9, serum creatinine (SCr) 1.6 mg/dL, K+ 4.5 meq/L, and thyroid stimulating hormone (TSH) 9.8 µIU/mL.The primary care provider (PCP) plans to increase the patient's levothyroxine today due to his symptoms of hypothyroidism (lethargy and weight gain). Increasing the dose of levothyroxine for this patient's hypothyroidism is most likely going to result in which effect?
Correct answer: Increased INR
Question : LA is a 78-year-old woman who presented to
emergency department for acute coronary syndrome. She was treated with heparin. After 5 days on therapy her platelet count dropped from 120,000 to 45,000 and she is diagnosed with heparin-induced thrombocytopenia (HIT). She is also
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found to have an acute kidney injury (AKI) and her renal function has decreased to 23 mL/min. The medical team wants to continue anticoagulation. Which drug can be used safely in a patient with HIT given her current renal function?
Correct answer: Argatroban
Question : A 25-year-old woman who was just diagnosed with
a deep vein thrombosis (DVT) presents with a new prescription for warfarin 5-mg tablets. What education should be provided to this patient?
Correct answer: It is important to use a highly effective
method of contraception with warfarin.
Question : An 83-year-old man is diagnosed with a new deep
vein thrombosis (DVT). He weighs 80 kg (height = 70") and his serum creatinine (SCr) is 1.6 mg/dL. His past medical history includes type 2 diabetes and gastroesophageal reflux disease (GERD). Which is an appropriate initial treatment recommendation?
Correct answer: Xarelto® 15 mg BID for 21 days then 20 mg
once daily