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An overview of antithrombotics in ischemic stroke

doi: 10.1097/01.NPR.0000484417.27495.9c
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INSTRUCTIONS An overview of antithrombotics in ischemic stroke

TEST INSTRUCTIONS

  • To take the test online, go to our secure website at www.nursingcenter.com/ce/NP.
  • On the print form, record your answers in the test answer section of the CE enrollment form on page 56. Each question has only one correct answer. You may make copies of these forms.
  • Complete the registration information and course evaluation. Mail the completed form and registration fee of $24.95 to: Lippincott Williams & Wilkins, CE Group, 74 Brick Blvd., Bldg. 4, Suite 206, Brick, NJ 08723. We will mail your certificate in 4 to 6 weeks. For faster service, include a fax number and we will fax your certificate within 2 business days of receiving your enrollment form.
  • You will receive your CE certificate of earned contact hours and an answer key to review your results.There is no minimum passing grade.
  • Registration deadline is June 30, 2018
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PROVIDER ACCREDITATION

Lippincott Williams & Wilkins, publisher of The Nurse Practitioner journal, will award 2.5 contact hours for this continuing nursing education activity.

Lippincott Williams & Wilkins is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.5 contact hours. Lippincott Williams & Wilkins is also an approved provider of continuing nursing education by the District of Columbia, Georgia, and Florida CE Broker #50-1223.

Your certificate is valid in all states. This activity has been assigned 2.5 pharmacology credits.

An overview of antithrombotics in ischemic stroke

General Purpose: To provide an overview of antithrombotics in ischemic stroke for the primary care NP. Learning Objectives: After completing this continuing-education activity, you should be able to: 1. Identify best practices for antithrombotic use in stroke. 2. Compare the specific agents used to treatand prevent stroke.

  1. Due to a high prevalence of vascular risk factors, stroke disproportionately affects
    1. women.
    2. younger people.
    3. underserved populations.
  2. Which medication improves stroke outcomes by 30% and is the drug of choice for reperfusion in acute ischemic stroke?
    1. alteplase
    2. heparin
    3. clopidogrel
  3. Which of the following is exclusion criteria for the use of alteplase?
    1. BP of 160/100 mm Hg
    2. PT of 12 seconds
    3. platelets of 90,000/mm3
  4. Compared to placebo or aspirin, early general administration of anticoagulants for arterial ischemic stroke has been shown to
    1. increase mortality.
    2. improve functional outcomes.
    3. decrease length of hospitalization.
  5. Which of the following plays the major role in primary prevention of noncardioembolic ischemic stroke?
    1. antiplatelet therapy
    2. warfarin
    3. modifiable risk factors
  6. Primary stroke prevention for individuals with atrial fibrillation primarily involves
    1. LMWH.
    2. oral anticoagulation.
    3. antiplatelet therapy.
  7. Due to more consistent outcomes, the recommended route of heparin administration is
    1. subcutaneous.
    2. I.V. bolus.
    3. I.V. infusion.
  8. Which is the best choice for outpatient use and for use when a bridging anticoagulant is necessary?
    1. LMWH
    2. warfarin
    3. heparin
  9. Which of the following statements about warfarin is accurate?
    1. Warfarin interferes with the hepatic synthesis of coagulation factors II, VII, IX, and X.
    2. The full antithrombotic effect of warfarin takes place within 60 to 72 hours.
    3. The half-life of warfarin is 6 to 24 hours.
  10. Dosing of dabigatran is based on
    1. weight.
    2. kidney function.
    3. PT values.
  11. What class of medications is rivaroxaban?
    1. factor Xa inhibitor
    2. direct thrombin inhibitor
    3. fibrinolytic
  12. Advantages of using apixaban over warfarin include
    1. once-daily fixed dosing.
    2. reduced risk of cerebral embolism.
    3. reduced risk of intracranial hemorrhage.
  13. Apixaban has a Black BoxWarning regarding
    1. essential blood monitoring.
    2. premature discontinuation.
    3. risk of significant bleeding.
  14. Aspirin exerts its therapeuticeffect by inhibiting
    1. coagulation factors VII and IX.
    2. prostaglandin synthesis.
    3. proteins C and S.
  15. Omeprazole and esomeprazole are associated with a decrease in effectiveness of
    1. clopidogrel.
    2. edoxaban.
    3. rivaroxaban.
  16. Thienopyridines attain their antiplatelet effects by inhibiting
    1. nucleotide phosphodiesterase.
    2. the CYP450 system.
    3. adenosine diphosphate.
  17. Prasugrel is contraindicated in patients
    1. with a history of stroke.
    2. with cardiac dysrhythmias.
    3. taking proton pump inhibitors.
  18. Ticagrelor carries an FDA Black Box Warning stating that maintenance of daily doses of aspirin
    1. is contraindicated.
    2. should not exceed 100 mg.
    3. may cause significant bleeding or hemorrhage.
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