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When administering enoxaparin (Lovenox) to a client for DVT prophylaxis, what is the most important lab value to monitor?
- A. Platelet count
- B. PT/INR
- C. aPTT
- D. Hemoglobin
Correct Answer: A
Rationale: The correct answer is A: Platelet count. When administering enoxaparin for DVT prophylaxis, monitoring platelet count is crucial because enoxaparin can cause thrombocytopenia. Decreased platelet count can increase the risk of bleeding. Monitoring PT/INR and aPTT is more relevant for monitoring warfarin or heparin therapy, not enoxaparin. Hemoglobin monitoring is important for assessing anemia but not specifically related to enoxaparin administration for DVT prophylaxis.
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A patient with heart failure has tachypnea, severe dyspnea, and a SpO2 of 84%. The nurse identifies a nursing diagnosis of impaired gas exchange related to increased preload and mechanical failure. An appropriate nursing intervention for this diagnosis is
- A. Assist the patient to cough and deep breath every 2 hours
- B. Assess intake and output every 8 hours and weigh daily
- C. Encourage to alternate rest and activity to reduce cardiac workload
- D. Place the patient in a high Fowler's position with the legs horizontal
Correct Answer: D
Rationale: A high fowler's position increases the thoracic capacity, improving ventilation, and sitting with the legs horizontal will decrease venous return.
What test uses high-frequency sound waves to create images of the heart, allowing doctors to assess its structure and function?
- A. Echocardiogram
- B. MRI
- C. CT scan
- D. X-ray
Correct Answer: A
Rationale: The correct answer is A: Echocardiogram. An echocardiogram uses high-frequency sound waves to create detailed images of the heart's structure and function in real-time. It is a non-invasive and safe diagnostic tool commonly used to assess heart health. MRI (B) uses magnetic fields and radio waves, CT scan (C) uses X-rays, and X-ray (D) uses electromagnetic radiation, but they do not provide the same level of detail and real-time assessment of the heart as an echocardiogram does.
The laboratory tests for four patients show the following results. Which patient should the nurse teach first about preventing CAD because the patient is at the greatest risk for CAD even without other risk factors?
- A. Total cholesterol: 152 mg/dL, triglycerides: 148 mg/dL, LDL: 148 mg/dL, HDL: 52 mg/dL
- B. Total cholesterol: 160 mg/dL, triglycerides: 102 mg/dL, LDL: 138 mg/dL, HDL: 56 mg/dL
- C. Total cholesterol: 200 mg/dL, triglycerides: 150 mg/dL, LDL: 160 mg/dL, HDL: 48 mg/dL
- D. Total cholesterol: 250 mg/dL, triglycerides: 164 mg/dL, LDL: 172 mg/dL, HDL: 32 mg/dL
Correct Answer: D
Rationale: Low HDL and high LDL increase CAD risk.
The client on spironolactone should avoid which of the following?
- A. Foods high in potassium
- B. Foods high in sodium
- C. Foods high in calcium
- D. Foods high in chloride
Correct Answer: A
Rationale: The correct answer is A: Foods high in potassium. Spironolactone is a potassium-sparing diuretic that can increase potassium levels in the body. Consuming foods high in potassium while taking spironolactone can lead to hyperkalemia, a serious condition characterized by high levels of potassium in the blood. The other choices (B: Foods high in sodium, C: Foods high in calcium, D: Foods high in chloride) are not directly contraindicated with spironolactone use. Sodium intake is typically restricted in patients taking diuretics, but it is not specifically related to spironolactone. Calcium and chloride levels are not significantly affected by spironolactone, so foods high in these minerals do not need to be avoided.
A client is admitted to the hospital with a dysrhythmia. Which of the following is the most common cause of dysrhythmias?
- A. Hypothermia
- B. Metabolic acidosis
- C. Drug therapy
- D. Ischemic heart disease
Correct Answer: D
Rationale: Ischemic heart disease is the leading cause of dysrhythmias due to compromised blood flow to the heart muscle.