Nokea
What should be monitored to evaluate the effectiveness of enoxaparin in a patient with deep vein thrombosis (DVT)?
- A. Prothrombin time (PT)
- B. Partial thromboplastin time (PTT)
- C. International normalized ratio (INR)
- D. Platelet count
Correct Answer: C
Rationale: Rationale:
1. Enoxaparin is a low molecular weight heparin that primarily affects the intrinsic pathway of coagulation.
2. INR is used to monitor the effectiveness of anticoagulants affecting the intrinsic pathway.
3. Monitoring INR helps ensure the patient is within the therapeutic range to prevent clotting without excessive bleeding.
4. PT and PTT primarily evaluate the extrinsic and intrinsic pathways, respectively, not specific to enoxaparin.
5. Platelet count is not directly related to monitoring the effectiveness of enoxaparin in treating DVT.
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The nurse formulates a nursing diagnosis of 'High risk for ineffective airway clearance' for a client with myasthenia gravis. What is the most likely etiology for this nursing diagnosis?
- A. Pain when coughing.
- B. Diminished cough effort.
- C. Thick, dry secretions.
- D. Excessive inflammation.
Correct Answer: B
Rationale: The correct answer is B: Diminished cough effort. In myasthenia gravis, muscle weakness can affect the respiratory muscles, leading to ineffective coughing and clearance of airways. Diminished cough effort can result in ineffective airway clearance, putting the client at high risk for respiratory complications.
A: Pain when coughing is not the primary etiology for ineffective airway clearance in myasthenia gravis.
C: Thick, dry secretions may contribute to airway clearance issues but are not the most likely etiology compared to diminished cough effort.
D: Excessive inflammation is not typically associated with ineffective airway clearance in myasthenia gravis.
The healthcare provider prescribes 15 mg/kg of Streptomycin for an infant weighing 4 pounds. The drug is diluted in 25 ml of D5W to run over 8 hours. How much Streptomycin will the infant receive?
- A. 9 mg
- B. 18 mg
- C. 27 mg
- D. 36 mg
Correct Answer: A
Rationale: To calculate the dose of Streptomycin, we first need to convert the infant's weight from pounds to kg (4 lbs = 1.81 kg). Then, we multiply the weight in kg by the prescribed dose (15 mg/kg) to get the total dose (1.81 kg * 15 mg/kg = 27.15 mg). Since the drug is diluted in 25 ml of D5W, the infant will receive 27.15 mg in 25 ml solution. To find how much Streptomycin the infant actually receives, we need to calculate the amount in 1 ml (27.15 mg / 25 ml = 1.086 mg/ml). Finally, to determine how much the infant will receive over 8 hours, we multiply the concentration by the infusion rate (1.086 mg/ml * 25 ml * 8 hours = 217.2 mg). Therefore, the correct answer is A: 9 mg, as it represents the amount
A client with heart failure is prescribed digoxin (Lanoxin). Which instruction should the nurse include in the client's teaching plan?
- A. Take your pulse before each dose and hold the medication if your pulse is below 60 beats per minute.
- B. Increase your intake of foods high in potassium.
- C. Take the medication with a high-fiber meal to enhance absorption.
- D. Skip a dose if you feel dizzy or lightheaded.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Digoxin is a medication that can cause bradycardia as a side effect.
2. Instructing the client to take their pulse before each dose is crucial to monitor for bradycardia.
3. Holding the medication if the pulse is below 60 beats per minute helps prevent potential adverse effects.
4. This instruction ensures the client's safety and adherence to the prescribed regimen.
Summary:
- Choice B is incorrect because increasing potassium intake can lead to hyperkalemia when taking digoxin.
- Choice C is incorrect as taking digoxin with a high-fiber meal may affect absorption negatively.
- Choice D is incorrect because skipping a dose based on dizziness or lightheadedness may lead to suboptimal treatment outcomes.
For a patient with asthma, what is the primary purpose of prescribing montelukast?
- A. Relieve acute bronchospasm
- B. Prevent asthma attacks
- C. Thin respiratory secretions
- D. Suppress cough
Correct Answer: B
Rationale: The primary purpose of prescribing montelukast for a patient with asthma is to prevent asthma attacks. Montelukast is a leukotriene receptor antagonist that helps to reduce inflammation in the airways, thereby preventing asthma symptoms and attacks. It is not used to relieve acute bronchospasm (Choice A), as it is not a fast-acting rescue medication like a bronchodilator. Montelukast also does not thin respiratory secretions (Choice C) or suppress cough (Choice D) as its main mechanism of action is to prevent and control asthma symptoms by inhibiting leukotrienes.
A patient with depression is prescribed fluoxetine. What is an important side effect for the nurse to monitor?
- A. Weight gain
- B. Bradycardia
- C. Dry mouth
- D. Suicidal thoughts
Correct Answer: D
Rationale: The correct answer is D: Suicidal thoughts. When a patient with depression is prescribed fluoxetine, there is a risk of increased suicidal thoughts, especially in the initial weeks of treatment. This is important for the nurse to monitor because it can lead to serious consequences. Weight gain (A) is a common side effect of fluoxetine but not as critical to monitor as suicidal thoughts. Bradycardia (B) and dry mouth (C) are not common side effects of fluoxetine and are less relevant to monitor in this scenario. Monitoring for suicidal thoughts is crucial for patient safety.