Nokea
A client is receiving rivaroubahn (Xareth) and asks the nurse to explain how it works. What response by the nurse is best?
- A. It inhibits thrombin.
- B. It inhibits fibrinogen.
- C. It thin your blood.
- D. It thin your blood vitamin K.
Correct Answer: A
Rationale: Rivaroubahn is a direct thrombin inhibitor. It does not work on fibrinogen or vitamin K. It is not a blood thinner, although many clients call anticoagulants by this name.
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The health care provider tells the nurse that a client is to be started on a platelet inhibitor. About what drug does the nurse plan to teach the client?
- A. Clopidogrel (Flavix)
- B. Enoxaparin (Coumacidin)
- C. Retetplase (Retavase)
- D. Warfarin
Correct Answer: A
Rationale: Clopidogrel is a platelet inhibitor. Enoxaparin is an indirect thrombin inhibitor. Reteplase is a fibrinolytic agent. Warfarin is a vitamin K antagonist.
A nurse is assessing a dark-skinned client for pallor. What action is best?
- A. Assess the conjunctiva of the eye.
- B. Have the client open the hand widely.
- C. Look at the roof of the client's mouth.
- D. Palpate for areas of mild swelling.
Correct Answer: A
Rationale: To assess pallor in dark-skinned people, assess the conjunctiva of the eye or the mucous membranes. Looking at the roof of the mouth can reveal jaundice. Opening the hand widely is not related to pallor, nor is palpating for mild swelling.
A client is having a bone marrow biopsy and is extremely anxious. What action by the nurse is best?
- A. Assess client fears and coping mechanisms.
- B. Reassure the client this is a common test.
- C. Sedate the client prior to the procedure.
- D. Tell the client he or she will be asleep.
Correct Answer: A
Rationale: Assessing the client's specific fears and coping mechanisms helps guide the nurse in providing holistic care that best issues the client's needs. Reassurance will be helpful but is not the best option. Sedation is usually used. The client may or may not be totally asleep during the procedure.
A nurse is caring for four clients. After reviewing today's laboratory results, which client should the nurse see first?
- A. Client with an international normalized ratio of 2.8
- B. Client with a platelet count of 128,000 / mm3.
- C. Client with a prothrombin time (PT) of 28 seconds
- D. Client with a red blood cell count of 5.1 million/L
Correct Answer: C
Rationale: A normal PT is 11 to 12.5 seconds. This client is at high risk of bleeding. The other values are within normal limits.
A hospitalized client has a platelet count of 58,000 / mm3. What action by the nurse is best?
- A. Encourage high protein foods.
- B. Institute neutropenia precautions.
- C. Institute bleeding precautions.
- D. Place the client on safety precautions.
Correct Answer: D
Rationale: With a platelet count between 40,000 and 80,000 / mm3, clients are at risk of prolonged bleeding even after minor trauma. The nurse should place the client on safety precautions. High-protein foods, while healthy, are not the priority. Neutropenia precautions are not needed as the client's white blood cell count is not low.