Nokea
A client with a history of deep vein thrombosis is prescribed enoxaparin (Lovenox). Which laboratory value does not require routine monitoring?
- A. Platelet count
- B. Prothrombin time (PT)
- C. Activated partial thromboplastin time (aPTT)
- D. Hemoglobin
Correct Answer: B
Rationale: Enoxaparin, a low-molecular-weight heparin, does not require routine PT monitoring, unlike warfarin, as it primarily affects anti-factor Xa activity.
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The nurse is assessing a client with a suspected urinary tract infection. Which of the following symptoms is most likely to be present?
- A. Flank pain.
- B. Hypotension.
- C. Bradycardia.
- D. Dry skin.
Correct Answer: A
Rationale: Flank pain is a common symptom of a urinary tract infection, especially if it involves the kidneys.
A client with a diagnosis of breast cancer is prescribed letrozole (Femara). The nurse should instruct the client to report which of the following side effects immediately?
- A. Hot flashes.
- B. Bone pain.
- C. Nausea.
- D. Fatigue.
Correct Answer: B
Rationale: Bone pain may indicate bone loss or metastasis, a serious side effect of letrozole requiring immediate reporting.
A 72-year-old client is referred for counseling. During the initial nursing assessment, the client denies the need for counseling. The nurse would agree with the client if she made which of the following comments?
- A. My doctor just put me on an antidepressant, and I'll be fine in a week or so.'
- B. My daughter sent me here. She's mad because I don't have the energy to take care of my grandkids.'
- C. Since I've gotten over the death of my husband, I've had more energy and been more active than before he died.'
- D. My son got worried because I made this silly comment about wanting to be with my husband in heaven.'
Correct Answer: C
Rationale: Increased energy and activity post-grief suggest the client is coping well, supporting her denial of needing counseling.
A client with type 2 diabetes is admitted with a blood glucose level of 450 mg/dL. The nurse should anticipate which of the following orders?
- A. Regular insulin IV
- B. Oral metformin
- C. Glucagon injection
- D. Potassium supplement
Correct Answer: A
Rationale: Hyperglycemia requires regular insulin IV to rapidly lower blood glucose. Metformin is oral and slower, glucagon raises glucose, and potassium is not indicated without further assessment.
Which sound should you expect to hear when you percuss the liver during a complete physical assessment?
- A. Resonance
- B. Flatness
- C. Tympany
- D. Dullness
Correct Answer: D
Rationale: The liver, a solid organ, produces a dull sound when percussed, as opposed to the tympanic sound of air-filled structures or the resonant sound of lung tissue.