Nokea
A healthcare provider is preparing to administer heparin sodium to a client with deep vein thrombosis (DVT). Which of the following laboratory values should the provider monitor during therapy?
- A. INR
- B. Serum creatinine
- C. aPTT
- D. Bilirubin
Correct Answer: C
Rationale: The correct answer is C: aPTT. The healthcare provider should monitor the activated partial thromboplastin time (aPTT) value during heparin therapy to assess the client's coagulation status. Heparin affects the intrinsic pathway of the coagulation cascade, and monitoring aPTT helps ensure that the client is within the therapeutic range to prevent bleeding or clotting issues. INR (Choice A) is used to monitor warfarin therapy, not heparin. Serum creatinine (Choice B) is not directly related to monitoring heparin therapy. Bilirubin (Choice D) is related to liver function, not heparin therapy.
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A nurse is caring for a client with hypothyroidism. Which of the following findings indicates that the client is experiencing an adverse effect from the prescribed levothyroxine?
- A. Tachycardia
- B. Bradycardia
- C. Weight loss
- D. Increased appetite
Correct Answer: A
Rationale: Tachycardia is the correct answer as it is an adverse effect of levothyroxine. Levothyroxine is a medication used to treat hypothyroidism by supplementing the body with thyroid hormone. Tachycardia, or a fast heart rate, can indicate an overdosage or increased sensitivity to levothyroxine. Bradycardia, slow heart rate, weight loss, and increased appetite are not typically associated with adverse effects of levothyroxine. Bradycardia may actually be a symptom of untreated hypothyroidism.
A nurse is caring for a client prescribed montelukast. Which of the following should the nurse include in teaching related to this medication?
- A. Advise the client to take the medication once daily at bedtime
- B. This medication is for the acute management of asthma
- C. Avoid dairy products while taking this medication
- D. If the client forgets to take the medication for a few days, he should not double up on doses to catch up
Correct Answer: A
Rationale: The correct answer is to advise the client to take montelukast once daily at bedtime to maintain therapeutic effects. Choice B is incorrect because montelukast is not typically used for acute asthma management but for chronic treatment. Choice C is incorrect as there are no known interactions between montelukast and dairy products. Choice D is incorrect as it is not safe to double up on doses if the client forgets to take the medication; the missed dose should be skipped and the regular dosing schedule maintained.
A client has been prescribed vasopressin for the treatment of diabetes insipidus. What is the expected pharmacologic action of this medication?
- A. To stimulate the pancreas to secrete insulin
- B. To slow the absorption of glucose in the intestine
- C. To increase reabsorption of water in the renal tubules
- D. To increase blood pressure
Correct Answer: C
Rationale: The correct answer is C: To increase reabsorption of water in the renal tubules. Vasopressin, also known as antidiuretic hormone (ADH), works by increasing the reabsorption of water in the renal tubules, which helps to concentrate urine and reduce excessive urination in diabetes insipidus. Choice A is incorrect as vasopressin does not stimulate the pancreas to secrete insulin. Choice B is incorrect as vasopressin does not affect the absorption of glucose in the intestine. Choice D is incorrect as vasopressin's primary action is not to increase blood pressure, although it can have some vasoconstrictive effects.
Before administering blood products, which action should be taken?
- A. Assess the client's temperature
- B. Document client response
- C. Prime IV tubing with 0.45% sodium chloride
- D. Administer epinephrine
Correct Answer: A
Rationale: Correct answer: Before administering blood products, the client's temperature must be assessed to establish a baseline and monitor for transfusion reactions. Choice B is incorrect because documenting client response should occur after administering the blood products. Choice C is incorrect as priming IV tubing with 0.45% sodium chloride is not directly related to assessing the client before administering blood products. Choice D is incorrect because administering epinephrine is not a routine action before administering blood products.
A client with an artificial heart valve is prescribed warfarin therapy. Which of the following laboratory values should the nurse monitor to assess the therapeutic effect of warfarin?
- A. Hemoglobin (Hgb)
- B. Prothrombin time (PT)
- C. Bleeding time
- D. Activated partial thromboplastin time (aPTT)
Correct Answer: B
Rationale: The correct answer is B: Prothrombin time (PT). Warfarin is an anticoagulant medication that works by inhibiting the clotting factors dependent on vitamin K, such as factors II, VII, IX, and X. The prothrombin time (PT) measures the extrinsic pathway and is used to monitor the therapeutic effects of warfarin therapy. Monitoring PT helps assess the time it takes for the blood to clot, ensuring that the anticoagulant effect is within the desired range. Choices A, C, and D are incorrect because hemoglobin (Hgb) measures the amount of hemoglobin in the blood, bleeding time assesses the time it takes for bleeding to stop, and activated partial thromboplastin time (aPTT) is used to monitor heparin therapy, not warfarin therapy.