Nokea
A male client is started on IV anticoagulant therapy with heparin. Which of the following laboratory studies will be ordered to monitor the therapeutic effects of heparin?
- A. Partial thromboplastin time
- B. Hemoglobin
- C. Red blood cell (RBC) count
- D. Prothrombin time
Correct Answer: A
Rationale: Partial thromboplastin time is used to monitor the effects of heparin, and dosage is adjusted depending on test results. It is a screening test used to detect deficiencies in all plasma clotting factors except factors VII and XIII and platelets. Hemoglobin is the main component of RBCs. Its main function is to carry O2 from the lungs to the body tissues and to transport CO2 back to the lungs. RBC count is the determination of the number of RBCs found in each cubic millimeter of whole blood. PT is used to monitor the effects of oral anticoagulants, e.g., coumarin-type anticoagulants.
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A client with a history of a pituitary tumor is receiving Bromocriptine (Parlodel). The nurse should monitor the client for:
- A. Hypotension
- B. Hyperglycemia
- C. Weight gain
- D. Hair loss
Correct Answer: A
Rationale: Bromocriptine, a dopamine agonist, can cause hypotension due to vasodilation. Hyperglycemia, weight gain, and hair loss are not primary side effects.
The nurse begins morning assessment on a male client and notices that she is unable to palpate either of his dorsalis pedis pulses in his feet. What is the first nursing action after assessing this finding?
- A. Palpate these pulses again in 15 minutes.
- B. Use a Doppler to determine presence and strength of these pulses.
- C. Document the finding that the pulses are not palpable.
- D. Call the physician and notify the physician of this finding.
Correct Answer: B
Rationale: Any time during an assessment that the nurse is unable to palpate pulses, the nurse should then obtain a Doppler and assess for presence or absence of the pulse and pulse strength, if a pulse is present.
The nurse is caring for a client with diabetes mellitus. Which instruction should be given to the client?
- A. Tell the client to avoid stairs
- B. Tell the client to decrease her intake of sodium
- C. Instruct the client to weigh daily
- D. Tell the client to report numbness and tingling in her feet and toes
Correct Answer: D
Rationale: Numbness and tingling in the feet and toes may indicate diabetic neuropathy a serious complication requiring prompt reporting. Avoiding stairs reducing sodium or daily weighing are not specific to diabetes management unless indicated.
The nurse is caring for a client with a history of a stroke who has expressive aphasia. The nurse should:
- A. Speak loudly to the client
- B. Use simple, short sentences
- C. Provide a whiteboard for communication
- D. Limit all verbal interactions
Correct Answer: C
Rationale: Expressive aphasia impairs speech production. A whiteboard facilitates communication. Simple sentences help, but writing aids are critical, and loud speech or limiting interaction is unhelpful.
Which statement by the parent of a child with sickle cell anemia indicates an understanding of the disease?
- A. The pain he has is due to the presence of too many red blood cells.
- B. He will be able to go snow skiing with his friends as long as he stays warm.
- C. He will need extra fluids in summer to prevent dehydration.
- D. There is very little chance that his brother will have sickle cell.
Correct Answer: C
Rationale: Sickle cell anemia increases dehydration risk due to impaired blood flow, especially in heat. Extra fluids in summer prevent crises. Pain is due to vaso-occlusion, not excess RBCs, and skiing poses risks.