Nokea
A postoperative client is prescribed enoxaparin (Lovenox) 40 mg subcutaneous daily. Which laboratory value should the nurse monitor?
- A. Platelet count.
- B. Prothrombin time (PT).
- C. Activated partial thromboplastin time (aPTT).
- D. International normalized ratio (INR).
Correct Answer: A
Rationale: Enoxaparin can cause thrombocytopenia. Monitoring platelet count ensures early detection of this potential adverse effect.
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The nurse has reinforced education at a conference on intramuscular (IM) injections. Which of the following statements by the participant would indicate a correct understanding of the teaching?
- A. "1 mL is the maximum volume in a single site for small children and older infants."
- B. "Depress the plunger as the needle is being inserted into the client's skin to minimize discomfort."
- C. "Insert the needle quickly using a dart-like motion at a 60-degree angle."
- D. "Injecting in the ventrogluteal muscle is more painful than the vastus lateralis."
Correct Answer: A
Rationale: The maximum volume for IM injections in small children and older infants is 1 mL to prevent tissue damage; other options contain incorrect techniques or assumptions.
A client with bladder cancer reports fatigue and weight loss. The nurse should assess for:
- A. Metastasis.
- B. Dehydration.
- C. Infection.
- D. Anemia.
Correct Answer: A
Rationale: Fatigue and weight loss in bladder cancer may indicate metastasis, as the disease progresses.
Which of the following nursing interventions is most important in preventing postoperative complications?
- A. Progressive diet planning.
- B. Pain management.
- C. Bowel and elimination monitoring.
- D. Early ambulation.
Correct Answer: D
Rationale: Early ambulation prevents multiple complications, including deep vein thrombosis, pneumonia, and atelectasis, by promoting circulation and lung expansion.
A client who has a history of mitral valve prolapse tells the nurse that she is scheduled to get her teeth cleaned. Which of the following replies by the nurse is most appropriate?
- A. The physician will need to reevaluate the status of your heart condition before your dental appointment.'
- B. The nurse to remind your dentist that you have a heart condition.'
- C. It is important for you to care for your teeth because your heart condition makes you more susceptible to developing oral infections.'
- D. We will prescribe a prophylactic antibiotic for you to take before getting your teeth cleaned.'
Correct Answer: D
Rationale: Clients with mitral valve prolapse may require prophylactic antibiotics before dental procedures to prevent infective endocarditis, depending on current guidelines. This is the most appropriate response as it directly addresses the need for preventive measures. The other options either lack specificity or do not address the immediate clinical concern.
The nurse has attended a staff developmental conference on pediatric pain management. Which of the following statements by the nurse would indicate a correct understanding of the teaching?
- A. Patient-controlled analgesia (PCA) can be used as early as age 7.
- B. Lidocaine-adrenaline-tetracaine (LAT) can provide local anesthesia 2 hours after it is applied.
- C. Transdermal fentanyl patch can provide acute pain relief.
- D. Intramuscular delivery of pain medication is preferred for children.
Correct Answer: A
Rationale: PCA can be used in children as young as 7 if they understand the concept. LAT works within 30-60 minutes, fentanyl patches are for chronic pain, and IM injections are avoided in children due to pain and variability.