Nokea
The client is receiving heparin therapy for deep vein thrombosis (DVT). Which lab test should be monitored to evaluate the effectiveness of heparin?
- A. Prothrombin time (PT)
- B. International normalized ratio (INR)
- C. Activated partial thromboplastin time (aPTT)
- D. Fibrinogen levels
Correct Answer: C
Rationale: Activated partial thromboplastin time (aPTT) is the appropriate lab test to monitor the therapeutic effectiveness of heparin therapy. Heparin affects the intrinsic pathway of the coagulation cascade, and monitoring aPTT helps ensure the client is within the therapeutic range to prevent clot formation. Prothrombin time (PT) and International normalized ratio (INR) are used to monitor warfarin therapy, a different anticoagulant that affects the extrinsic pathway of the coagulation cascade. Fibrinogen levels are not specific to monitoring heparin therapy.
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An adolescent girl has decided to become a vegetarian. The primary care NP should counsel her about iron intake and considering a vitamin containing:
- A. zinc.
- B. vitamin A.
- C. vitamin C.
- D. potassium.
Correct Answer: A
Rationale: The correct answer is A because vegetarians often lack zinc, critical alongside iron. Choice B is incorrect (vitamin A not primary). Choice C is wrong (vitamin C aids iron, not primary). Choice D is inaccurate (potassium unrelated).
A woman who is pregnant develops gestational diabetes. The NP's initial action is to:
- A. prescribe an oral antidiabetic agent.
- B. give her information about diet and exercise.
- C. begin treating her with daily insulin injections.
- D. reassure her that her glucose levels will return to normal after pregnancy.
Correct Answer: B
Rationale: The correct answer is B because diet and exercise are the initial management for gestational diabetes. Choice A is incorrect (oral agents lack sufficient safety data). Choice C is wrong (insulin isn’t first-line). Choice D is inaccurate (reassurance alone doesn’t address current needs).
The nurse is caring for a client with hypertension who is prescribed enalapril (Vasotec). The nurse should monitor the client for which potential adverse effect?
- A. Hypertension
- B. Hypotension
- C. Tachycardia
- D. Hyperglycemia
Correct Answer: B
Rationale: The correct answer is B: Hypotension. Enalapril is an ACE inhibitor that works by dilating blood vessels and reducing blood pressure. Therefore, a potential adverse effect of enalapril is hypotension, not hypertension (choice A), tachycardia (choice C), or hyperglycemia (choice D). Monitoring for hypotension is crucial to prevent complications.
Pharmacokinetic changes in women's bodies that affect drug dosing include:
- A. Increased body fat
- B. Increased glomerular filtration rate in pregnancy
- C. Decreased gastric emptying
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because increased body fat (alters distribution), higher GFR in pregnancy (increases clearance), and slower gastric emptying (affects absorption) all change pharmacokinetics, impacting dosing. Choice A is incorrect alone as fat is one change. Choice B is wrong by itself because GFR is just part. Choice C is incorrect solo since gastric emptying is only one factor.
Patient education for the elderly should include:
- A. Explanation of drug purpose
- B. Instructions for safe administration
- C. Potential side effects
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because explaining purpose (improves adherence), safe administration (prevents errors), and side effects (enhances safety) are all key for elderly education, per geriatric care. Choice A is incorrect alone as it's one aspect. Choice B is wrong by itself because administration is just part. Choice C is incorrect solo since side effects are only one element.