Nokea
The nurse is caring for a patient who is receiving heparin. Which of the following laboratory tests should the nurse monitor?
- A. Prothrombin time (PT)
- B. Fibrin degradation products (FDP)
- C. International normalized ratio (INR)
- D. Activated partial thromboplastin time (aPTT)
Correct Answer: D
Rationale: aPTT testing is used to determine whether heparin is at a therapeutic level. FDP is useful in diagnosis of problems such as disseminated intravascular coagulation (DIC). PT and INR are most commonly used to test for therapeutic levels of warfarin.
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The nurse is caring for a patient with persistent iron-deficiency anemia. Which of the following assessment findings should the nurse anticipate?
- A. Yellow-tinged sclerae
- B. Shiny, smooth tongue
- C. Numbness of the extremities
- D. Gum bleeding and tenderness
Correct Answer: B
Rationale: Loss of the papillae of the tongue occurs with persistent iron-deficiency. Scleral jaundice is associated with hemolysis, gum bleeding and tenderness occur with thrombocytopenia or neutropenia, and extremity numbness is associated with vitamin B12 deficiency or pernicious anemia.
The health care provider orders an ultrasound of the spleen for a patient who has been in a car accident. Which of the following actions should the nurse take before this procedure?
- A. Check for any iodine allergy
- B. Insert a large-bore IV catheter
- C. Place the patient on NPO status
- D. Assist the patient to a flat position
Correct Answer: D
Rationale: The patient is placed in a flat position before splenic ultrasound. The patient does not have to be NPO or have an IV line. No iodine-containing materials are used for ultrasound.
The nurse is obtaining a health history from a patient and notes numerous petechiae. Which of the following assessments should the nurse anticipate?
- A. Bruising on the skin
- B. Pinpoint purplish-red lesions
- C. Small focal red lesions
- D. Brown spots on mucous membranes
Correct Answer: B
Rationale: Petechiae are small, purplish-red lesions. Ecchymosis is bruising on the skin. Small focal red lesions are telangiectasia. Purpura are small hemorrhages on the skin or mucous membranes resulting in a rash of purple, red, or brown spots.
The nurse is reviewing laboratory data for an older-adult patient. Which of the following results should be of most concern?
- A. White blood cell (WBC) count of 3.5 x 10^9/L
- B. Hematocrit of 37%
- C. Platelet count of 400 x 10^9/L
- D. Hemoglobin of 118 g/L
Correct Answer: A
Rationale: The total WBC count is not usually affected by aging, and the low WBC here would indicate that the patient's immune function may be compromised. The platelet count is normal. The slight decrease in hemoglobin and hematocrit is not unusual for an older patient.
The nurse is reviewing the complete blood count (CBC) for a patient admitted with abdominal pain. Which of the following information will be most important for the nurse to communicate to the health care provider?
- A. Monocytes 4%
- B. Hemoglobin 116 g/L
- C. Platelet count 44 x 10^9/L
- D. White blood cells 13.5 x 10^9/L
Correct Answer: D
Rationale: The elevation in WBCs indicates that an abdominal infection may be the cause of the patient's pain and that further diagnostic testing is needed. The monocytes are at a normal level. The slight decreases in hemoglobin and platelet count also would be reported but would not require any immediate action.