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When administering enoxaparin (Lovenox) to a client for DVT prophylaxis, what is the most important lab value to monitor?
- A. Platelet count
- B. PT/INR
- C. aPTT
- D. Hemoglobin
Correct Answer: A
Rationale: The correct answer is A: Platelet count. When administering enoxaparin for DVT prophylaxis, monitoring platelet count is crucial because enoxaparin can cause thrombocytopenia. Decreased platelet count can increase the risk of bleeding. Monitoring PT/INR and aPTT is more relevant for monitoring warfarin or heparin therapy, not enoxaparin. Hemoglobin monitoring is important for assessing anemia but not specifically related to enoxaparin administration for DVT prophylaxis.
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Which chronic respiratory condition is characterized by the narrowing and inflammation of the airways, leading to difficulty breathing?
- A. Asthma
- B. COPD
- C. Bronchitis
- D. Pneumonia
Correct Answer: A
Rationale: Step-by-step rationale:
1. Asthma is characterized by airway inflammation and narrowing, leading to difficulty breathing.
2. It is a chronic respiratory condition with symptoms like wheezing, coughing, and shortness of breath.
3. Asthma exacerbations can be triggered by various factors like allergens or exercise.
4. Treatment includes bronchodilators and anti-inflammatory medications to manage symptoms.
5. COPD, bronchitis, and pneumonia involve different pathophysiological mechanisms and are not primarily characterized by airway narrowing.
Summary:
Asthma is the correct answer due to its specific features of airway inflammation and narrowing, distinct from COPD, bronchitis, and pneumonia, which have different underlying causes and symptoms.
A client on spironolactone (Aldactone) has a potassium level of 6.0 mEq/L. What is the nurse's priority action?
- A. Hold the spironolactone and notify the healthcare provider.
- B. Administer a potassium supplement.
- C. Continue the spironolactone as ordered.
- D. Increase the dose of spironolactone.
Correct Answer: A
Rationale: The correct answer is A: Hold the spironolactone and notify the healthcare provider. Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia. With a potassium level of 6.0 mEq/L, the client is at risk for serious cardiac complications. Holding the medication and notifying the healthcare provider is the priority to prevent further increase in potassium levels. Administering a potassium supplement (B) would exacerbate the hyperkalemia. Continuing the spironolactone as ordered (C) or increasing the dose (D) would also worsen the situation.
What is a condition where the arteries that supply blood to the heart muscle become hardened and narrowed due to the buildup of plaque?
- A. Atherosclerosis
- B. Aneurysm
- C. Arrhythmia
- D. Peripheral artery disease
Correct Answer: A
Rationale: The correct answer is A: Atherosclerosis. Atherosclerosis is the condition where arteries supplying blood to the heart become hardened and narrowed due to plaque buildup, leading to decreased blood flow and potential heart issues. Aneurysm (B) is the weakening and bulging of an artery wall, not related to plaque buildup. Arrhythmia (C) is an irregular heartbeat, not directly related to arterial blockages. Peripheral artery disease (D) involves narrowing of arteries in the limbs, not specifically related to the heart. Thus, Atherosclerosis is the most fitting choice for the given condition.
You are working with an experienced nursing assistant and LPN/LVN in caring for a group of patients. You have developed a nursing diagnosis of Activity Intolerance related to fatigue and chest pain for a patient who had an acute myocardial infarction 3 days ago. Which of these nursing activities included in the care plan is best delegated to the LPN/LVN?
- A. Administer nitroglycerin (Nitro-Stat) if chest discomfort occurs during patient activities.
- B. Monitor pulse, blood pressure, and oxygen saturation before and after patient ambulation.
- C. Teach the patient energy conservation techniques to decrease myocardial oxygen demand.
- D. Explain the rationale for alternating rest periods with exercise to the patient and family.
Correct Answer: B
Rationale: Monitoring vital signs is within the scope of practice for an LPN/LVN and does not require advanced assessment skills.
The client on spironolactone should avoid which of the following?
- A. Foods high in potassium
- B. Foods high in sodium
- C. Foods high in calcium
- D. Foods high in chloride
Correct Answer: A
Rationale: The correct answer is A: Foods high in potassium. Spironolactone is a potassium-sparing diuretic that can increase potassium levels in the body. Consuming foods high in potassium while taking spironolactone can lead to hyperkalemia, a serious condition characterized by high levels of potassium in the blood. The other choices (B: Foods high in sodium, C: Foods high in calcium, D: Foods high in chloride) are not directly contraindicated with spironolactone use. Sodium intake is typically restricted in patients taking diuretics, but it is not specifically related to spironolactone. Calcium and chloride levels are not significantly affected by spironolactone, so foods high in these minerals do not need to be avoided.