A client has a prescription for heparin 5000 units IV STAT. Several pre-filled syringes of low molecular weight heparin are available in the client’s medication drawer. Which action should the nurse implement?

Request a prescription to change the route of administration and use the available heparin.

Calculate and administer the equivalent dose of the available low molecular weight heparin.

Dilute the available heparin in 250 ml of normal saline solution prior to IV administration.

Advise the pharmacy of the need to deliver a vial of heparin to the nursing unit immediately.

Answer and Explanation

The Correct Answer is D

Choice A reason:

Requesting a prescription to change the route of administration and use the available heparin is not appropriate. Low molecular weight heparin (LMWH) and unfractionated heparin (UFH) are not interchangeable on a unit-for-unit basis. They have different pharmacokinetics and dosing requirements. Changing the route without proper guidance can lead to incorrect dosing and potential complications.

Choice B reason:

Calculating and administering the equivalent dose of the available low molecular weight heparin is incorrect. LMWH and UFH have different dosing protocols and are not directly interchangeable. Administering LMWH instead of UFH without proper conversion and guidance can result in inappropriate anticoagulation.

Choice C reason:

Diluting the available heparin in 250 ml of normal saline solution prior to IV administration is not appropriate. The prescription specifies heparin 5000 units IV STAT, which indicates an immediate need for intravenous administration. Diluting and administering it in this manner does not align with the urgency of the order.

Choice D reason:

Advising the pharmacy of the need to deliver a vial of heparin to the nursing unit immediately is the correct action. This ensures that the client receives the prescribed medication in the correct form and dosage as ordered by the healthcare provider. It is crucial to follow the specific instructions for heparin administration to ensure patient safety and effective anticoagulation.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"D"}

Explanation

Choice A: Syncope

Reason: Syncope, or fainting, is a temporary loss of consciousness typically caused by a drop in blood flow to the brain. The client has a history of symptomatic bradycardia, which is a slow heart rate that can lead to insufficient blood flow and oxygen to the brain, causing syncope. The client reported passing out once due to a low heart rate, which aligns with the symptoms of syncope. Bradycardia can cause a significant drop in cardiac output, leading to decreased cerebral perfusion and resulting in fainting episodes.

Choice B: Hypovolemic Shock

Reason: Hypovolemic shock occurs when there is a significant loss of blood or fluids, leading to decreased blood volume and inadequate tissue perfusion. Symptoms include rapid heartbeat, low blood pressure, and confusion. However, the client’s history and current condition do not indicate any significant blood or fluid loss. The primary issue is related to the heart’s electrical activity and rate, not volume loss.

Choice C: Heart Failure

Reason: Heart failure is a condition where the heart cannot pump blood effectively, leading to symptoms like shortness of breath, fatigue, and fluid retention. While the client has a history of atrial fibrillation, which can contribute to heart failure, the immediate concern is the symptomatic bradycardia causing syncope. The client’s symptoms of low heart rate and fainting are more directly related to bradycardia rather than heart failure.

Choice D: Adverse Drug Reaction

Reason: An adverse drug reaction could cause various symptoms, including changes in heart rate and blood pressure. However, the client has not reported any new medications or changes in her current regimen that would suggest an adverse reaction. The symptoms described are consistent with her known condition of bradycardia.

Choice A: Anxiety

Reason: Anxiety can cause various physiological responses, including increased heart rate and blood pressure. However, the client’s primary issue is a low heart rate, which is not typically associated with anxiety. Anxiety might exacerbate symptoms but is not the root cause of the blood pressure changes in this case.

Choice B: Antibiotic

Reason: While antibiotics can cause side effects, they are not typically associated with significant changes in blood pressure. The vancomycin administered was for endocarditis prophylaxis and is unlikely to be the cause of the blood pressure changes observed.

Choice C: IV Infiltration

Reason: IV infiltration occurs when IV fluids leak into the surrounding tissue, causing swelling, pain, and potential tissue damage. While this can cause localized issues, it is not typically associated with systemic blood pressure changes. The client’s symptoms are more consistent with a systemic issue related to her heart condition.

Choice D: Vasodilation

Reason: Vasodilation refers to the widening of blood vessels, which can lead to a drop in blood pressure. This can occur as a response to various factors, including medications, heat, or a physiological response to low blood flow. In the context of bradycardia, the body’s compensatory mechanisms might include vasodilation to improve blood flow, which can result in lower blood pressure.

A. Avoid taking on an empty stomach. B. Consume 2 liters of water daily. C. Reduce caffeine and acidic intake. D. Double the dose if a dose is missed.

Correct Answer is D

Explanation

Choice A Reason:

Avoiding taking allopurinol on an empty stomach is a common recommendation to prevent stomach upset. Taking the medication with food can help reduce gastrointestinal discomfort, making this advice appropriate and not requiring additional instruction.

Choice B Reason:

Consuming 2 liters of water daily is advised when taking allopurinol to help prevent kidney stones and ensure proper hydration. Adequate fluid intake helps to dilute the urine and reduce the risk of uric acid crystal formation, making this advice correct and not needing further instruction.

Choice C Reason:

Reducing caffeine and acidic intake can be beneficial for individuals taking allopurinol, as these substances can increase uric acid levels and potentially exacerbate gout symptoms. This advice is appropriate and does not require additional instruction.

Choice D Reason:

Doubling the dose if a dose is missed is incorrect and potentially dangerous. Allopurinol should be taken exactly as prescribed, and doubling up on doses can increase the risk of side effects and toxicity. If a dose is missed, the client should take it as soon as they remember, but if it is almost time for the next dose, they should skip the missed dose and continue with their regular schedule. This instruction requires correction by the nurse.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A client has a prescription for heparin 5000 units IV STAT. Several pre-filled syringes of low molecular weight heparin are available in the client’s medication drawer. Which action should the nurse implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"D"}

Explanation

A client receives a prescription for allopurinol. Which information provided by the client requires additional instruction by the nurse?

Correct Answer is D

Explanation

A client has a prescription for heparin 5000 units IV STAT. Several pre-filled syringes of low molecular weight heparin are available in the client’s medication drawer. Which action should the nurse implement?

The nurse is caring for a client receiving a prescription for sucralfate to treat a peptic ulcer. Which instruction should the nurse provide during discharge education?

The nurse is assessing a client who was recently diagnosed with Parkinson’s disease and is taking carbidopa-levodopa. The client is concerned that the medication is not working. Which intervention should the nurse implement first?

The nurse observes that a client has become lethargic 30 minutes after receiving an opioid injection for pain. Which vital sign should the nurse obtain first?

The healthcare provider prescribes propylthiouracil (PTU) and Lugol’s solution, a strong iodine solution, for a client with hyperthyroidism. How should the nurse schedule the administration of these medications?

A client with chronic lower back pain has been taking ibuprofen PO twice a day for several months. Which assessment is most important for the nurse to complete?

The nurse is teaching a client who has been diagnosed with human immunodeficiency virus (HIV) about the antiretroviral medication regimen. Which statement provided by the client requires additional instruction by the nurse?