A nurse is caring for a client who has a pulmonary embolism and has been on a heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make?

"Both heparin and warfarin work together to dissolve the clots."

"Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level."

"The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay."

"I will call the provider to get a prescription for discontinuing the IV heparin today."

Answer and Explanation

The Correct Answer is B

Choice A reason: Heparin and warfarin do not work together to dissolve clots. Heparin acts quickly to prevent further clotting, while warfarin is used for long-term anticoagulation.

Choice B reason: Warfarin's onset of action is slow, requiring several days to reach therapeutic levels. During this time, heparin is used to provide immediate anticoagulation to prevent new clot formation or the growth of existing clots.

Choice C reason: IV heparin does not increase the effects of warfarin. They are used concurrently because of the delay in warfarin's onset of action.

Choice D reason: It is not appropriate to discontinue heparin immediately after starting warfarin due to the delay in warfarin reaching therapeutic levels. The overlap is necessary to ensure continuous anticoagulation.

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Correct Answer is D

Explanation

Choice A reason: Tenderness in the left upper abdomen is not typically associated with an obstruction of the common bile duct. This symptom is more commonly related to conditions affecting the stomach, pancreas, or spleen. The common bile duct is in the right upper quadrant of the abdomen, and tenderness in this area might be expected with its obstruction.

Choice B reason: Ecchymosis of the extremities is not a common finding in common bile duct obstruction. Ecchymosis, or bruising, is usually due to trauma, blood disorders, or other causes of fragile blood vessels and is not related to bile duct issues.

Choice C reason: Pale-colored urine is the opposite of what might be expected with common bile duct obstruction. Typically, the urine may become dark due to increased bilirubin levels that are excreted by the kidneys when the bile duct is obstructed.

Choice D reason: Fatty stools, or steatorrhea, are a classic finding in common bile duct obstruction. When bile flow is blocked, fats are not properly digested and absorbed, leading to stools that are bulky, greasy, and often have a foul odor. This occurs because bile is necessary for the emulsification and absorption of dietary fats in the intestine.

A. The client states that pain occurs 30 minutes to 60 minutes after a meal. B. The client states that pain often occurs at night. C. The client reports a sensation of bloating. D. The client reports pain relieved by eating. E. The client experiences pain upon palpation of the epigastric region.

Correct Answer is ["A","B","C","D","E"]

Explanation

Choice A reason: Pain occurring 30 to 60 minutes after a meal is a common symptom of gastric ulcers due to the increased gastric acid secretion during digestion that can aggravate the ulcer.

Choice B reason: Pain at night is also typical for gastric ulcers as the circadian rhythm can influence acid secretion, potentially leading to increased discomfort during the night.

Choice C reason: A sensation of bloating can be associated with gastric ulcers due to delayed gastric emptying or increased sensitivity of the stomach lining.

Choice D reason:Pain relieved by eating is indicative of gastric ulcers because food can act as a buffer to stomach acid, temporarily relieving pain².

Choice E reason:Pain upon palpation of the epigastric region is expected in clients with gastric ulcers due to the localized inflammation and sensitivity of the stomach lining².

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has an obstruction of the common bile duct resulting from chronic cholecystitis. Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

A nurse is completing an assessment of a client who has a gastric ulcer. Which of the following findings should the nurse expect? (Select all that apply).

Correct Answer is ["A","B","C","D","E"]

Explanation

A nurse is caring for a client during his first hemodialysis treatment. The client reports a headache, nausea, and is agitated. Which of the following complications should the nurse identify these findings as manifestations of?

A client who has a recent closed head injury reports a severe headache and is restless. Which of the following is an appropriate nursing intervention?

A nurse is assessing a client who has a pneumothorax with a chest tube in place. For which of the following findings should the nurse notify the provider immediately?

A nurse is caring for a client who has cirrhosis of the liver. Which of the following medications should the nurse anticipate may be ordered for this client? (Select all that apply.)

A nurse is preparing to administer a 2 mg IV bolus of morphine sulfate. Morphine sulfate is available in a concentration of 10 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

A nurse is caring for a client who has sustained a traumatic brain injury. The nurse should monitor the client for which of the following manifestations of increased intracranial pressure?

A nurse in an emergency department is planning care for a client who is having an acute myocardial infarction (MI). Which of the following medications should the nurse plan to administer after the initial acute phase to manage the client's pain and anxiety?

A nurse is reviewing the laboratory data of a client following a hemodialysis treatment. The nurse should expect to find a decrease in which of the following laboratory values?