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 A

Explanation

Aspiration is a common complication in patients with dysphagia post-stroke due to impaired swallowing reflexes, leading to food or liquid entering the lungs.

Choice B reason: Gastroesophageal reflux disease could be a concern but is not directly related to dysphagia post-stroke.

Choice C reason: Peptic ulcer disease is not typically a complication of dysphagia post-stroke.

Choice D reason: Dumping syndrome is related to rapid gastric emptying post-meal, not dysphagia post-stroke.

A. Bubbling of the water in the water seal chamber with exhalation B. Crepitus in the area above and surrounding the insertion site C. Movement of the trachea toward the unaffected side D. Eyelets are not visible

Correct Answer is B

Explanation

Choice A reason:Bubbling in the water seal chamber with exhalation can be normal, indicating that air is being evacuated from the pleural space.

Choice B reason:Crepitus, or subcutaneous emphysema, can indicate that air is leaking into the tissue around the chest tube site, which is a serious complication that requires immediate attention.

Choice C reason:

Movement of the trachea toward the unaffected side can indicate tension pneumothorax, a life-threatening condition that also requires immediate attention.

Choice D reason:If the eyelets of the chest tube are not visible, it may simply mean that the tube is inserted fully, which is not an immediate cause for concern unless other symptoms are present.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who had a stroke and has dysphagia. For which of the following complications should the nurse monitor the client?

Correct Answer is A

Explanation

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?

Correct Answer is B

Explanation

A nurse is instructing a client with diabetes mellitus about peritoneal dialysis. The nurse tells the client that it is important to maintain the prescribed dwell time for the dialysis due to the risk of which complication?

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 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 monitoring an older adult female client who had a myocardial infarction (MI) for the development of an acute kidney injury (AKI). Which of the following findings indicate an increased risk of acute kidney injury (AKI)?

A client is admitted to the emergency room with renal calculi. Upon assessment, which of the following findings should the nurse expect?

A client with a history of angina is being admitted to the emergency department with a suspected myocardial infarction (MI). Which of the following findings will help the nurse distinguish stable angina from an MI?

A nurse in the emergency department is caring for a client who took three nitroglycerin tablets sublingually for chest pain. The client reports relief from the chest pain but now is experiencing a headache. Which of the following statements should the nurse make?

A nurse is caring for a client who reports a new onset of severe chest pain. Which of the following actions should the nurse take to determine if the client is experiencing a myocardial infarction?