A nurse is caring for a client who has a thrombus and is receiving a continuous infusion of heparin. The client asks the nurse how long it will take for the heparin to dissolve the clot.
Which of the following responses should the nurse make?
"The time it takes for heparin to dissolve a clot depends on the size of the clot.".
"The time it takes for heparin to dissolve a clot varies between clients.".
"Usually, it takes at least 2 to 3 days for heparin to dissolve a clot.".
"Heparin prevents new clots from forming rather than dissolving existing ones.".
The Correct Answer is D
Heparin is an anticoagulant that is used to decrease the clotting ability of the blood and help prevent harmful clots from forming in blood vessels 1.
However, heparin will not dissolve blood clots that have already formed, but it may prevent the clots from becoming larger and causing more serious problems 12.
Choices A, B, and C are incorrect because heparin does not dissolve existing clots. Instead, it works to prevent new clots from forming 12.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
“I understand your request to have only male staff members attend to your care.” This response acknowledges the client’s request and shows that the nurse is willing to listen to his concerns.
Choice A is not the correct answer because it can be perceived as confrontational and may make the client feel uncomfortable.
Choice C is not the correct answer because it dismisses the client’s request and may make him feel unheard.
Choice D is not the correct answer because it implies that the nurse will immediately comply with the client’s request without further discussion or consideration of other options.
Correct Answer is ["50"]
Explanation
To calculate the flow rate in gtt/min, you need to divide the total volume of the IV fluid (400 mL) by the total infusion time in minutes (8 hours x 60 minutes/hour = 480 minutes) and then multiply by the drop factor of the manual IV tubing (60 gtt/mL).
This gives you a flow rate of (400 mL / 480 minutes) x 60 gtt/mL = 50 gtt/min.
The other choices are not answers because they are not provided in the question.
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