A nurse is caring for a client who has deep vein thrombosis (DVT). The client has received intravenous (IV) heparin for the past 5 days and now has a new prescription for oral warfarin in addition to the heparin. The client asks the nurse if both medications are necessary. Which of the following is an appropriate response by the nurse?

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

"Heparin enhances the effects of the warfarin."

"I will ask the charge nurse to call your provider and get an explanation."

"Heparin will be continued until the warfarin reaches a therapeutic level."

Answer and Explanation

The Correct Answer is D

Choice A reason : This statement is incorrect because neither heparin nor warfarin dissolves clots. They prevent the formation of new clots and the growth of existing clots.

Choice B reason : This statement is not accurate. Heparin and warfarin do not enhance each other's effects. They work in different pathways of the clotting cascade. Heparin acts quickly, whereas warfarin takes several days to reach therapeutic levels.

Choice C reason : While seeking clarification from a provider is a part of good nursing practice, it is not the most informative response for the client. The nurse should provide education based on their knowledge and available information.

Choice D reason : This is the correct response. Heparin acts quickly and is used to stabilize the patient while waiting for warfarin to reach therapeutic levels, which is monitored by the international normalized ratio (INR) and usually takes several days.

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Correct Answer is C

Explanation

Choice A reason : Advising a client with PVD not to go barefoot is correct. Going barefoot can increase the risk of injury to the feet, which can be particularly dangerous in individuals with PVD due to poor circulation. Any injuries to the feet may heal poorly and can lead to complications such as ulcers or infections.

Choice B reason : Using a thermometer to check the temperature of bath water is a recommended practice for clients with PVD. Due to potential nerve damage and reduced sensation in the extremities, clients may not accurately gauge water temperature, leading to burns. Therefore, using a thermometer helps prevent thermal injury.

Choice C reason : Wearing stockings with elastic tops is not recommended for clients with PVD. Elastic tops can constrict blood flow in the legs, exacerbating circulation problems. Instead, clients should wear non-constricting, well-fitting socks or stockings that promote blood flow.

Choice D reason : Avoiding crossing legs at the knees is good advice for clients with PVD. Crossing the legs can restrict blood flow to the lower extremities, which is already compromised in PVD. Keeping the legs uncrossed and elevating them when possible can help improve circulation.

A. Low sodium diet B. Serum cardiac enzyme levels C. MRI of the chest D. Physical therapy

Correct Answer is C

Explanation

Choice A reason : A low sodium diet is often prescribed for patients with heart conditions to help manage blood pressure and fluid retention. It is not typically something that would need to be questioned in the context of recent pacemaker surgery.

Choice B reason : Checking serum cardiac enzyme levels is a common practice after heart surgery to monitor for any signs of damage to the heart muscle. This would not typically be questioned unless there were specific contraindications for the patient.

Choice C reason : An MRI of the chest should be questioned because MRI machines use strong magnetic fields that can interfere with the functioning of a pacemaker. Unless the pacemaker is specifically labeled as MRI-safe, this type of imaging could be dangerous for the patient.

Choice D reason : Physical therapy is a standard part of recovery after many types of surgery, including pacemaker insertion, to help the patient regain strength and mobility. It would not typically be questioned unless the patient had specific restrictions.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a client who has peripheral vascular disease (PVD). The nurse should recognize that which of the following statements by the client indicates a need for further teaching?

Correct Answer is C

Explanation

A nurse is caring for a client who recently had surgery for the insertion of a permanent pacemaker. Which of the following prescriptions should the nurse question?

Correct Answer is C

Explanation

A nurse is reviewing the laboratory results for a male adult client who is at risk for peripheral arterial disease due to atherosclerosis. The nurse should identify which of the following results places the client at risk :

A nurse is contributing to the plan of care for a client who is admitted with deep vein thrombosis (DVT) of the left leg. Which of the following interventions should the nurse include in the plan?

A nurse is assisting with teaching a class about documenting blood pressure. The nurse should include documenting which of the following information?

A nurse is caring for a client immediately following a cardiac catheterization with a femoral artery approach. Which of the following actions should the nurse take?

A nurse is assisting with the care of a client who was admitted to the telemetry unit after experiencing chest pain, dyspnea, and diaphoresis. Which of the following ECG findings is a manifestation of acute myocardial infarction?

A nurse is caring for a client who has a prescription for digoxin 0.25 mg PO daily. The amount available is digoxin 0.125 mg/tablet. How many tablets should the nurse administer per dose? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A nurse is collecting data from a client who has atrial fibrillation. When documenting the quality of the client's pulse, which of the following terms should the nurse use?