A nurse is caring for a client who is receiving intravenous heparin therapy for deep vein thrombosis. The nurse evaluates for side effects of this drug by observing for:

Petechiae

Slowing pulse rate

Confusion

Pruritus

Answer and Explanation

The Correct Answer is A

Rationale:

A. Petechiae are small, pinpoint red or purple spots on the skin that may indicate bleeding or thrombocytopenia, which can be a side effect of heparin therapy.

B. Slowing pulse rate is not typically associated with heparin therapy.

C. Confusion is not typically associated with heparin therapy.

D. Pruritus (itching) is not typically associated with heparin therapy.

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Free Nursing Study Resources

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

Explanation

Rationale:

A. Preventing vagal stimulation can help prevent bradycardia.

B. Acute pain is not typically associated with sinus bradycardia.

C. Preventing falls is important because bradycardia can lead to dizziness and falls.

D. Assessing for neurologic changes is important because bradycardia can affect cerebral perfusion.

E. Monitoring fluid volume excess is not directly related to sinus bradycardia.

A. "The next pacemaker check will be when the batteries need to be replaced." B. "My pacemaker will need reprogramming if I stand too close to a microwave oven." C. "I will take my pulse weekly." D. "The pacemaker can be checked from home by using the telephone."

Correct Answer is D

Explanation

A. Regular pacemaker checks are scheduled periodically, not only when the battery needs replacement.
B. Modern pacemakers are well-shielded and are not affected by household microwaves.
C. Clients should check their pulse daily to ensure proper pacemaker function, not just weekly.
D. Many pacemakers can be checked remotely using telephone or wireless technology, allowing for convenient monitoring.

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A nurse is caring for a client who is receiving intravenous heparin therapy for deep vein thrombosis. The nurse evaluates for side effects of this drug by observing for:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client has undergone diagnostic testing and received a diagnosis of sinus bradycardia. Which interventions are most appropriate and should be included in the client's plan of care? (SELECT ALL THAT APPLY)

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

Explanation

A nurse is providing teaching to a client who has a permanent pacemaker and has just had the initial pacemaker check. Which of the following client statements indicates to the nurse that the teaching was effective?

Correct Answer is D

Explanation

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