A nurse is monitoring a client who is receiving intravenous heparin for angina and has a history of atrial fibrillation. Which of the following laboratory tests should the nurse use to evaluate the effectiveness of heparin therapy?

Prothrombin time (PT)

International normalized ratio (INR)

Activated partial thromboplastin time (aPTT)

Platelet count.

Answer and Explanation

The Correct Answer is C

Activated partial thromboplastin time (aPTT) is the laboratory test that the nurse should use to evaluate the effectiveness of heparin therapy. Heparin is an anticoagulant that works by helping antithrombin inactivate thrombin and factor Xa, reducing the production of fibrin and thus decreasing the formation of clots. The aPTT measures the time it takes for a clot to form in a sample of blood after adding certain substances. The normal range for aPTT is 25 to 35 seconds. A therapeutic level of heparin is 1.5 to 2.5 times the normal value, or 46 to 70 seconds.

Choice A is wrong because prothrombin time (PT) is a test that measures the time it takes for a clot to form in a sample of blood after adding tissue factor. PT is used to monitor warfarin therapy, not heparin therapy. The normal range for PT is 11 to 13 seconds.

Choice B is wrong because international normalized ratio (INR) is a standardized way of reporting the PT results, taking into account the variations in different laboratories and reagents. INR is also used to monitor warfarin therapy, not heparin therapy. The normal range for INR is 0.8 to 1.2.

Choice D is wrong because platelet count is a test that measures the number of platelets in a sample of blood. Platelets are cell fragments that help with blood clotting by sticking together and forming a plug at the site of injury. Platelet count is not directly related to heparin therapy, although heparin can cause a rare but serious adverse effect called heparin-induced thrombocytopenia (HIT), which is a drop in platelet count due to an immune reaction that leads to excessive clotting. The normal range for platelet count is 150,000 to 400,000/mm3.

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Correct Answer is A

Explanation

Nitroprusside is a vasodilator that lowers blood pressure by dilating blood vessels.It is used to treat hypertensive crisis, which is a life-threatening condition of very high blood pressure.However, nitroprusside can cause excessive hypotension, which is a serious side effect that can lead to irreversible ischemic injuries or death. Therefore, the nurse should monitor the client’s blood pressure continuously and adjust the infusion rate accordingly.

Choice B is wrong because Bradycardia is wrong because nitroprusside does not affect the heart rate directly.However, bradycardia can occur as a reflex response to hypotension, which is a possible adverse effect of nitroprusside. Therefore, the nurse should also monitor the client’s heart rate and rhythm.

Choice C is wrong because Tachycardia is wrong because nitroprusside does not cause tachycardia directly.However, tachycardia can occur as a compensatory mechanism to hypotension, which is a possible adverse effect of nitroprusside. Therefore, the nurse should also monitor the client’s heart rate and rhythm.

Choice D is wrong because Hypertension is wrong because nitroprusside is used to lower blood pressure, not to raise it.However, hypertension can occur if the infusion is stopped abruptly, which can cause rebound vasoconstriction and increased blood pressure. Therefore, the nurse should taper off the infusion gradually and avoid sudden discontinuation.

Normal ranges for blood pressure are systolic less than 120 mmHg and diastolic less than 80 mmHg.

Normal ranges for heart rate are 60 to 100 beats per minute.

A. “I should keep the tablets in a dark, glass bottle.” B. “I should take one tablet every 5 minutes for up to three doses if I have chest pain.” C. “I should swallow the tablet with a glass of water.” D. “I should replace the tablets every 6 months.”.

Correct Answer is C

Explanation

This statement indicates a need for further teaching because sublingual nitroglycerin tablets should not be swallowed, but dissolved under the tongue for rapid absorption and onset of action. Swallowing the tablet would reduce its effectiveness and delay its action.

Choice A is wrong because nitroglycerin tablets should be kept in a dark, glass bottle to protect them from light, heat, and moisture, which can degrade the drug.The bottle should be tightly closed and labeled with the date of opening.

Choice B is wrong because nitroglycerin tablets can be taken every 5 minutes for up to three doses if chest pain persists.If the pain is not relieved after three doses, the client should call 911 or seek emergency medical attention.

Choice D is wrong because nitroglycerin tablets have a short shelf life and should be replaced every 6 months or as indicated by the manufacturer.The client should check the expiration date and discard any unused tablets after 6 months.

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A nurse is monitoring a client who is receiving intravenous heparin for angina and has a history of atrial fibrillation. Which of the following laboratory tests should the nurse use to evaluate the effectiveness of heparin therapy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is receiving nitroprusside for hypertensive crisis. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect of this medication?

Correct Answer is A

Explanation

A nurse is teaching a client who has stable angina about the use of sublingual nitroglycerin. Which of the following statements by the client indicates a need for further teaching?

Correct Answer is C

Explanation

A nurse is administering aspirin to a client who has angina and is at risk for myocardial infarction. Which of the following statements by the nurse explains the rationale for this medication?

A client with hypertension is prescribed hydrochlorothiazide (HCTZ). Which of the following statements by the client indicates an understanding of the medication?

A nurse is teaching a middle-age client about hypertension. Which of the following information should the nurse include in the teaching?

A nurse is screening a male client for hypertension. The nurse should identify that which of the following actions by the client increase his risk for hypertension? (Select all that apply.)

A nurse is monitoring a client who is receiving intravenous heparin for angina and has a history of atrial fibrillation. Which of the following laboratory tests should the nurse use to evaluate the effectiveness of heparin therapy?

A nurse is screening a male client for hypertension. The nurse should identify that which of the following actions by the client increase his risk for hypertension? (Select one).