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 B

Explanation

Diuretics are drugs that increase urine output and reduce fluid volume in the body. They lower blood pressure by decreasing the amount of sodium and water in the blood vessels, which reduces the pressure on the walls of the arteries. Diuretics are often the first-line therapy for hypertension, especially for older adults and African Americans.

Choice A is wrong because reaching the goal blood pressure depends on many factors, such as the severity of hypertension, the response to medication, and the lifestyle changes of the client. It may take longer than 2 months to achieve optimal blood pressure control.

Choice C is wrong because limiting alcohol consumption to three drinks a day is not enough to prevent or treat hypertension. Alcohol can raise blood pressure by interfering with the effects of medication, stimulating the nervous system, and increasing fluid retention. The recommended limit for alcohol intake is no more than one drink a day for women and two drinks a day for men.

Choice D is wrong because hypertension cannot be cured with medication. Hypertension is a chronic condition that requires lifelong management and monitoring. Medication can help lower blood pressure, but it does not address the underlying causes of hypertension, such as genetics, obesity, stress, or kidney disease. Lifestyle modifications, such as diet, exercise, weight loss, and smoking cessation, are also essential for preventing complications and improving quality of life.

Normal ranges for blood pressure are:

• Systolic: less than 120 mm Hg

• Diastolic: less than 80 mm Hg

Hypertension is defined as:

• Systolic: 130 mm Hg or higher

• Diastolic: 80 mm Hg or higher

A. Drinking 8 oz nonfat milk daily. B. Eating popcorn at the movie theater. C. Walking 1 mile daily at 12 min/mile pace. D. Consuming 36 oz beer daily.

Correct Answer is D

Explanation

Drinking 8 oz nonfat milk daily: Nonfat milk is low in fat and calories and is often recommended as part of a healthy diet that can help manage blood pressure. This action does not increase the risk of hypertension.

Eating popcorn at the movie theater: While movie theater popcorn can be high in salt and unhealthy fats, eating it occasionally in moderation may not significantly impact blood pressure. However, a regular high-sodium diet could contribute to hypertension.

Walking 1 mile daily at 12 min/mile pace: Regular physical activity like walking can help lower blood pressure and reduce the risk of hypertension. This is a positive action that helps in managing and preventing hypertension.

Consuming 36 oz beer daily: Consuming alcohol in large quantities regularly can lead to increased blood pressure and is a known risk factor for developing hypertension. 36 ounces of beer daily is a significant amount and could contribute to high blood pressure and other health issues.

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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

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Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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