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 E

Explanation

All of the statements by the client indicate alack of understandingof the medication.

Here is why:

Choice A is wrong because hydrochlorothiazide (HCTZ) is a diuretic (water pill) that increases the amount of urine produced and excreted by the kidneys. Taking this medication at bedtime may cause frequent urination at night and disrupt the sleep cycle.It is recommended to take HCTZ in the morning or early afternoon.

Choice B is wrong because HCTZ is prescribed to treat high blood pressure (hypertension), which is a chronic condition that requires long-term management. Stopping the medication abruptly may cause a rebound increase in blood pressure and increase the risk of complications such as stroke, heart attack, or kidney failure.The client should continue taking HCTZ as directed by the doctor, even if the blood pressure becomes normal.

Choice C is wrong because a persistent cough is not a common side effect of HCTZ. A cough may be a sign of an allergic reaction, a respiratory infection, or another condition that needs medical attention. HCTZ may cause other side effects such as nausea, dizziness, headache, low blood pressure, low potassium levels, high calcium levels, or skin rash.The client should report any unusual or bothersome symptoms to the doctor.

Choice D is wrong because HCTZ is not a medication that can be taken as needed for symptoms of high blood pressure. High blood pressure often has no symptoms and can damage the blood vessels and organs over time. HCTZ works by reducing the fluid volume and pressure in the blood vessels.It needs to be taken regularly and consistently to maintain its effectiveness and prevent fluctuations in blood pressure. The client should be educated about the purpose, benefits, risks, and instructions of taking HCTZ. The client should also be advised to monitor their blood pressure, weight, fluid intake and output, and electrolyte levels while on this medication.The client should also be counseled about lifestyle modifications such as diet, exercise, stress management, and smoking cessation that can help lower blood pressure and improve overall health.

A. “Aspirin will help lower your blood pressure and reduce your cardiac workload.” B. “Aspirin will help prevent blood clots from forming in your coronary arteries.” C. “Aspirin will help dilate your coronary arteries and increase blood flow to your heart.” D. “Aspirin will help reduce inflammation and pain in your chest.”.

Correct Answer is B

Explanation

Aspirin is an antiplatelet drug that inhibits the aggregation of platelets and prevents the formation of thrombi, which can occlude the coronary arteries and cause angina or myocardial infarction.Aspirin is recommended for clients who have angina and are at risk for myocardial infarction as a secondary prevention measure.

Choice A is wrong because aspirin does not lower blood pressure or reduce cardiac workload.These effects are achieved by other drugs such as beta blockers, calcium channel blockers, or angiotensin-converting enzyme inhibitors.

Choice C is wrong because aspirin does not dilate the coronary arteries or increase blood flow to the heart.These effects are achieved by other drugs such as nitrates or calcium channel blockers.

Choice D is wrong because aspirin does not reduce inflammation or pain in the chest.These effects are achieved by other drugs such as nonsteroidal anti-inflammatory drugs or opioids.

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

Correct Answer is E

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?

Correct Answer is B

Explanation

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 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?

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).

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 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?

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