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

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.

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. E. Eating a diet high in sodium.

Correct Answer is ["D","E"]

Explanation

Drinking 36 oz beer daily and eating a diet high in sodium are actions that increase the risk for hypertension.

Here is why:

• Drinking too much alcohol can raise blood pressure and also damage the liver, brain, and heart.The American Heart Association recommends limiting alcohol intake to no more than one drink per day for women and two drinks per day for men.

• Eating a diet high in sodium can cause the body to retain fluid, which increases blood pressure.The American Heart Association recommends limiting sodium intake to no more than 2,300 mg per day, and ideally no more than 1,500 mg per day.

Choice A, B, and C are wrong because:

• Drinking 8 oz nonfat milk daily is not a risk factor for hypertension.In fact, dairy products may help lower blood pressure by providing calcium, potassium, and protein.

• Eating popcorn at the movie theater is not a risk factor for hypertension, unless the popcorn is heavily salted or buttered.Popcorn is a whole grain that can provide fiber and antioxidants.

• Walking 1 mile daily at 12 min/mile pace is not a risk factor for hypertension.On the contrary, physical activity can help lower blood pressure by strengthening the heart and blood vessels.

Normal blood pressure range is less than 120/80 mm Hg (millimeters of mercury).

Elevated blood pressure range is 120-129/less than 80 mm Hg.

Hypertension stage 1 range is 130-139/80-89 mm Hg.

Hypertension stage 2 range is 140 or higher/90 or higher mm Hg.Hypertensive crisis range is higher than 180/higher than 120 mm Hg.

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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 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.)

Correct Answer is ["D","E"]

Explanation

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 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 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 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 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 one).