A nurse is preparing to administer enoxaparin to a client. Which of the following actions should the nurse take?

Administer the medication into the client's muscle.

Apply firm pressure to the injection site following administration.

Insert the syringe needle halfway into the client's skin.

Expel the air bubble from the syringe prior to injection

Answer and Explanation

The Correct Answer is D

A. Administer the medication into the client's muscles.
Explanation: This is incorrect because enoxaparin is usually administered subcutaneously, not into the muscle.
B. Apply firm pressure to the injection site following administration.
Explanation: This is incorrect because while applying gentle pressure after a subcutaneous injection is common practice, it is not specific to enoxaparin.
C. Insert the syringe needle halfway into the client's skin.
Explanation: This is incorrect because the needle should be inserted fully into the subcutaneous tissue, not just halfway, for proper administration of enoxaparin.
D. Expel the air bubble from the syringe prior to injection.
Explanation: This is the correct action. Expelling air bubbles from the syringe prior to injection helps ensure accurate dosing and prevents air from being injected into the subcutaneous tissue.
When administering enoxaparin (low molecular weight heparin) subcutaneously, it's important to expel any air bubbles from the syringe before injection. Air bubbles can cause discomfort and inaccuracies in dosage. The nurse should gently tap the syringe to move air bubbles to the top and then push the plunger slightly to expel the air. The other options are not correct procedures for administering enoxaparin. It is typically injected into the subcutaneous tissue, not a muscle, and firm pressure is not typically applied after administration. The needle is fully inserted into the skin, not halfway.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is C

Explanation

A. Instruct the client to increase his fluid intake: While adequate fluid intake is generally important for various reasons, increasing fluid intake would not alter the orange-red discoloration caused by rifampin. This side effect is due to the drug's action on body fluids, not dehydration.
B. Prepare the client for dialysis: Dialysis is not indicated for the harmless orange-red discoloration caused by rifampin. Dialysis is typically used for clients with kidney failure or significant electrolyte imbalances, and it would not address this specific side effect.
C. Document this as an expected finding.
Explanation:
Rifampin, an antibiotic commonly used in the treatment of tuberculosis (TB), can cause a harmless side effect known as "orange-red discoloration." This can affect bodily fluids such as urine, sweat, and tears. This is not a harmful effect and does not indicate a need for any specific intervention. Therefore, the nurse should document this as an expected finding due to the client's use of rifampin.
D. Check the client's liver function test results: The orange-red discoloration is not related to liver function, so checking liver function test results would not provide relevant information about this particular side effect.

A. Hct 43% B. Creatinine 2.5 mg/dL C. Sodium 137 mEq/L D. Hgb 15 g/dL

Correct Answer is B

Explanation

A. Hct 43%
Explanation: Hematocrit (Hct) measures the proportion of blood volume that is occupied by red blood cells. A low Hct level could indicate anemia, which might affect the body's ability to deliver sufficient oxygen to tissues.
B. Creatinine 2.5 mg/dL
Explanation: Elevated creatinine levels indicate potential kidney dysfunction. Tobramycin is primarily excreted by the kidneys, so elevated creatinine levels can increase the risk of tobramycin toxicity due to reduced drug clearance.
C. Sodium 137 mEq/L
Explanation: Sodium level within the normal range. It doesn't directly impact the administration of tobramycin.
D. Hgb 15 g/dL
Explanation: Hemoglobin (Hgb) measures the concentration of oxygen-carrying protein in the blood. A normal hemoglobin level is not directly related to the administration of tobramycin.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse is preparing to administer enoxaparin to a client. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who has active tuberculosis and is taking rifampin reports that his urine and sweat have developed a red-orange tinge. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A nurse is reviewing the laboratory data of a client prior to administering IV tobramycin. Which of the following laboratory values should the nurse report to the provider?

Correct Answer is B

Explanation

A nurse is caring for a client who has major depression and a new prescription for citalopram. Which of the following adverse effects is the priority for the nurse to report to the provider?

A nurse is teaching a client who has pernicious anemia to self-administer nasal cyanocobalamin. Which of the following information should the nurse include in the teaching?

A nurse is reviewing the medical record of a client who has sinusitis and a new prescription for cefuroxime. Which of the following client information is the priority for the nurse to report to the provider?

A nurse is preparing to administer subcutaneous heparin to a client. Which of the following actions should the nurse take?

A home health nurse is visiting a client who has heart failure and a prescription for furosemide. The nurse identifies that the client has gained 2.5 kg (5 lb) since the last visit 2 days ago. Which of the following actions should the nurse take first?

A nurse is receiving a medication prescription by telephone from a provider. The provider states, "Administer 6 milligrams of morphine IV push every 3 hours as needed for acute pain." How should the nurse transcribe the prescription in the client's medical record?

A nurse is reviewing the medical record of an adult client who has a fever and a prescription for acetaminophen. Which of the following findings should the nurse identify as a contraindication for receiving this medication?