A nurse is preparing to administer subcutaneous enoxaparin 40 mg using a prefilled syringe of enoxaparin 40 mg/0.4 ml to an adult client following hip arthroplasty.
Which of the following actions should the nurse plan to take?
Aspirate carefully after inserting the needle into the client’s skin.
Administer the injection in the client’s thigh.
Insert the needle at 90 degrees.
Expel the air bubble from the prefilled syringe before injecting.
The Correct Answer is C
This is because enoxaparin is administered subcutaneously, which means under the skin, and the needle should be inserted fully into the skin to ensure proper delivery of the drug.
Choice A is wrong because aspirating (pulling back on the plunger) after inserting the needle is not recommended for subcutaneous injections of enoxaparin, as it may increase the risk of bleeding or bruising.
Choice B is wrong because administering the injection in the client’s thigh is not the preferred site for enoxaparin. The preferred site is the abdomen, at least 2 inches away from the navel, as it has more fatty tissue and less blood vessels than other areas.
Choice D is wrong because expelling the air bubble from the prefilled syringe is not necessary for enoxaparin. The air bubble helps to ensure that the entire dose of enoxaparin is injected and prevents blood from entering the syringe.
Normal ranges for enoxaparin dosage depend on the indication and the patient’s weight, but for prophylaxis of deep vein thrombosis after hip arthroplasty, the usual dose is 40 mg once a day for 3 weeks.
The prefilled syringe of enoxaparin 40 mg/0.4 ml contains the correct dose for this indication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Thrombolytic agents are a classification of drugs that dissolve blood clots by activating the enzyme plasmin, which breaks down the proteins (fibrins) that form clots. They are used for serious conditions, such as stroke, pulmonary embolism, or heart attack when the blood flow needs to be restored quickly.
Choice A is wrong because salicylates are anti-inflammatory drugs that inhibit the synthesis of prostaglandins, which are involved in inflammation and pain. They also have antiplatelet effects, but they do not dissolve existing clots.
Choice B is wrong because antiplatelets are drugs that prevent platelets from sticking together and forming clots. They are used to prevent clotting in conditions such as coronary artery disease, stroke, or peripheral arterial disease. They do not dissolve existing clots either.
Choice C is wrong because anticoagulants are drugs that prevent clots from forming by interfering with the clotting factors that are normally present in the blood.
They are used to treat or prevent conditions such as deep vein thrombosis, pulmonary embolism, or atrial fibrillation. They do not dissolve existing clots.
Normal ranges for clotting factors vary depending on the laboratory and the method used, but some common values are:
• Prothrombin time (PT): 11 to 13 seconds
• International normalized ratio (INR): 0.8 to 1.2
• Activated partial thromboplastin time (aPTT): 25 to 35 seconds
• Fibrinogen: 200 to 400 mg/dL
• D-dimer: less than 0.5 mcg/mL
Correct Answer is B
Explanation
Class IV antidysrhythmics or calcium channel blockers decrease the flow of calcium ions into cardiac and vascular smooth muscle cells, thus decreasing heart rate and contractions.By reducing the calcium influx, they also decrease the slope of phase 0 and 4 and prolong phase 2 of the cardiac action potential.This results in vasodilation, reduced myocardial oxygen demand, and decreased conduction through the AV node.
Choice A is wrong because calcium channel blockers do not increase blood vessel spasm, but rather cause vasodilation.
Choice C is wrong because calcium channel blockers do not decrease refractory period, but rather prolong it by extending phase 2 of the cardiac action potential.
Choice D is wrong because calcium channel blockers do not increase heart rate, but rather decrease it by slowing down the pacemaker activity and AV nodal conduction.
Normal ranges for heart rate are 60 to 100 beats per minute, and for blood pressure are 120/80 mmHg or lower.
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