If the patient PTT lab level is too long and greater than 80 seconds, the nurse should notify the doctor.
Which doctor’s order should the nurse anticipate?

Continue with the same dosage.

Hold dose.

Increase in dosage.

Decrease in dosage.

Answer and Explanation

The Correct Answer is B

This is because a PTT (partial thromboplastin time) test measures how long it takes for blood to clot. A normal PTT range is between 25 to 35 seconds. If the patient’s PTT is too long and greater than 80 seconds, it means their blood is taking too long to clot and they are at risk of bleeding excessively. The nurse should notify the doctor and expect an order to hold the dose of heparin, a type of anticoagulant that prevents blood clots by prolonging the PTT.
Choice A is wrong because continuing with the same dosage of heparin would not correct the prolonged PTT and could cause more bleeding problems for the patient.
Choice C is wrong because increasing the dosage of heparin would further prolong the PTT and increase the risk of bleeding.
Choice D is wrong because decreasing the dosage of heparin would not be enough to bring the PTT back to normal range and would still pose a bleeding risk for the patient.

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Correct Answer is D

Explanation

Nitroglycerin sublingual is a medication that is used to treat chest pain or angina by relaxing the blood vessels and reducing the oxygen demand of the heart.A common side effect of nitroglycerin sublingual is headache, which may be severe and throbbing.Headache is often a sign that the medication is working.Other possible side effects include flushing, dizziness, lightheadedness, nausea, vomiting, fast heart rate, numbness, tingling, burning pain, rash, hives, sweating, pale skin, difficulty breathing and allergic reaction.

Choice A is wrong because nausea is not the most common adverse effect of nitroglycerin sublingual.Nausea may occur in some people, but it is usually mild and transient.

Choice B is wrong because bradycardia (slow heart rate) is not a common adverse effect of nitroglycerin sublingual.Nitroglycerin sublingual may cause tachycardia (fast heart rate) in some people as a result of vasodilation and reflex stimulation of the heart.

Choice C is wrong because hypertension (high blood pressure) is not a common adverse effect of nitroglycerin sublingual.Nitroglycerin sublingual may cause hypotension (low blood pressure) in some people due to its vasodilating action.Hypotension may lead to lightheadedness, fainting or shock in severe cases.

The normal range for blood pressure is less than 120/80 mmHg for adults.

The normal range for heart rate is 60 to 100 beats per minute for adults.

A. Aspirate carefully after inserting the needle into the client’s skin. B. Administer the injection in the client’s thigh. C. Insert the needle at 90 degrees. D. Expel the air bubble from the prefilled syringe before injecting.

Correct Answer is C

Explanation

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.

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If the patient PTT lab level is too long and greater than 80 seconds, the nurse should notify the doctor. Which doctor’s order should the nurse anticipate?

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Naxlex Comprehensive Predictor Exams

When administering sublingual nitroglycerin for emergency treatment of angina or chest pain, the nurse monitors for which common adverse effect?

Correct Answer is D

Explanation

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?

Correct Answer is C

Explanation

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If the patient PTT lab level is too long and greater than 80 seconds, the nurse should notify the doctor.
Which doctor’s order should the nurse anticipate?