The nurse is caring for a client receiving a heparin infusion for disseminated intravascular coagulation (DIC). Which of the following lab results would indicate a sub-therapeutic level? An activated partial thromboplastin time (aPTT) of :……. (normal value: 25-35 seconds)

119 seconds

98 seconds

37 seconds

69 seconds

Answer and Explanation

The Correct Answer is D

A.   A value of 119 seconds would indicate a therapeutic or even elevated level of heparin, as it is much higher than the normal aPTT range.
B.   A value of 98 seconds is still above the normal aPTT range, suggesting that the heparin level is therapeutic, or even too high, but not sub-therapeutic.
C.   This is just slightly above the normal range and might be considered a therapeutic range for someone
on heparin, but it’s not sub-therapeutic.
D.   This aPTT value is above the normal range but likely not high enough to indicate therapeutic heparin levels, which should typically be between 1.5 to 2.5 times the normal aPTT. A sub-therapeutic level could be indicated with a lower value.

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Correct Answer is ["31"]

Explanation

(Volume to be infused (mL) × Drop factor (gtt/mL)) / Time (min).

For the patient prescribed 250 mL of packed red blood cells with a drop factor of 15 gtt/mL over 120 minutes, the calculation would be (250 mL × 15 gtt/mL) / 120 min, which equals 31.25 gtt/min.

Therefore, the nurse should regulate the IV to 31 gtt/min.

A. Report the findings and anticipate a medical prescription for amiodarone B. Initiate a rapid response call and increase the monitor's sensitivity C. Start compressions and prepare for defibrillation D. Establish unresponsiveness and check the carotid pulse

Correct Answer is D

Explanation

A. Reporting the findings and anticipating a prescription for amiodarone may be necessary later, but the first step is to assess the patient's immediate condition (unresponsiveness, pulse status, etc.).
B. Although increasing monitor sensitivity and initiating a rapid response call might be helpful, these actions come after assessing the patient’s condition. If the patient is in distress or unresponsive, the nurse needs to check for a pulse and intervene right away.
C. This is a crucial action if the patient is unresponsive and pulseless (cardiac arrest). If the patient is found to be unresponsive and pulseless, starting chest compressions immediately and preparing for defibrillation is the next step. However, the first action is to check for pulse and responsiveness.
Why it's incorrect: Compressions and defibrillation are correct actions if the patient is pulseless, but before taking these steps, the nurse must assess the patient for responsiveness and check the carotid pulse. Starting CPR and preparing defibrillation without verifying the patient's condition could delay appropriate care.
D. Checking responsiveness and pulse is the most immediate and critical action because VT may be asymptomatic or cause deterioration, including cardiac arrest. Once pulse and responsiveness are determined, appropriate interventions (such as defibrillation or CPR) can be initiated quickly.

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LAB	Result	Normal Range
Potassium	2.8 mEq/L	3.5-5.3mEq/L
Sodium	133 mEq/L	135-145 mEqL
Chloride	90 mEq/L	97-107 mEqL
Glucose	200 mg/dL	70mg/dL to 110mg/dL
Magnesium	2.5 mg/dL	1.6-2.2 mg/dL
Calcium	8.0 mg/dL	8.2-10.2 mg/dL:

The nurse is caring for a client receiving a heparin infusion for disseminated intravascular coagulation (DIC). Which of the following lab results would indicate a sub-therapeutic level? An activated partial thromboplastin time (aPTT) of :……. (normal value: 25-35 seconds)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient is prescribed 250 mL of packed red blood cells to be transfused over 120 minutes. The drop factor on the tubing is 15 gtt/mL. At what rate should the nurse regulate the IV (gtt/min)? (round to the nearest whole number)

Correct Answer is ["31"]

Explanation

The nurse observes the following rhythm of a client on the telemetry unit. Which action should be completed first?

Correct Answer is D

Explanation

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The nurse is caring for a client receiving a heparin infusion for disseminated intravascular coagulation (DIC). Which of the following lab results would indicate a sub-therapeutic level? An activated partial thromboplastin time (aPTT) of :……. (normal value: 25-35 seconds)

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