The nurse is caring for a patient who has received alteplase [Activase]. It is most important for the nurse to take which action?

Avoid applying pressure to needleless access sites after giving medications.

Monitor neurologic status every 15 minutes during and after infusion.

Administer heparin when partial thromboplastin time (PTT) is less than 70 seconds.

Give aspirin when platelet count is greater than 150,000/mm3.

Answer and Explanation

The Correct Answer is B

This is because alteplase [Activase] is a thrombolytic drug that dissolves blood clots and can cause bleeding complications, especially intracranial hemorrhage. Neurologic assessment is essential to detect any signs of bleeding in the brain, such as altered level of consciousness, headache, or focal deficits.

Choice A is wrong because applying pressure to needleless access sites after giving medications is a standard precaution to prevent bleeding and infection. It is not specific to alteplase [Activase] therapy.

Choice C is wrong because administering heparin when partial thromboplastin time (PTT) is less than 70 seconds is not recommended for patients who have received alteplase [Activase].

Heparin is an anticoagulant that can increase the risk of bleeding and should be used with caution in patients who have received thrombolytic therapy. The PTT should be monitored closely and heparin should be withheld if the PTT is above the therapeutic range.

Choice D is wrong because giving aspirin when platelet count is greater than 150,000/mm3 is not indicated for patients who have received alteplase [Activase].

Aspirin is an antiplatelet drug that can also increase the risk of bleeding and should be avoided in patients who have received thrombolytic therapy.

The platelet count should be monitored closely and aspirin should be withheld if the platelet count is below the normal range (150,000 to 450,000/mm3).

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Correct Answer is B

Explanation

Argatroban is a direct thrombin inhibitor (DTI) that is used as an alternative anticoagulant for patients with heparin-induced thrombocytopenia (HIT) who require urgent surgery. Argatroban has a half-life of about 40 to 50 minutes and is cleared by the liver.The infusion should be stopped at least 4 hours before the surgery to allow adequate time for the anticoagulant effect to wear off.The activated partial thromboplastin time (aPTT) should be monitored before and after the infusion to assess the degree of anticoagulation.

Choice A is wrong because 2 hours is not enough time to stop the argatroban infusion before surgery.

The patient may still have a high risk of bleeding if the aPTT is prolonged.

Choice C is wrong because 6 hours is longer than necessary to stop the argatroban infusion before surgery.

The patient may have a higher risk of thrombosis if the anticoagulation effect is too low.

Choice D is wrong because 8 hours is much longer than necessary to stop the argatroban infusion before surgery.

The patient may have a very low level of anticoagulation and a high risk of thrombosis if the infusion is stopped for too long.

A. Decreased heart rate B. Increased contractility C. Dilated coronary arteries D. Reduced blood pressure E. E. Relieved chest pain.

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

Explanation

Verapamil is a calcium channel blocker that is used to treat variant angina by dilating the coronary arteries and relieving the chest pain caused by spasms.It also reduces blood pressure and heart rate, but these are not the expected outcomes for variant angina.

Choice A is wrong because verapamil decreases heart rate, not increases it.This can help reduce the oxygen demand of the heart, but it is not the main goal of therapy for variant angina.

Choice B is wrong because verapamil decreases contractility, not increases it.This can also help reduce the oxygen demand of the heart, but it is not the main goal of therapy for variant angina.

Choice D is wrong because verapamil reduces blood pressure, not increases it.This can help lower the workload of the heart, but it is not the main goal of therapy for variant angina.

Normal ranges for heart rate are 60 to 100 beats per minute, for blood pressure are 120/80 mm Hg or lower, and for contractility are measured by ejection fraction, which is normally 55% or higher.

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The nurse is caring for a patient who has received alteplase [Activase]. It is most important for the nurse to take which action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is receiving argatroban IV for HIT and requires urgent surgery. The nurse should stop the infusion at least how many hours before the surgery?

Correct Answer is B

Explanation

A nurse is caring for a client who has variant angina and is prescribed verapamil. Which of the following are expected outcomes of this medication? (Select all that apply.)

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

Explanation

A client who has atrial fibrillation is prescribed dabigatran etexilate mesylate (Pradaxa). The nurse should instruct the client to report which of the following findings immediately? (Select all that apply.)

The nurse recognizes what absolute contraindication to the administration of a thrombolytic to a patient having an acute myocardial infarction?

A patient is receiving heparin therapy during hemodialysis for chronic renal failure and develops heparin-induced thrombocytopenia (HIT). The nurse anticipates that which medication will be ordered for this patient?

A nurse is caring for a client who has pulmonary embolism and is receiving alteplase via continuous IV infusion.The nurse should monitor for which adverse effects of this medication? (Select all that apply.)

Which patients below would be at a HIGH risk for developing adverse effects of Heparin drug therapy? Select all that apply:

A nurse is caring for a patient who has been prescribed apixaban (Eliquis) for deep vein thrombosis (DVT). Which instructions should be included in patient teaching? Select all that apply.

A nurse is reviewing the medication list of a client who is prescribed dabigatran and has a history of peptic ulcer disease. The nurse should recognize that which of the following medications can increase the risk of bleeding in this client?

A patient has been prescribed rivaroxaban (Xarelto) for deep vein thrombosis (DVT). Which statement by the patient indicates understanding of medication teaching?