Which serum laboratory test is most important for the nurse to monitor when administering enoxaparin to a client?

Protein and albumin.

Complete blood count (CBC).

BUN and creatinine.

Electrolytes.

Answer and Explanation

The Correct Answer is B

Choice A reason: Protein and albumin reflect nutritional or liver status but are unaffected by enoxaparin, a low-molecular-weight heparin inhibiting factor Xa. These do not monitor anticoagulation effects or complications like bleeding. CBC is critical, as enoxaparin increases bleeding risk, requiring platelet and hemoglobin monitoring to detect serious hematological issues.

Choice B reason: Enoxaparin, an anticoagulant, heightens bleeding risk and can cause thrombocytopenia. Monitoring CBC, especially platelets and hemoglobin, detects heparin-induced thrombocytopenia (HIT) or hemorrhage. This ensures early identification of complications, allowing timely intervention to prevent severe bleeding or thrombosis, making CBC the most critical test for safe administration.

Choice C reason: BUN and creatinine assess renal function, relevant for renally cleared drugs, but enoxaparin is primarily liver-metabolized. Renal monitoring is secondary unless severe impairment exists. CBC is more urgent, as enoxaparin’s anticoagulant effect increases bleeding risk, necessitating hematological surveillance to prevent life-threatening complications.

Choice D reason: Electrolytes like potassium or sodium are not directly affected by enoxaparin’s action on the coagulation cascade. Imbalances may occur in critical illness but are not primary concerns. CBC monitoring for bleeding or thrombocytopenia is critical, as enoxaparin’s anti-Xa activity poses hematological risks requiring immediate attention.

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Correct Answer is B

Explanation

Choice A reason: Exercise lowers blood glucose in type 2 diabetes by enhancing insulin sensitivity and glucose uptake via GLUT4 transporters in muscles. This statement is incorrect, as physical activity is vital for glycemic control, reducing hyperglycemia and cardiovascular risks. Proper understanding involves recognizing exercise’s role in metabolic management, not denying its impact.

Choice B reason: Following a tailored meal plan and avoiding high-fat diets is correct, as it regulates blood glucose and lipids in type 2 diabetes. Balanced carbohydrates and low saturated fats prevent insulin resistance and atherosclerosis. This reflects understanding of dietary management’s role in glycemic control, reducing complications like neuropathy or cardiovascular disease.

Choice C reason: Soaking feet in hot water is dangerous in diabetes due to neuropathy, which reduces sensation and increases burn risk. Hot water also dries skin, raising infection risk. Proper foot care involves daily inspection and avoiding extreme temperatures, making this statement incorrect and harmful for effective diabetes management.

Choice D reason: Covering wounds with antibiotic ointment without medical evaluation is risky, as diabetes impairs wound healing due to hyperglycemia and immune dysfunction. Proper care involves cleaning, monitoring, and consulting providers to prevent infections. This statement shows incomplete understanding, as it overlooks the need for professional wound management.

A. Discontinue the use of the nasal cannula. B. Decrease the flow rate to 1 L/minute. C. Apply lubricant to the cannula tubing. D. Place padding around the cannula tubing.

Correct Answer is D

Explanation

Choice A reason: Discontinuing the nasal cannula is inappropriate, as 94% SpO₂ indicates mild hypoxemia from pneumonia, requiring oxygen to support alveolar diffusion. The rash likely results from cannula pressure, not oxygen delivery. Padding addresses the rash without compromising respiratory support, ensuring continued therapy.

Choice B reason: Decreasing to 1 L/minute may worsen hypoxemia in pneumonia, where inflamed alveoli impair gas exchange (SpO₂ 94%). The rash is from mechanical irritation, not flow rate. Padding relieves pressure, maintaining oxygen delivery to improve saturation, making flow reduction counterproductive to respiratory needs.

Choice C reason: Applying lubricant reduces friction but not pressure causing the red macular rash from prolonged cannula contact. Lubricants risk aspiration. Padding alleviates pressure points, preventing skin breakdown while maintaining oxygen for pneumonia, addressing the rash’s mechanical cause more effectively than lubrication.

Choice D reason: Placing padding around the cannula tubing relieves pressure on the cheek, preventing skin breakdown from the red macular rash. This maintains oxygen at 3 L/minute, critical for pneumonia’s hypoxemia, where inflamed alveoli reduce oxygen diffusion. Padding ensures skin integrity and respiratory support, addressing both issues effectively.

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Which serum laboratory test is most important for the nurse to monitor when administering enoxaparin to a client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing teaching to a client with type 2 diabetes mellitus about important points for disease and symptom management. Which statement by the client indicates understanding?

Correct Answer is B

Explanation

After obtaining an oxygen saturation level of 94% for a client with pneumonia who is receiving oxygen per nasal cannula at 3 L/minute, the nurse observes a red macular rash developing on the client’s right cheek. Which intervention should the nurse implement?

Correct Answer is D

Explanation

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