a patient with a diagnosis of deep vein thrombosis dvt is receiving heparin therapy which laboratory test should the nurse monitor to evaluate the eff

ATI LPN

ATI Learning System PN Medical Surgical Final Quizlet

1. A patient with a diagnosis of deep vein thrombosis (DVT) is receiving heparin therapy. Which laboratory test should the nurse monitor to evaluate the effectiveness of the heparin therapy?

A. Prothrombin time (PT)
B. Partial thromboplastin time (PTT)
C. Bleeding time
D. Platelet count

Correct answer: B

Rationale: The correct answer is B: Partial thromboplastin time (PTT). Heparin affects the intrinsic pathway of the coagulation cascade, which is reflected by changes in the PTT. Monitoring the PTT helps ensure that the patient's blood is within the desired therapeutic range and prevents complications related to clotting or bleeding. Prothrombin time (PT) primarily assesses the extrinsic pathway and is not as sensitive to heparin therapy. Bleeding time and platelet count are not specific tests for monitoring the effectiveness of heparin therapy in DVT.

2. In which situation is it most important for the registered nurse (RN) working on a medical unit to provide direct supervision?

A. A graduate nurse needs to access a client's implanted port to start an infusion of Ringer's Lactate.
B. A postpartum nurse pulled to the unit needs to start a transfusion of packed red blood cells.
C. A practical nurse is preparing to assist the healthcare provider with a lumbar puncture at the bedside.
D. An unlicensed assistive personnel is preparing to weigh an obese bedfast client using a bed scale.

Correct answer: A

Rationale: Direct supervision is essential when a complex task, such as accessing an implanted port, is being performed by a less experienced healthcare provider, in this case, a graduate nurse. This oversight ensures patient safety and proper execution of the procedure, especially when it is the nurse's first time performing such a task.

3. The nurse is caring for four clients: Client A, who has emphysema and an oxygen saturation of 94%; Client B, with a postoperative hemoglobin of 8.7 g/dL; Client C, newly admitted with a potassium level of 3.8 mEq/L; and Client D, scheduled for an appendectomy with a white blood cell count of 15,000/mm3. What intervention should the nurse implement?

A. Increase Client A's oxygen to 4 liters per minute via nasal cannula.
B. Determine if Client B has two units of packed cells available in the blood bank.
C. Ask the dietitian to add a banana to Client C's breakfast tray.
D. Inform Client D that surgery is likely to be delayed until the infection is treated.

Correct answer: D

Rationale: A high white blood cell count, as seen in Client D, indicates infection, which may require postponing surgery to treat the infection adequately. It is crucial to address the underlying infection before proceeding with the appendectomy to prevent complications and ensure a successful surgical outcome.

4. A 32-year-old woman presents with a 10-month history of an intermittent burning sensation in the epigastrium that is sometimes related to eating. She has heard about bacteria that can cause gastrointestinal (GI) symptoms. She has had no change in her weight and denies dysphagia. Her laboratory tests are normal. Which of the following would you recommend?

A. Serum qualitative test for H. pylori
B. Refer for endoscopy
C. Obtain an upper GI series
D. Treat her for H. pylori infection

Correct answer: A

Rationale: The patient presents with dyspepsia, described as an intermittent burning sensation in the epigastrium, sometimes related to eating. In individuals under 45 years without warning signs such as anemia, weight loss, or dysphagia, a serum qualitative test for H. pylori is recommended to document H. pylori infection, especially if the patient has not been previously treated. It's important to note that a serum IgG can remain positive post-eradication. If H. pylori-positive patients do not respond to treatment, an endoscopy would be the next step for evaluation. An upper GI series is less sensitive than endoscopy in detecting lesions of the upper GI tract and cannot specifically detect H. pylori. Empiric therapy for H. pylori without confirmation is not recommended.

5. A client with hyperthyroidism is prescribed propylthiouracil (PTU). Which instruction should the nurse include in the client's discharge teaching?

A. Report any signs of infection, such as sore throat or fever, to your healthcare provider.'
B. Increase your intake of iodine-rich foods, such as seafood and dairy products.'
C. Take the medication on an empty stomach for better absorption.'
D. You may experience weight gain and fatigue as side effects of the medication.'

Correct answer: A

Rationale: Propylthiouracil (PTU) can suppress bone marrow function, increasing the risk of infection, so it is important to report signs of infection promptly.