Heparin therapy is usually considered therapeutic when the patient’s activated partial thromboplasin time (aPTT) is how many times normal? a) 1.5 to 2 The amount of heparin administered is based on aPTT results, which should be obtained in follow-up to any alteration of dosage. b) .5 to 1 The patient’s aPTT value would have to be greater than .5 to 1 times normal to be considered therapeutic. c) 2.5 to 3 An aPTT value that is 2.5 to 3 times normal would be too high to be considered therapeutic. d) .25 to .75 The patient’s aPTT value would have to be greater than .25 to .75 times normal to be considered therapeutic.

Heparin therapy is usually considered therapeutic when the
patient’s activated partial thromboplasin time (aPTT) is how many
times normal?
a) 1.5 to 2
The amount of heparin administered is based on aPTT results, which
should be obtained in follow-up to any alteration of dosage.
b) .5 to 1
The patient’s aPTT value would have to be greater than .5 to 1 times
normal to be considered therapeutic.
c) 2.5 to 3
An aPTT value that is 2.5 to 3 times normal would be too high to be
considered therapeutic.
d) .25 to .75
The patient’s aPTT value would have to be greater than .25 to .75
times normal to be considered therapeutic.
by

1 Answer

Answer :

a) 1.5 to 2
The amount of heparin administered is based on aPTT results, which
should be obtained in follow-up to any alteration of dosage.
by

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Last Answer : Answer: a, c In monitoring the effect of heparin, an activated partial thromboplastin time (aPTT) of 1.5 control or a thrombin clotting time (TCT) of 2 times control reflects adequate ... system. Therefore the dose of heparin need not be adjusted in cases of liver or renal dysfunction

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When gastric analysis testing reveals excess secretion of gastric acid, which of the following diagnoses is supported? a) Duodenal ulcer Patients with duodenal ulcers usually secrete an excess amount of hydrochloric acid.

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Which of the following factors are associated with increased fluid requirements in the management of patients with burn injury? a) Inhalation injuries Factors associated with increased fluid requirements include inhalation injuries, delayed resuscitation, scald burn injuries, high-voltage electrical injuries, hyperglycemia, alcohol intoxification and chronic diuretic therapy.

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In which range of body mass index (BMI) are patients considered to have increased risk for problems associated with poor nutritional status? a) Below 24 Additionally, higher mortality rates in hospitalized patients and community-dwelling elderly are associated with individuals who have low BMI. b) 25-29 Those who have a BMI of 25 to 29 are considered overweight. c) 30 to 39 Those who have BMI of 30-39 are considered obese. d) Over 40 Those who have BMI over 40 are considered extremely obese.

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Bleeding complications are frequently associated with fibrinolytic therapy. Which of the following statement(s) concerning complications of fibrinolytic therapy is/are true? a. Careful monitoring of prothrombin time and aPTT time are necessary to avoid bleeding complications b. A level of serum fibrinogen less than 100 mg/dl is associated with an increased risk of bleeding c. Recent (less than 10 days) major surgery is a contraindication to systemic but not regional fibrinolytic therapy d. A patient with a cerebrovascular event occurring less than two months ago can be treated with fibrinolytic therapy if head CT scan is normal

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For individuals known to be dying by virtue of age and/or diagnoses, which of the following signs indicate approaching death: a) Increased restlessness As the oxygen supply to the brain decreases, the patient may become restless. b) Increased wakefulness As the body weakens, the patient will sleep more and begin to detach from the environment. c) Increased eating For many patients, refusal of food is an indication that they are ready to die. d) Increased urinary output Based upon decreased intake, urinary output generally decreases in amount and frequency.

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Which stage of anesthesia is termed surgical anesthesia? a) III With proper administration of the anesthetic, this stage may be maintained for hours. b) I Stage I is beginning anesthesia, as the patient breathes in the anesthetic mixture and experiences warmth, dizziness, and a feeling of detachment. c) II Stage II is the excitement stage, which may be characterized by struggling, singing, laughing, or crying. d) IV Stage IV is a stage of medullary depression and is reached when too much anesthesia has been administered.

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When the nurse notes that the post cardiac surgery patient demonstrates low urine output (< 25 ml/hr) with high specific gravity (> 1.025), the nurse suspects: a) Inadequate fluid volume Urine output of less than 25 ml/hr may indicate a decrease in cardiac output. A high specific gravity indicates increased concentration of solutes in the urine which occurs with inadequate fluid volume. b) Normal glomerular filtration Indices of normal glomerular filtration are output of 25 ml or greater per hour and specific gravity between 1.010 and 1.025. c) Overhydration Overhydration is manifested by high urine output with low specific gravity. d) Anuria The anuric patient does not produce urine.

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Which of the following statements reflect current research regarding the utilization of non-pharmacological measures in the management of burn pain? a) Music therapy may provide reality orientation, distraction, and sensory stimulation. Researchers have found that music affects both the physiologic and psychological aspects of the pain experience. Music diverts the patient’s attention away from the painful stimulus. Music may also provide reality orientation, distraction, and sensory stimulation. It also allows for patient self-expression.

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Palliation refers to a) relief of symptoms associated with cancer. Palliation is the goal for care in terminal cancer patients. b) hair loss. Alopecia is the term that refers to hair loss. c) the spread of cancer cells from the primary tumor to distant sites. Metastasis is the term that refers to the spread of cancer cells from the primary tumor to distant sites. d) the lowest point of white blood cell depression after therapy that has toxic effects on the bone marrow. Nadir is the term that refers to the lowest point of white blood cell depression after therapy that has toxic effects on the bone marrow.

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Which of the following ranges identifies the amount of pressure within the endotracheal tube cuff that is believed to prevent both injury and aspiration? a) 20-25 mm Hg water pressure. Usually the pressure is maintained at less than 25 cm water pressure to prevent injury and at more than 20 cm water pressure to prevent aspiration. b) 10-15 mm Hg water pressure. A measure of 10–15 mm Hg water pressure would indicate that the cuff is underinflated. c) 30-35 mm Hg water pressure. A measure of 30–35 mm Hg water pressure would indicate that the cuff is overinflated. d) 0-5 mm Hg water pressure A measure of 0-5 mm Hg water pressure would indicate that the cuff is underinflated.

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When the nurse notes that the patient’s left great toe deviates laterally, she recognizes that the patient has a a) hallux valgus. Hallux valgus is commonly referred to as a bunion. b) hammertoe. Hammertoes are usually pulled upward. c) pes cavus. Pes cavus refers to a foot with an abnormally high arch and a fixed equinus deformity of the forefoot. d) flatfoot. In flatfoot, the patient demonstrates a diminished longitudinal arch of the foot.

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Which of the following statement(s) is/are true concerning heparin-associated thrombocytopenia? a. Heparin-associated thrombocytopenia occurs only in the face of over anticoagulation with heparin b. Severe thrombocytopenia (platelet count less than 100,000) is seen in less than 10% of patients treated with heparin c. Heparin-associated thrombocytopenia is due to the aggregation of platelets and may result in thrombosis or embolic episodes d. Heparin-associated thrombocytopenia may be seen within hours of initiation of heparin therapy

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58. For effective dosing, Ocreotide acetate must be administered by which appropriate route, three times weekly?

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40. The nurse should ensure that all components of medications are documented. Identify all these components. 1. Dosage, route and frequency 2. Name of client and medication 3. Date and time the medication was ordered 4. Dosage, route, frequency and strength 5. Physician’s signature and specialty 6. Physician’s signature and PRC license number

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The patient receiving mitoxantrone (Novantrone) for treatment of secondary progressive multiple sclerosis (MS) is closely monitored for a) leukopenia and cardiac toxicity. Mitoxantrone is an antineoplastic agent used primarily to treat leukemia and lyphoma but is also used to treat secondary progressive MS. Patients need to have laboratory tests ordered and the results closely monitored due to the potential for leukopenia and cardiac toxicity.

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Which of the following statements accurately reflects a rule of thumb upon which the nurse may rely in assessing the patient’s fluid balance? a) Minimal intake of 1.5 liters per day If food and fluids are withheld, IV fluids (3L/day) are usually prescribed. b) Minimal urine output of 50 milliliters per hour Minimal urine output may be less than 50 mL/hr. c) Minimal urine output of 10 milliliters per hour Minimal urine output must exceed 10 mL/hr. d) Minimal intake of 2 liters per day Minimal intake, as a rule of thumb, is less than 2 liters per day.

Description : Which of the following statements accurately reflects a rule of thumb upon which the nurse may rely in assessing the patient's fluid balance? a) Minimal intake of 1.5 liters per day If food and fluids are ... 2 liters per day Minimal intake, as a rule of thumb, is less than 2 liters per day.

Last Answer : a) Minimal intake of 1.5 liters per day If food and fluids are withheld, IV fluids (3L/day) are usually prescribed.

Low dose subcutaneous heparin therapy is indicated for: A. Prevention of leg vein thrombosis in elderly patients undergoing abdominal surgery B. Ischaemic stroke C. Patients undergoing neurosurgery D. Prevention of extention of coronary artery thrombus in acute myocardial infarction

Description : Low dose subcutaneous heparin therapy is indicated for: A. Prevention of leg vein thrombosis in elderly patients undergoing abdominal surgery B. Ischaemic stroke C. Patients undergoing neurosurgery D. Prevention of extention of coronary artery thrombus in acute myocardial infarction

Last Answer : A. Prevention of leg vein thrombosis in eld

The charge nurse reported to the chief nurse that the Demerol 50 cc vial inventory has been incorrect for the last 24 hours. The most appropriate action of the narcotic nurse is: A. Log every injection of Demerol B. Make fraction dosage like 0.5 ml as 1 ml C. Demerol inventory must be checked every endorsement by the narcotic nurse D. Review endorsement of clients who received Demerol within the last 24 hours

Description : The charge nurse reported to the chief nurse that the Demerol 50 cc vial inventory has been incorrect for the last 24 hours. The most appropriate action of the narcotic nurse is: A. Log ... by the narcotic nurse D. Review endorsement of clients who received Demerol within the last 24 hours

Last Answer : D. Review endorsement of clients who received Demerol within the last 24 hours

The patient with Herpes Simplex Virus (HSV) encephalitis is receiving acyclovir (Zovirax). The nurse monitors blood chemistry test results and urinary output for a) renal complications related to acyclovir therapy. Monitoring of blood chemistry test results and urinary output will alert the nurse to the presence of renal complications related to acyclovir therapy.

Description : The patient with Herpes Simplex Virus (HSV) encephalitis is receiving acyclovir (Zovirax). The nurse monitors blood chemistry test results and urinary output for a) renal complications related to ... output will alert the nurse to the presence of renal complications related to acyclovir therapy.

Last Answer : a) renal complications related to acyclovir therapy. Monitoring of blood chemistry test results and urinary output will alert the nurse to the presence of renal complications related to acyclovir therapy.

Which of the phases of a migraine headache usually lasts less than an hour? a) Aura The aura phase occurs in about 20% of patients who have migraines and may be characterized by focal neurological symptoms.

Description : Which of the phases of a migraine headache usually lasts less than an hour? a) Aura The aura phase occurs in about 20% of patients who have migraines and may be characterized by focal neurological ... to 72 hours. d) Recovery During the post-headache phase, patients may sleep for extended periods.

Last Answer : a) Aura The aura phase occurs in about 20% of patients who have migraines and may be characterized by focal neurological symptoms.

In assessing the appropriateness of removing a suprapubic catheter, the nurse recognizes that the patient’s residual urine must be less than which of the following amounts on two separate occasions (morning and evening)? a) 100 cc If the patient complains of discomfort or pain, however, the suprapubic catheter is usually left in place until the patient can void successfully.

Description : In assessing the appropriateness of removing a suprapubic catheter, the nurse recognizes that the patient's residual urine must be less than which of the following amounts on two separate occasions ... urine that is greater than 100 cc indicates that the suprapubic catheter cannot be discontinued.

Last Answer : a) 100 cc If the patient complains of discomfort or pain, however, the suprapubic catheter is usually left in place until the patient can void successfully.

The patient with which of the follow characteristics is considered high risk for the development of infective endocarditis? a) The patient who has complex cyanotic congenital malformations is at high risk for the development of infective endocarditis.

Description : The patient with which of the follow characteristics is considered high risk for the development of infective endocarditis? a) The patient who has complex cyanotic congenital malformations is ... with acquired valvular dysfunction is at moderate risk for the development of infective endocarditis.

Last Answer : a) The patient who has complex cyanotic congenital malformations is at high risk for the development of infective endocarditis.

Which of the following statements describes benign paroxysmal positional vertigo (BPPV)? a) The vertigo is usually accompanied by nausea and vomiting; however hearing impairment does not generally occur. BPPV is a brief period of incapacitating vertigo that occurs when the position of the patient’s head is changed with respect to gravity. The vertigo is usually accompanied by nausea and vomiting; however hearing impairment does not generally occur.

Description : Which of the following statements describes benign paroxysmal positional vertigo (BPPV)? a) The vertigo is usually accompanied by nausea and vomiting; however hearing impairment does not generally occur. ... as acetaminophen. BPPV is frequently stimulated by head trauma, infection, or other events.

Last Answer : a) The vertigo is usually accompanied by nausea and vomiting; however hearing impairment does not generally occur. BPPV is a brief period of incapacitating vertigo that occurs when the ... vertigo is usually accompanied by nausea and vomiting; however hearing impairment does not generally occur.

Which of the following observations regarding ulcer formation on the patient’s lower extremity indicate to the nurse that the ulcer is a result of venous insufficiency? a) The border of the ulcer is irregular. The border of an ulcer caused by arterial insufficiency is circular. b) The ulcer is very painful to the patient, even though superficial. Superficial venous insufficiency ulcers cause minimal pain. c) The ulcer base is pale to black. The base of a venous insufficiency ulcer shows beefy red to yellow fibrinous color. d) The ulcer is deep, involving the joint space. Venous insufficiency ulcers are usually superficial.

Description : Which of the following observations regarding ulcer formation on the patient's lower extremity indicate to the nurse that the ulcer is a result of venous insufficiency? a) The border of the ... d) The ulcer is deep, involving the joint space. Venous insufficiency ulcers are usually superficial.

Last Answer : a) The border of the ulcer is irregular. The border of an ulcer caused by arterial insufficiency is circular.

Regarding tolerance and addiction, the nurse understands that a) although patients may need increasing levels of opioids, they are not addicted. Physical tolerance usually occurs in the absence of addiction. b) tolerance to opioids is uncommon. Tolerance to opioids is common. c) addiction to opioids commonly develops. Addiction to opioids is rare. d) the nurse must be primarily concerned about development of addiction by the patient in pain. Addiction is rare and should never be the primary concern for a patient in pain.

Description : Regarding tolerance and addiction, the nurse understands that a) although patients may need increasing levels of opioids, they are not addicted. Physical tolerance usually occurs in the absence of addiction. b ... pain. Addiction is rare and should never be the primary concern for a patient in pain.

Last Answer : a) although patients may need increasing levels of opioids, they are not addicted. Physical tolerance usually occurs in the absence of addiction.

Appropriate guidelines for the use of TPN in cancer patients include: a. Long-term TPN in patients with rapid progressive tumor growth unresponsive to other therapy b. Mildly malnourished patients undergoing surgery for a curable cancer c. Preoperatively administered TPN prior to surgery or other therapy in patients with severe malnutrition d. Patients in whom treatment toxicity precludes the use of enteral nutrition

Description : Appropriate guidelines for the use of TPN in cancer patients include: a. Long-term TPN in patients with rapid progressive tumor growth unresponsive to other therapy b. Mildly malnourished ... with severe malnutrition d. Patients in whom treatment toxicity precludes the use of enteral nutrition

Last Answer : Answer: c, d As a general rule, the most important factor to consider when making decisions about the use of TPN in patients with cancer is the response of the tumor to antineoplastic ... . Long-term TPN is not indicated with rapidly progressive tumor growth which is unresponsive to such therapy

Which of the following statement(s) is/are true concerning the results of a National Institute of Health Consensus Conference on venous thrombosis and low-dose heparin prophylaxis? a. The odds of developing deep venous thrombosis with low-dose heparin prophylaxis decreases by 67% b. The risk of pulmonary embolism is decreased by almost 50% c. There is no increase in mortality from other causes found in patients treated with low-dose heparin d. There was no difference in the incidence of bleeding complications

Description : Which of the following statement(s) is/are true concerning the results of a National Institute of Health Consensus Conference on venous thrombosis and low-dose heparin prophylaxis? a. The odds of ... treated with low-dose heparin d. There was no difference in the incidence of bleeding complications

Last Answer : Answer: a, b, c In a metaanalysis of 70 randomized trials in 16,000 patients comparing low-dose heparin prophylaxis with standard therapy, the odds of developing deep venous thrombosis ... Similarly, the effectiveness of prophylaxis was not influenced by either two or three times daily dosage

Bladder retraining following removal of an indwelling catheter begins with instructing the patient to follow a 2-3 hour timed voiding schedule. Immediately after the removal of the indwelling catheter, the patient is placed on a timed voiding schedule, usually two to three hours. At the given time interval, the patient is instructed to void. a) encouraging the patient to void immediately. Immediate voiding is not usually encouraged. The patient is commonly placed on a timed voiding schedule, usually within two to three hours.

Description : Bladder retraining following removal of an indwelling catheter begins with instructing the patient to follow a 2-3 hour timed voiding schedule. Immediately after the removal of the indwelling ... in the bladder after voiding, straight catheterization may be performed for complete bladder emptying.

Last Answer : a) encouraging the patient to void immediately. Immediate voiding is not usually encouraged. The patient is commonly placed on a timed voiding schedule, usually within two to three hours.

To ensure patency of central venous line ports, dilute heparin flushes are used in which of the following situations? a) Daily when not in use Daily instillation of dilute heparin flush when a port is not in use will maintain the port.

Description : To ensure patency of central venous line ports, dilute heparin flushes are used in which of the following situations? a) Daily when not in use Daily instillation of dilute heparin flush when a port ... the line is discontinued Heparin flush of ports is not necessary if a line is to be discontinued.

Last Answer : a) Daily when not in use Daily instillation of dilute heparin flush when a port is not in use will maintain the port.

Which of the following medications are used to reverse the effects of heparin? a) Protamine sulfate Protamine sulfate is known as the antagonist to heparin. b) Streptokinase Streptokinase is a thrombolytic agent. c) Clopidigrel (Plavix) Clopidigrel (Plavix) is an antiplatelet medication that is given to reduce the risk of thrombus formation post coronary stent placement. d) Aspirin The antiplatelet effect of aspirin does not reverse the effects of heparin.

Description : Which of the following medications are used to reverse the effects of heparin? a) Protamine sulfate Protamine sulfate is known as the antagonist to heparin. b) Streptokinase Streptokinase is a ... placement. d) Aspirin The antiplatelet effect of aspirin does not reverse the effects of heparin.

Last Answer : a) Protamine sulfate Protamine sulfate is known as the antagonist to heparin.