A nurse is administering enoxaparin, a low-molecular-weight heparin, to a client who has undergone orthopedic surgery. The nurse should administer this medication by which route and at which site?

Intramuscular injection in the deltoid muscle

Subcutaneous injection in the abdomen

Intravenous infusion in a peripheral vein

Intradermal injection in the forearm.

Answer and Explanation

The Correct Answer is B

Subcutaneous injection in the abdomen. This is because enoxaparin is a low-molecular-weight heparin that is administered subcutaneously, usually in the abdomen or outer thigh. The drug should be clear and colorless or pale yellow. The dosage for adults is typically 30mg every 12 hours for 7 to 10 days, or 40mg once a day for 3 weeks after hip replacement surgery. The needle should be inserted fully into the skin and the syringe plunger should be pressed down to inject the drug. Injection sites should be rotated and areas of active skin disease or injury should be avoided.

Choice A is wrong because intramuscular injection in the deltoid muscle is not the recommended route or site for enoxaparin. Intramuscular injection may cause bleeding, bruising, or hematoma formation.

Choice C is wrong because intravenous infusion in a peripheral vein is not the recommended route for enoxaparin. Enoxaparin can be given intravenously only as a bolus injection for acute coronary syndrome, not as an infusion.

Choice D is wrong because intradermal injection in the forearm is not the recommended route or site for enoxaparin. Intradermal injection may cause skin irritation, infection, or necrosis.

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Correct Answer is ["A","B","E"]

Explanation

Clopidogrel is an antiplatelet drug that inhibits the ability of platelets to clump together as part of a blood clot.It is used to prevent recurrent stroke and other cardiovascular events in people who are at high risk.

Choice A is correct because taking aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) while on clopidogrel can increase the risk of bleeding.These drugs also affect platelet function and can interfere with the action of clopidogrel.

Choice B is correct because bleeding is the most common side effect of clopidogrel.Any signs of bleeding, such as nosebleeds, bruising, or black stools, should be reported to the provider as they may indicate a serious complication.

Choice C is wrong because clopidogrel can be taken with or without food.Taking it with food does not prevent gastrointestinal upset, which is another possible side effect of clopidogrel.

Choice D is wrong because clopidogrel does not affect blood pressure.However, having high blood pressure can increase the risk of stroke and other cardiovascular events, so it is important to have it checked regularly and treated if necessary.

Choice E is correct because clopidogrel should be stopped at least 5 days before any planned surgery.This is to reduce the risk of excessive bleeding during or after the surgery.The provider should be informed about the use of clopidogrel and any other medications before undergoing any surgical procedure.

A. “It inhibits platelet aggregation and adhesion.” B. “It interferes with one or more steps of the coagulation cascade.” C. “It activates plasminogen, which converts to plasmin, an enzyme that degrades fibrin.” D. “It blocks the action of platelet activators or receptors.”.

Correct Answer is C

Explanation

Alteplase works by activating plasminogen, which converts to plasmin, an enzyme that degrades fibrin.Fibrin is a protein that forms the meshwork of a blood clot, so by breaking it down, alteplase helps dissolve the clot and restore blood flow.

Choice A is wrong because alteplase does not inhibit platelet aggregation and adhesion.

Platelets are blood cells that stick together and form the initial plug in a blood clot.Alteplase does not affect platelets directly, but rather targets fibrin.

Choice B is wrong because alteplase does not interfere with the coagulation cascade.

The coagulation cascade is a series of reactions that lead to the formation of fibrin from fibrinogen.Alteplase does not inhibit any of the steps in this process, but rather activates plasminogen, which is already present in the blood.

Choice D is wrong because alteplase does not block the action of platelet activators or receptors.

Platelet activators are substances that stimulate platelets to aggregate and adhere, such as thrombin, ADP, and collagen.

Platelet receptors are molecules on the surface of platelets that bind to these activators or to other platelets, such as GPIIb/IIIa and GPVI.Alteplase does not affect these molecules, but rather targets fibrin.

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A nurse is administering enoxaparin, a low-molecular-weight heparin, to a client who has undergone orthopedic surgery. The nurse should administer this medication by which route and at which site?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who is prescribed clopidogrel, an antiplatelet drug, to prevent recurrent stroke. Which of the following statements should the nurse include in the teaching? (Select all that apply.)

Correct Answer is ["A","B","E"]

Explanation

A nurse is preparing to administer alteplase, a thrombolytic drug, to a client who has an acute myocardial infarction. The nurse knows that this drug works by which mechanism?

Correct Answer is C

Explanation

A nurse is caring for a client who has a history of coronary thrombosis and is taking warfarin as a long-term anticoagulant therapy. What laboratory test should the nurse monitor to evaluate the effectiveness of warfarin?

A nurse is reviewing the medication history of a client who is prescribed cilostazol, an antiplatelet drug, for intermittent claudication. The nurse should recognize that which of the following medications is contraindicated with cilostazol?

A nurse is administering enoxaparin, a low-molecular-weight heparin, to a client who has undergone orthopedic surgery. The nurse should administer this medication by which route and at which site?