A nurse is assisting with the care of a postoperative client following a total knee replacement. Which of the following medications should the nurse anticipate the provider to prescribe to prevent the formulation of a deep vein thrombosis (DVT)?

Warfarin

Alteplase (PA)

Clopidogrel

Enoxaparin

Answer and Explanation

The Correct Answer is D

A. Warfarin. Warfarin (Coumadin) is an anticoagulant used to prevent blood clots, but it typically requires several days to achieve a therapeutic effect and needs close monitoring of INR (International Normalized Ratio) levels. While it can be used for long-term prevention of DVT, it's not the immediate choice for post-operative prophylaxis.

B. Alteplase (tPA). Alteplase is a thrombolytic agent, used to break down existing clots, not prevent their formation. It is typically used in emergency situations, such as for treating ischemic stroke.

C. Clopidogrel. Clopidogrel is an antiplatelet agent, often used to prevent arterial clots, not DVTs. It is more commonly used in conditions like stroke and heart disease.

D. Enoxaparin. Enoxaparin, a low molecular weight heparin, is commonly used to prevent DVT after surgery by inhibiting specific clotting factors. It’s frequently prescribed for DVT prevention in orthopedic surgery patients.

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Correct Answer is D

Explanation

A. Peripheral Artery Disease (PAD). PAD is a chronic condition related to reduced blood flow in peripheral arteries. It is not directly associated with MI complications.

B. Gastroesophageal Reflux Disease (GERD). GERD involves acid reflux and is not related to post-MI complications.

C. Hypertension. While hypertension is a risk factor for MI, it does not directly explain the symptoms of shortness of breath and irregular heartbeats following an MI.

D. Heart Failure. Heart failure is a common post-MI complication, especially if a significant portion of heart muscle is damaged. Symptoms of shortness of breath and irregular heartbeats could indicate left-sided heart failure, where fluid backs up into the lungs, or right-sided failure, which can lead to systemic congestion.

A. Hypovolemia leading to decreased renal perfusion B. Acute tubular necrosis C. Urinary tract obstruction D. Chronic kidney disease

Correct Answer is A

Explanation

A. Hypovolemia leading to decreased renal perfusion. Hypovolemia from dehydration and low blood pressure reduces blood flow to the kidneys, resulting in pre-renal AKI, characterized by elevated BUN and creatinine.

B. Acute tubular necrosis. Acute tubular necrosis may cause AKI but is often due to prolonged hypoperfusion, nephrotoxic drugs, or ischemia, not the immediate presentation seen here.

C. Urinary tract obstruction. A urinary tract obstruction leads to post-renal AKI, often with symptoms like flank pain or difficulty urinating, not dehydration and low blood pressure.

D. Chronic kidney disease. Chronic kidney disease is a long-term condition and would not cause the acute symptoms or sudden onset of AKI as seen in this patient.

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A nurse is assisting with the care of a postoperative client following a total knee replacement. Which of the following medications should the nurse anticipate the provider to prescribe to prevent the formulation of a deep vein thrombosis (DVT)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient is recovering from a myocardial infarction (MI). Which of the following complications should the nurse be most concerned about if the patient reports new-onset shortness of breath and irregular heartbeats?

Correct Answer is D

Explanation

Correct Answer is A

Explanation

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