A nurse is caring for a client who has deep vein thrombosis and has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make?

"I will call the provider to get a prescription for discontinuing the IV heparin today."

"Both heparin and warfarin work together to dissolve the clots."

"The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay."

"Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level."

Answer and Explanation

The Correct Answer is D

Rationale:

A. Discontinuing heparin abruptly without achieving therapeutic levels of warfarin increases the risk of thrombus formation.

B. Heparin and warfarin have different mechanisms of action, but they both serve to prevent clot formation.

C. Heparin and warfarin do not directly affect each other's therapeutic effects.

D. Warfarin takes time to reach therapeutic levels and become effective, so heparin is continued until warfarin is fully active.

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Correct Answer is B

Explanation

Rationale:

A. Alteplase (fibrinolytics) is used to dissolve clots in coronary arteries during an acute myocardial infarction (AMI).

B. IV Nitroglycerine is a vasodilator that dilates coronary blood vessels, increasing blood flow to the myocardium.

C. Metoprolol (beta blockers) are used to decrease heart rate, blood pressure, and myocardial oxygen demand.

D. IV Heparin is used to prevent further clot formation in coronary arteries during an acute myocardial infarction (AMI).

A. Look for P waves on the strip B. Count how many QRS occur in a 6 second strip C. Read the monitor or electrocardiogram interpretation. D. Measure the T waves

Correct Answer is B

Explanation

Rationale:

A. Looking for P waves is important for assessing atrial activity, but it does not directly calculate heart rate.

B. Counting how many QRS complexes occur in a 6-second strip and multiplying by 10 is a quick and accurate way to calculate heart rate.

C. Reading the monitor or ECG interpretation provides information about the rhythm and morphology of the heart, but it does not directly calculate heart rate.

D. Measuring T waves is important for assessing cardiac repolarization, but it does not directly calculate heart rate.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client with an acute myocardial infarction (AMI). The nurse is preparing medications for the client and recognizes that which medication will dilate the client’s coronary blood vessels?

Correct Answer is B

Explanation

A nurse is teaching a newly licensed nurse about evaluating cardiac rhythms. Which of the following best explains calculation of the heart rate?

Correct Answer is B

Explanation

A nurse is caring for a client with heart failure (HF) and preparing to give a daily dose of Digoxin (Lanoxin). The nurse understands the rationale for giving this medication for HF is which of the following?

A nurse is assessing a patient with known mitral valve regurgitation. The nurse should expect to hear which of the following heart sounds?

A nurse is providing discharge instructions for a client diagnosed with congestive heart failure. Which of the following client statements indicates to the nurse that the teaching was effective?

A nurse is caring for a heart failure client with a history of dietary non compliance. The nurse suspects the client has fluid volume overload. Which of the following findings should the nurse expect? (SELECT ALL THAT APPLY))

A nurse is providing teaching to a client who has a permanent pacemaker and has just had the initial pacemaker check. Which of the following client statements indicates to the nurse that the teaching was effective?

A nurse is caring for a client in a critical care unit who is 4 hours post operative coronary artery bypass surgery. The nurse performs the reassessment and suspects the client may be developing a pericardial effusion. What assessment findings would the nurse note in this case?