A nurse is caring for a client who has deep vein thrombosis (DVT). The client has received intravenous (IV) heparin for the past 5 days and now has a new prescription for oral warfarin in addition to the heparin. The client asks the nurse if both medications are necessary. Which of the following is an appropriate response by the nurse?

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

"Heparin enhances the effects of the warfarin."

"I will ask the charge nurse to call your provider and get an explanation."

"Heparin will be continued until the warfarin reaches a therapeutic level."

Answer and Explanation

The Correct Answer is D

Choice A reason : This statement is incorrect because neither heparin nor warfarin dissolves clots. They prevent the formation of new clots and the growth of existing clots.

Choice B reason : This statement is not accurate. Heparin and warfarin do not enhance each other's effects. They work in different pathways of the clotting cascade. Heparin acts quickly, whereas warfarin takes several days to reach therapeutic levels.

Choice C reason : While seeking clarification from a provider is a part of good nursing practice, it is not the most informative response for the client. The nurse should provide education based on their knowledge and available information.

Choice D reason : This is the correct response. Heparin acts quickly and is used to stabilize the patient while waiting for warfarin to reach therapeutic levels, which is monitored by the international normalized ratio (INR) and usually takes several days.

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Free Nursing Study Resources

Correct Answer is ["2"]

Explanation

Step 1 is to identify the prescribed dose of digoxin, which is 0.25 mg.

Step 2 is to identify the amount of digoxin available per tablet, which is 0.125 mg/tablet.

Step 3 is to calculate the number of tablets the nurse should administer per dose. This is done by dividing the prescribed dose by the amount available per tablet. So, 0.25 mg ÷ 0.125 mg/tablet = 2 tablets.

The nurse should administer 2 tablets per dose.

A. Dyspnea B. Jugular vein distention C. Orthopnea D. Crackles

Correct Answer is ["A","C","D"]

Explanation

Choice A reason : Dyspnea, or difficulty breathing, is a common symptom of left-sided heart failure. It occurs because the heart is unable to pump efficiently, leading to a backup of fluid in the lungs, which can cause shortness of breath.

Choice B reason : Jugular vein distention is typically associated with right-sided heart failure, not left-sided. It occurs when there is an increased pressure in the right atrium, leading to visible bulging of the neck veins.

Choice C reason : Orthopnea, or difficulty breathing while lying flat, is another symptom of left-sided heart failure. Fluid accumulation in the lungs makes it difficult for the patient to breathe without elevation, hence they may need to sleep with extra pillows.

Choice D reason : Crackles, which are heard during lung auscultation, are indicative of fluid accumulation in the alveoli due to the inefficiency of the left side of the heart to pump blood, leading to pulmonary congestion.

Choice E reason : Tachycardia, or rapid heartbeat, can be a response to left-sided heart failure as the body attempts to compensate for the decreased cardiac output by increasing the heart rate to maintain adequate blood flow.

Choice F reason : Gastrointestinal bloating is more commonly associated with right-sided heart failure due to systemic venous congestion leading to fluid accumulation in the abdominal organs and tissues.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a prescription for digoxin 0.25 mg PO daily. The amount available is digoxin 0.125 mg/tablet. How many tablets should the nurse administer per dose? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["2"]

Explanation

A nurse is preparing to administer digoxin to a client who has left-sided heart failure. Which of the following clinical manifestations should the nurse expect to see in this client? (Select all that apply.)

Correct Answer is ["A","C","D"]

Explanation

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