A nurse is preparing to administer enoxaparin to a patient for deep vein thrombosis (DVT) prophylaxis. The nurse is using a prefilled syringe with enoxaparin. Which action by the nurse indicates a need for further teaching?

The nurse massages the area after administration to ensure absorption.

The nurse administers the medication at a 90-degree angle.

The nurse injects the medication at least 2 inches from the umbilicus.

The nurse rotates the site of the injection each administration.

Answer and Explanation

The Correct Answer is A

Choice A reason: Massaging the injection site after enoxaparin administration is incorrect, as it can increase the risk of hematoma formation. Enoxaparin, a low-molecular-weight heparin, is absorbed subcutaneously without massage, which may disrupt tissue and enhance bleeding risk, a critical concern in anticoagulant therapy.

Choice B reason: Administering enoxaparin at a 90-degree angle is correct for subcutaneous injections. This ensures the drug reaches the subcutaneous tissue, optimizing absorption and anticoagulant activity. Enoxaparin inhibits factor Xa, preventing thrombus formation, and proper injection technique is essential for effective DVT prophylaxis.

Choice C reason: Injecting enoxaparin at least 2 inches from the umbilicus is correct to avoid areas with high vascularity or scar tissue, reducing the risk of bruising or poor absorption. This ensures consistent drug delivery into subcutaneous tissue, maintaining therapeutic levels for DVT prevention.

Choice D reason: Rotating injection sites for enoxaparin is appropriate to prevent tissue irritation or lipodystrophy. Alternating sites, such as the abdomen or thighs, ensures consistent absorption and minimizes local complications, supporting safe administration of this anticoagulant for DVT prophylaxis.

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Correct Answer is C

Explanation

Choice A reason: Fluticasone propionate, an inhaled corticosteroid, reduces airway inflammation over days, not suitable for acute asthma or COPD exacerbations. Its slow onset targets chronic control, not immediate bronchodilation, making it ineffective for rapid relief of acute bronchospasm or worsening respiratory symptoms.

Choice B reason: Salmeterol, a long-acting beta-2 agonist, provides sustained bronchodilation (12 hours) for maintenance therapy. Its slow onset (20-30 minutes) makes it unsuitable for acute asthma or COPD exacerbations, where rapid-acting agents like albuterol are needed for immediate airway relaxation.

Choice C reason: Albuterol, a short-acting beta-2 agonist, has a rapid onset (within minutes) by stimulating beta-2 receptors, increasing cyclic AMP, and relaxing airway smooth muscle. This makes it the first-line choice for acute asthma attacks or COPD exacerbations, providing quick relief of bronchospasm and dyspnea.

Choice D reason: Zafirlukast, a leukotriene receptor antagonist, prevents inflammation and bronchoconstriction for asthma maintenance. Its oral administration and slow onset (hours) make it ineffective for acute asthma or COPD exacerbations, which require rapid bronchodilation from inhalers like albuterol, not leukotriene modifiers.

A. Nothing; these are expected side effects of this medication. B. Reduce the infusion rate gradually until the adverse effects subside. C. Discontinue the infusion immediately. D. Administer the medication by rapid IV infusion to reduce these effects.

Correct Answer is C

Explanation

Choice A reason: Tingling and numbness are not expected side effects of amphotericin B. Common side effects include fever, chills, and nephrotoxicity. Neurological symptoms like paresthesia may indicate serious toxicity or infusion reactions, requiring immediate action, not dismissal, to prevent potential nerve damage or systemic complications.

Choice B reason: Reducing the infusion rate may help with infusion-related reactions like fever but is not the first action for tingling and numbness, which suggest neurotoxicity or electrolyte imbalances (e.g., hypomagnesemia). Stopping the infusion is prioritized to assess and prevent further harm, followed by physician consultation.

Choice C reason: Discontinuing amphotericin B infusion immediately is critical for tingling and numbness, as these may indicate neurotoxicity or severe infusion reactions. Amphotericin B’s binding to ergosterol can cause systemic toxicity, and stopping the infusion prevents further exposure, allowing assessment of symptoms and potential electrolyte or neurological issues.

Choice D reason: Rapid IV infusion of amphotericin B is contraindicated, as it increases toxicity, including nephrotoxicity and infusion reactions. Tingling and numbness require stopping the infusion, not speeding it up, to avoid exacerbating potential neurotoxic or systemic effects, ensuring patient safety during antifungal therapy.

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A nurse is preparing to administer enoxaparin to a patient for deep vein thrombosis (DVT) prophylaxis. The nurse is using a prefilled syringe with enoxaparin. Which action by the nurse indicates a need for further teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which drug has a quick onset of action and is recommended for use during an acute asthma attack or chronic obstructive pulmonary disease (COPD) exacerbation?

Correct Answer is C

Explanation

During an intravenous (IV) infusion of amphotericin B, a patient develops tingling and numbness in his toes and fingers. What will the nurse do first?

Correct Answer is C

Explanation

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