A patient diagnosed with a pulmonary embolism is receiving a continuous Heparin infusion. Which findings should prompt the nurse to notify the healthcare provider?

The patient’s PTT is 70 seconds (control 25-40).

The patient develops ecchymosis at the venipuncture site.

The patient develops hematuria.

There is an order for Coumadin 2.5 mg to start today.

Answer and Explanation

Correct Answer : A,C,D

Choice A rationale
A PTT of 70 seconds (control 25-40) indicates that the patient’s blood is taking longer than normal to clot, which could increase the risk of bleeding. This could be a sign of excessive anticoagulation from the Heparin infusion.
Choice B rationale
Ecchymosis at the venipuncture site could be a sign of bleeding under the skin, which could indicate that the patient is receiving too much Heparin.
Choice C rationale
Hematuria, or blood in the urine, could be a sign of bleeding in the urinary tract, which could be a side effect of Heparin therapy.
Choice D rationale
If there is an order for Coumadin 2.5 mg to start today, the healthcare provider should be notified. Coumadin and Heparin are both anticoagulants, and using them together could increase the risk of bleeding.

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Correct Answer is A

Explanation

Choice A rationale
In a client diagnosed with chronic obstructive pulmonary disease (COPD), an arterial blood gas (ABG) test would typically show an increased level of carbon dioxide (PaCO2)56. This is because COPD affects the ability of the lungs to expel carbon dioxide, leading to its buildup in the blood.
Choice B rationale
An increased pH is not typically seen in COPD. In fact, due to the increased carbon dioxide (which is acidic), the pH may be lower, indicating respiratory acidosis.
Choice C rationale
Decreased alveolar function is a characteristic of COPD, but it is not something that would be directly measured in an ABG test.
Choice D rationale
An increased arterial oxygen (PaO2) is not typically seen in COPD. In fact, due to the impaired gas exchange, PaO2 may be lower.

A. The patient can drink water through a straw without choking. B. The patient has intact cough and swallowing reflexes. C. The patient has clear breath sounds upon auscultation. D. The patient reports that they are not experiencing a sore throat.

Correct Answer is B

Explanation

Choice A rationale
While being able to drink water through a straw without choking is a positive sign, it is not the primary indicator that a patient can safely resume oral liquids after a bronchoscopy. The primary indicator is the return of the patient’s cough and swallowing reflexes.
Choice B rationale
The patient has intact cough and swallowing reflexes is the primary indicator that a patient can safely resume oral liquids after a bronchoscopy. These reflexes are essential for preventing aspiration, which can lead to pneumonia.
Choice C rationale
While clear breath sounds upon auscultation are a positive sign, they are not the primary indicator that a patient can safely resume oral liquids after a bronchoscopy. The primary indicator is the return of the patient’s cough and swallowing reflexes.
Choice D rationale
The absence of a sore throat is not the primary indicator that a patient can safely resume oral liquids after a bronchoscopy. The primary indicator is the return of the patient’s cough and swallowing reflexes.

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A patient diagnosed with a pulmonary embolism is receiving a continuous Heparin infusion. Which findings should prompt the nurse to notify the healthcare provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is analyzing arterial blood gas results for a client diagnosed with chronic obstructive pulmonary disease (COPD). What abnormal finding should the nurse anticipate?

Correct Answer is A

Explanation

A nurse is caring for a patient who has just returned to the unit following a bronchoscopy and requests coffee. The nurse assesses that it is safe for the patient to resume oral liquids when which of the following behaviors is demonstrated?

Correct Answer is B

Explanation

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