The nurse is preparing a prescription for enoxaparin 40 mg subcutaneous (sub) daily. Enoxaparin is available in a pre-filled cartridge labelled, "60 mg per 0.6 mall" How many mL should the nurse administer?

(Enter numeric value only. If rounding is required, round to the nearest tenth.)

Choice A reason: Clay-coloured stool is a symptom of bile duct obstruction. It indicates that bile is not reaching the intestines to help digest food. While this is important to note, it is not the most urgent finding that requires immediate reporting to the healthcare provider.

Choice B reason: A distended, hard, and rigid abdomen is a sign of possible peritonitis or other severe abdominal complications. This finding indicates a medical emergency that requires immediate attention and intervention by the healthcare provider. Prompt reporting is essential to prevent further complications and ensure appropriate treatment.

Choice C reason: Bile-stained emesis suggests that bile is being regurgitated, which is indicative of a blocked or compromised bile duct. However, this finding does not require as urgent reporting as a rigid abdomen, which could indicate a more serious condition.

Choice D reason: Radiating, sharp pain in the right shoulder is often referred pain from gallbladder issues. While this symptom is significant and should be monitored, it does not take precedence over the urgent finding of a distended and rigid abdomen that might indicate a severe complication.

Choice A reason: Tachycardia, or a rapid heart rate, can be a symptom associated with COPD, especially during exacerbations or due to medication effects. However, it is not the primary symptom used to evaluate the effectiveness of COPD treatment.

Choice B reason: Edem of the ankles can occur in COPD patients due to right-sided heart failure (cur pulmonale) associated with chronic lung disease. While it is an important symptom to monitor, it is not the primary indicator of COPD treatment effectiveness.

Choice C reason: Dyspneal, or difficulty breathing, is the most significant and primary symptom of COPD. The primary goal of COPD treatment is to improve the client's breathing and reduce dyspneal. Assessing the client's level of breathlessness provides direct insight into how well the treatment is managing the condition.

Choice D reason: Unilateral diminished breath sounds can indicate localized issues such as pneumothorax or pleural effusion rather than the overall effectiveness of COPD treatment. Bilateral lung sounds and general respiratory status are more relevant to evaluating COPD management.