The nurse recognizes what absolute contraindication to the administration of a thrombolytic to a patient having an acute myocardial infarction?

History of hypertension

History of stroke

History of peptic ulcer disease

History of diabetes mellitus.

Shortness of breath.

Answer and Explanation

The Correct Answer is B

A history of stroke is an absolute contraindication to the administration of a thrombolytic to a patient having an acute myocardial infarction (AMI). This is because thrombolytics can increase the risk of intracranial hemorrhage and worsen the neurological outcome.

Choice A is wrong because history of hypertension is not an absolute contraindication, but a relative one. This means that the benefits of thrombolytic therapy may outweigh the risks in some cases, depending on the severity and duration of hypertension.

Choice C is wrong because history of peptic ulcer disease is also a relative contraindication, not an absolute one. Thrombolytics can increase the risk of gastrointestinal bleeding, but this can be managed with proton pump inhibitors or histamine-2 blockers.

Choice D is wrong because history of diabetes mellitus is not a contraindication at all to thrombolytic therapy. In fact, some studies have shown that diabetic patients with AMI may benefit more from thrombolytic therapy than non-diabetic patients.

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

Explanation

A patient with a high aPTT result is at risk for bleeding, so assessing for signs and symptoms of bleeding is important.

Holding heparin therapy per protocol is also appropriate, as heparin is the cause of the prolonged aPTT.

The other choices are wrong because:

• Choice B is wrong because continuing heparin therapy at the current rate will increase the risk of bleeding and further prolong the aPTT.

• Choice C is wrong because decreasing heparin therapy per protocol is not enough to reverse the effects of heparin.

Heparin should be stopped until the aPTT returns to the therapeutic range.

• Choice E is wrong because increasing heparin therapy per protocol will worsen the situation and cause more bleeding and coagulation problems.

The normal range for aPTT is 25 to 35 seconds, and the therapeutic range for heparin therapy is 60 to 80 seconds.A result of 90 seconds indicates excessive anticoagulation and increased bleeding risk.

A. Prothrombin time (PT) B. International normalized ratio (INR) C. Activated partial thromboplastin time (aPTT) D. Platelet count. E. Platelet count.

Correct Answer is C

Explanation

Activated partial thromboplastin time (aPTT).

Dabigatran (Pradaxa) is a direct oral anticoagulant (DOAC) that inhibits thrombin, a key enzyme in the coagulation cascade.

Dabigatran prolongs the aPTT, which is a measure of the intrinsic and common pathways of coagulation.The aPTT can be used to monitor the anticoagulant effect of dabigatran, although routine monitoring is not required.

Choice A) Prothrombin time (PT) is wrong because PT measures the extrinsic and common pathways of coagulation, which are not affected by dabigatran.

PT is used to monitor warfarin therapy, not dabigatran.

Choice B) International normalized ratio (INR) is wrong because INR is a standardized version of PT that is used to monitor warfarin therapy, not dabigatran.

INR is not affected by dabigatran.

Choice D) Platelet count is wrong because platelet count is a measure of the number of platelets in the blood, which are involved in primary hemostasis.

Platelet count is not affected by dabigatran, which acts on secondary hemostasis.

Normal ranges for these tests are:

• aPTT: 25 to 35 seconds

• PT: 11 to 13.5 seconds

• INR: 0.8 to 1.2

• Platelet count: 150,000 to 450,000 per microliter of blood

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The nurse recognizes what absolute contraindication to the administration of a thrombolytic to a patient having an acute myocardial infarction?

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Naxlex Comprehensive Predictor Exams

The patient has been receiving heparin therapy for deep vein thrombosis (DVT). The patient’s activated partial thromboplastin time (aPTT) result is 90 seconds (therapeutic range: 60-80 seconds). What will be included in patient care? (Select all that apply.).

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

Explanation

A patient has been prescribed dabigatran (Pradaxa) for atrial fibrillation (AF). Which laboratory test should be monitored while on this medication?

Correct Answer is C

Explanation

A client has been prescribed warfarin (Coumadin) for treatment of deep vein thrombosis (DVT). Which of the following instructions should the nurse include in patient teaching? Select all that apply.

A nurse is caring for a patient who is receiving heparin therapy via continuous IV infusion for treatment of deep vein thrombosis (DVT). The nurse should monitor which of the following laboratory values to evaluate therapeutic effectiveness of heparin therapy?

A nurse is teaching a client who has a new prescription for bivalirudin about potential adverse effects of the drug. Which of the following effects should the nurse include? (Select all that apply.)

Which patients below would be at a HIGH risk for developing adverse effects of Heparin drug therapy? Select all that apply:

A client who has atrial fibrillation is prescribed dabigatran etexilate mesylate (Pradaxa). The nurse should instruct the client to report which of the following findings immediately? (Select all that apply.)

A patient is receiving heparin therapy during hemodialysis for chronic renal failure and develops heparin-induced thrombocytopenia (HIT). The nurse anticipates that which medication will be ordered for this patient?

The nurse recognizes what absolute contraindication to the administration of a thrombolytic to a patient having an acute myocardial infarction?

A nurse is caring for a client who has pulmonary embolism and is receiving alteplase via continuous IV infusion.The nurse should monitor for which adverse effects of this medication? (Select all that apply.)