To prevent deep vein thromboses following knee replacement surgery, an adult male client is receiving daily subcutaneous enoxaparin. Which laboratory result requires immediate action by the nurse?

Reference Range:
Hematocrit [42% to 52% (0.42 to 0.52 volume fraction)]
Platelets [150,000 to 400,000/mm² (150 to 400 × 10^9/L)]
Creatinine [0.5 to 1.1 mg/dL (44 to 97 μmol/L)]
Blood Urea Nitrogen (BUN) [10 to 20 mg/dL (3.6 to 7.1 mmol/L)]

Platelet count of 100,000/mm³ (100 x 10^9/L).

Hematocrit 45% (0.45 volume fraction).

Blood urea nitrogen (BUN) 20 mg/dL (7.1 mmol/L).

Serum creatinine 1.0 mg/dL (88.4 μmol/L).

Answer and Explanation

The Correct Answer is A

Choice A reason: Platelet count of 100,000/mm³ (100 x 10^9/L) is below the normal range and indicates thrombocytopenia, which is a decrease in the number of platelets in the blood. Thrombocytopenia can increase the risk of bleeding and bruising, and can be a serious adverse effect of enoxaparin. This laboratory result requires immediate action by the nurse, such as notifying the prescriber, monitoring for signs of bleeding, and withholding the next dose of enoxaparin.

Choice B reason: Hematocrit 45% (0.45 volume fraction) is within the normal range and does not indicate any problem with the client's red blood cells or oxygen-carrying capacity.

Choice C reason: Blood urea nitrogen (BUN) 20 mg/dL (7.1 mmol/L) is within the normal range and does not indicate any problem with the client's kidney function or hydration status.

Choice D reason: Serum creatinine 1.0 mg/dL (88.4 μmol/L) is within the normal range and does not indicate any problem with the client's kidney function or muscle metabolism.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is D

Explanation

Choice A reason: Using a Snellen chart to assess visual acuity is not a direct measure of the effectiveness of pilocarpine, which is used to lower intraocular pressure by constricting the pupil and increasing aqueous humor outflow. Visual acuity may be affected by other factors, such as refractive errors, cataracts, or macular degeneration.

Choice B reason: Checking the amount of drainage from each eye is not a relevant action for evaluating the effectiveness of pilocarpine, which does not affect tear production or drainage. Excessive or abnormal eye drainage may indicate an infection, allergy, or injury.

Choice C reason: Palpating the eyelids for decreased swelling is not a useful action for evaluating the effectiveness of pilocarpine, which does not cause or reduce eyelid swelling. Eyelid swelling may be caused by inflammation, infection, allergy, or trauma.

Choice D reason: Reviewing eye pressure measurements is the correct action for evaluating the effectiveness of pilocarpine, which is used to lower intraocular pressure in patients with open-angle glaucoma. High intraocular pressure can damage the optic nerve and cause vision loss. Pilocarpine reduces intraocular pressure by constricting the pupil and increasing aqueous humor outflow.

A. Promotes stomach emptying and prevents gastric reflux. B. Buffers hydrochloric acid and prevents gastric erosion. C. Prevents indigestion associated with ingestion of spicy foods. D. Binds with phosphorus in foods and prevents absorption.

Correct Answer is D

Explanation

Choice A reason: Promoting stomach emptying and preventing gastric reflux is not a relevant action of sevelamer, which is a phosphate binder that lowers serum phosphate levels in patients with CKD. Gastric reflux may be caused by other factors, such as hiatal hernia, obesity, or spicy foods.

Choice B reason: Buffering hydrochloric acid and preventing gastric erosion is not a pertinent action of sevelamer, which does not affect gastric acidity or mucosal integrity. Gastric erosion may be caused by other factors, such as NSAIDs, alcohol, or Helicobacter pylori infection.

Choice C reason: Preventing indigestion associated with ingestion of spicy foods is not a significant action of sevelamer, which does not affect digestion or food tolerance. Indigestion may be caused by other factors, such as overeating, stress, or gallstones.

Choice D reason: Binding with phosphorus in foods and preventing absorption is the correct action of sevelamer, which should be taken with meals to reduce the amount of phosphorus that enters the bloodstream from the diet. High serum phosphate levels can cause bone loss, calcification of soft tissues, and secondary hyperparathyroidism in patients with CKD.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with open-angle glaucoma is using pilocarpine ophthalmic solution, a miotic agent. Which action should the nurse at the eye clinic include in evaluating the effectiveness of the medication?

Correct Answer is D

Explanation

The nurse is administering sevelamer during lunch to a client with chronic kidney disease (CKD). The client asks the nurse to bring the medication later. The nurse should describe which action of sevelamer as an explanation for taking it with meals?

Correct Answer is D

Explanation

A client is discharged with a prescription for warfarin. Which discharge instruction should the nurse emphasize to the client?

Patient Data Exhibits What other medications would the nurse expect the surgeon to prescribe along with morphine? Select all that apply.

A client with bipolar disorder admitted with severe depression and suicidal ideation receives a prescription for lithium carbonate. Which instruction should the nurse provide to the client?

Patient Data Exhibits Review H and P, and nurse’s note. Identify from the choices below which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client’s progress.

A client with bipolar disorder admitted with severe depression and suicidal ideation receives a prescription for lithium carbonate. Which instruction should the nurse provide to the client?

A client with multiple sclerosis starts a new prescription, baclofen, to control muscle spasticity. Three days later, the client calls the clinic nurse and reports feeling fatigued and dizzy. Which instruction should the nurse provide?

A client with bulimia and depression who is taking phenelzine 90 mg daily is admitted to an acute care hospital for uncontrolled hypertension. Which dietary choices should the nurse instruct the client to avoid?