Which intervention for VTE care and prevention can the RN delegate to the nursing assistant?

Evaluate the effect of anticoagulant drugs by monitoring appropriate laboratory results and side effects of therapy

Help ambulatory patients to walk at least 4 to 6 times daily.

Teach patients at risk for VTE about preventive measures

Assess patients for VTE risk and monitor for VTE in at-risk patients

Answer and Explanation

The Correct Answer is B

Choice A reason: Evaluating anticoagulants requires interpreting labs like PT/INR and assessing bleeding, a skilled nursing task. Delegation to an assistant is inappropriate, as it demands clinical judgment beyond their scope, involving pharmacokinetics and patient safety monitoring.

Choice B reason: Assisting ambulation promotes venous return, reducing VTE risk via muscle pump action on veins. This physical task aligns with a nursing assistant’s scope, requiring no clinical analysis, making it a safe, effective delegation for prevention.

Choice C reason: Teaching about VTE prevention involves explaining risks and interventions, requiring nursing knowledge of pathophysiology. Assistants lack training for patient education, so this remains an RN duty to ensure accuracy and comprehension.

Choice D reason: Assessing VTE risk and monitoring involve clinical skills like inspecting for swelling or interpreting symptoms. This exceeds an assistant’s scope, as it requires diagnostic reasoning and expertise reserved for licensed nurses.

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Correct Answer is D

Explanation

Choice A reason: Streptomycin treats TB, but persistent AFB after 2 months suggests resistance or non-adherence. Requesting it now skips assessing compliance, which is critical first, as adding drugs prematurely may worsen resistance.

Choice B reason: Injectable antibiotics (e.g., amikacin) address resistant TB, but without confirming adherence, this is premature. Non-compliance is common; discussing this assumes resistance without evidence, delaying root cause investigation.

Choice C reason: Teaching about drug-resistant TB is relevant if resistance is confirmed, not assumed. Positive AFB may reflect non-adherence, so education is secondary to verifying medication use, which drives next steps.

Choice D reason: Asking about adherence checks if the patient took drugs as directed, a common reason for persistent AFB. Non-compliance delays sputum conversion, making this the first action to guide further treatment decisions.

A. Aspirin B. Lisinopril C. Insulin Glargine D. Furosemide (Lasix) E. Metoprolol

Correct Answer is ["B","D","E"]

Explanation

Choice A reason: Aspirin prevents thrombosis in coronary disease, not a primary heart failure treatment. It reduces ischemic risk but doesn’t address fluid overload or cardiac workload, lacking direct symptom relief in heart failure management.

Choice B reason: Lisinopril, an ACE inhibitor, reduces afterload and preload by vasodilation, easing heart strain. It manages heart failure symptoms like dyspnea by improving cardiac output, a cornerstone therapy for pump dysfunction.

Choice C reason: Insulin Glargine controls diabetes, not heart failure symptoms. It manages glucose, indirectly benefiting cardiovascular health, but doesn’t relieve congestion or improve hemodynamics, making it irrelevant to direct symptom management.

Choice D reason: Furosemide, a diuretic, reduces fluid overload in heart failure, alleviating dyspnea and edema. It lowers preload by increasing urine output, directly targeting congestion, a key symptom, in evidence-based practice.

Choice E reason: Metoprolol, a beta-blocker, slows heart rate, reducing myocardial demand in heart failure. It improves ejection fraction and symptoms like fatigue, a standard therapy for stabilizing cardiac function long-term.

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Which intervention for VTE care and prevention can the RN delegate to the nursing assistant?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After 2 months of prescribed treatment with isoniazid, rifampin, pyrazinamide, and ethambutol, a patient continues to have positive sputum smears for acid-fast bacilli (AFB). Which action would the nurse take next?

Correct Answer is D

Explanation

The nurse is assessing the patient’s medication list. Which of the following medications are commonly prescribed to manage symptoms of heart failure? (Select all that apply)

Correct Answer is ["B","D","E"]

Explanation

The nurse is admitting a patient with possible respiratory failure and a high PaCO2. Which assessment information would the nurse immediately report to the health care provider?

A patient comes to the doctor’s office with the following complaints: Moderate to severe pain over the nose, eyes, and forehead, purulent nasal drainage, fever, and malaise. The nurse suspects the patient is suffering from ___________.

Which patient statement supports a history of intermittent claudication?

In a severely anemic patient, which assessment findings would the nurse expect to find?

The nurse is reviewing the patient’s recent symptoms and lab results. Which of the following symptoms or findings suggest worsening heart failure? (Select all that apply)

After change-of-shift report, which patient would the nurse assess first?

Which action would the nurse take first when a patient develops epistaxis (nose bleed)?

Interpret the ABG results: pH: 7.48, PaCO2: 28 mmHg, PaO2: 55 mmHg, HCO3-: 24 mEq/L, SaO2: 87%