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NURS 4000 Exam 1 Questions with complete Solutions
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NURS 4000 Exam 1 Questions with complete Solutions
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NURS 4000 Exam 1A nurse is caring for a patient with a diagnosis of deep venous thrombosis (DVT). The
patient has an order to receive 30 mg enoxaparin (Lovenox). Which injection site should
the nurse use to administer this medication safely?
A. Buttock, upper outer quadrant
B. Abdomen, anterior-lateral aspect
C. Back of the arm, 2 inches away from a mole
D. Anterolateral thigh, with no scar tissue nearby - B. Abdomen, anterior-lateral aspect
Enoxaparin (Lovenox) is a low-molecular-weight (LMW) heparin that is given as a deep
subcutaneous injection in the right and left anterolateral abdomen. All subcutaneous
injections should be given away from scars, lesions, or moles.
The nurse is preparing to administer a scheduled dose of enoxaparin (Lovenox) 30 mg
subcutaneously. What should the nurse do to administer this medication correctly?
A. Remove the air bubble in the prefilled syringe.
B. Aspirate before injection to prevent IV administration.
,C. Rub the injection site after administration to enhance absorption.
D. Pinch the skin between the thumb and forefinger before inserting the needle. - D.
Pinch the skin between the thumb and forefinger before inserting the needle.
The nurse should gather together or "bunch up" the skin between the thumb and the
forefinger before inserting the needle into the subcutaneous tissue. The nurse should
not remove the air bubble in the prefilled syringe, aspirate, nor rub the site after
injection.
The nurse is admitting a 68-year-old preoperative patient with a suspected abdominal
aortic aneurysm (AAA). The medication history reveals that the patient has been taking
warfarin (Coumadin) on a daily basis. Based on this history and the patient's admission
diagnosis, the nurse should prepare to administer which medication?
A. Vitamin K
B. Cobalamin
C. Heparin sodium
D. Protamine sulfate - A. Vitamin K
,Coumadin is a Vitamin K antagonist anticoagulant that could cause excessive bleeding
during surgery if clotting times are not corrected before surgery. For this reason, vitamin
K is given as the antidote for warfarin (Coumadin).
The nurse is caring for a patient who has been receiving warfarin (Coumadin) and
digoxin (Lanoxin) as treatment for atrial fibrillation. Because the warfarin has been
discontinued before surgery, the nurse should diligently assess the patient for which
complication early in the postoperative period until the medication is resumed?
A. Decreased cardiac output
B. Increased blood pressure
C. Cerebral or pulmonary emboli
D. Excessive bleeding from incision or IV sites - C. Cerebral or pulmonary emboli
Warfarin is an anticoagulant that is used to prevent thrombi from forming on the walls of
the atria during atrial fibrillation. Once the medication is terminated, thrombi could again
form. If one or more thrombi detach from the atrial wall, they could travel as cerebral
emboli from the left atrium or pulmonary emboli from the right atrium.
, The nurse is reviewing the laboratory test results for a 68-year-old patient whose
warfarin (Coumadin) therapy was terminated during the preoperative period. The nurse
concludes that the patient is in the most stable condition for surgery after noting which
INR (international normalized ratio) result?
A. 1.0
B. 1.8
C. 2.7
D. 3.4 - A. 1.0
The therapeutic range for INR is 2.0 to 3.0 for many clinical diagnoses. The larger the
INR number, the greater the amount of anticoagulation. For this reason, the safest value
before surgery is 1.0, meaning that the anticoagulation has been reversed.
The nurse would determine that a postoperative patient is not receiving the beneficial
effects of enoxaparin (Lovenox) after noting what during a routine shift assessment?
A. Generalized weakness and fatigue
B. Crackles bilaterally in the lung bases
C. Pain and swelling in lower extremity
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