which lab value is critical for a patient on heparin therapy

ATI RN

ATI RN Exit Exam

1. Which lab value is critical for a patient on heparin therapy?

A. Monitor aPTT
B. Monitor INR
C. Monitor platelet count
D. Monitor sodium levels

Correct answer: A

Rationale: The correct answer is to monitor aPTT. Activated Partial Thromboplastin Time (aPTT) is crucial for patients on heparin therapy as it helps determine the clotting ability of the blood. By monitoring aPTT, healthcare providers can adjust the dosage of heparin to maintain therapeutic levels and prevent bleeding complications. Monitoring INR is more commonly associated with warfarin therapy, not heparin. Monitoring platelet count is important for assessing the risk of bleeding or clotting disorders but is not specific to heparin therapy. Monitoring sodium levels is not directly related to assessing the effectiveness or safety of heparin therapy.

2. How should a healthcare professional administer a subcutaneous injection?

A. Insert the needle at a 45-degree angle
B. Insert the needle at a 90-degree angle
C. Use a Z-track method
D. Insert the needle at a 15-degree angle

Correct answer: A

Rationale: The correct technique for administering subcutaneous injections is to insert the needle at a 45-degree angle. This angle ensures that the medication is delivered into the subcutaneous tissue, which is located just below the skin. Inserting the needle at a 90-degree angle is more appropriate for intramuscular injections, while using a Z-track method is specific to intramuscular injections to prevent leakage of medication into the subcutaneous tissue. Inserting the needle at a 15-degree angle would not reach the subcutaneous tissue effectively.

3. A nurse is teaching a client who has a new prescription for clopidogrel. Which of the following instructions should the nurse include?

A. Take this medication with meals to prevent nausea.
B. Avoid drinking alcohol while taking this medication.
C. Avoid eating foods high in potassium.
D. Monitor for signs of infection.

Correct answer: D

Rationale: The correct answer is D: 'Monitor for signs of infection.' Clopidogrel affects platelet levels, increasing the risk of bleeding. Therefore, it is essential for clients taking clopidogrel to monitor for signs of infection, which could indicate a lowered immune response. Choices A, B, and C are incorrect because they do not directly relate to the specific monitoring needs associated with clopidogrel therapy.

4. A nurse is caring for a client who is 12 hours postoperative following abdominal surgery. Which of the following findings should the nurse report to the provider?

A. Serosanguineous drainage on the surgical dressing.
B. Respiratory rate of 16/min.
C. Heart rate of 90/min.
D. WBC count of 15,000/mm3.

Correct answer: D

Rationale: A WBC count of 15,000/mm3 is elevated, which may indicate infection, a common concern postoperatively. An elevated WBC count suggests the body is fighting an infection, and prompt reporting to the provider is essential for further evaluation and treatment. Serosanguineous drainage on the surgical dressing is expected in the immediate postoperative period, respiratory rate of 16/min is within the normal range, and a heart rate of 90/min is also within an acceptable range postoperatively. Therefore, these findings do not raise immediate concerns that necessitate reporting to the provider.

5. A nurse in a mental health facility receives a change of shift report on four clients. Which of the following clients should the nurse plan to assess first?

A. Client placed in restraints due to aggressive behavior
B. A new client with a history of 4.5 kg weight loss in the past two months
C. Client receiving PRN dose of haloperidol 2 hours ago for anxiety
D. Client receiving first ECT treatment today

Correct answer: A

Rationale: The nurse should plan to assess the client placed in restraints due to aggressive behavior first. Clients in restraints require immediate attention and frequent monitoring for safety. While weight loss, medication administration, and ECT treatment are important, the client in restraints is in a critical situation that requires immediate assessment and intervention.