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Questions 164

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Extract:

Laboratory results
Hematocrit
Male: 42%–52%
(0.42-0.52)

Female: 37%–47%
(0.37–0.47) 30%
(0.30)
Activated PTT
Baseline: 30–40 sec 110 sec
Platelets
150,000–400,000/mm3
(150–400 × 109/L) 80,000/mm3
(80 x 109/L)
PT
11–12.5 sec 11 sec


Question 1 of 5

The nurse is reinforcing teaching for a client who is prescribed acyclovir for genital herpes. Which statement should be included by the nurse?

Correct Answer: A

Rationale: Heparin is an anticoagulant that helps prevent further clot formation. It is titrated based on activated partial
thromboplastin time (aPTT). The therapeutic aPTT target is 1.5-2.0 times the normal reference range of 30-40
seconds. A aPTT value >100 seconds would be considered critical and could result in life-threatening side
effects. Common sentinel events that result from heparin drips include epistaxis, hematuria, and gastrointestina
bleeds (Option 1).
(Option 2) A normal hematocrit for a female is 37%-47% (0.37-0.47). In a client with a history of chronic
anemia, a hematocrit of 30% (0.30) may be an expected finding.
(Option 3) A normal platelet count is 150,000-400,000/mm* (150-400 x 10%L). In a client with a history of liver
cirrhosis, a platelet count of 80,000/mmª (80 x 10%/L) would be anticipated. An episode of bleeding rarely occurs
with a platelet count >50,000 mm* (50 x 10%/L).
(Option 4) A normal prothrombin time is 11-12.5 seconds, and so a level of 11 seconds would not be
concerning.

Extract:


Question 2 of 5

A patient has recently been prescribed Lidocaine Hydrochloride. Which of the following symptoms may occur with over dosage?

Correct Answer: B

Rationale: Lidocaine Hydrochloride can cause fatigue and confusion if an over dosage occurs.

Question 3 of 5

The nurse is reviewing new medication prescriptions for a client with an acute exacerbation of asthma. Which of the following prescriptions should the nurse clarify?

Correct Answer: B

Rationale: Potassium chloride (
B) is not indicated for asthma exacerbation unless hypokalemia is documented, requiring clarification. Albuterol (
A), methylprednisolone (
D) treat asthma, and enoxaparin (
C) may prevent thrombosis in immobile patients.

Question 4 of 5

A client is diagnosed as having secondary Cushing's syndrome. The nurse knows that the client has most likely been taking which medication?

Correct Answer: D

Rationale: Secondary Cushing's syndrome is often caused by long-term prednisone use, a corticosteroid mimicking cortisol excess. Estrogen, penicillin, or lovastatin do not cause this condition.

Question 5 of 5

Which situations require that the nurse report to an appropriate authority? Select all that apply.

Correct Answer: B,C,D,E

Rationale: Gonorrhea (
B) and syphilis (E) are reportable diseases, regardless of HIPAA. Suspected abuse in a teenager (
C) or elderly client (
D) mandates reporting, despite provider or client denial. Cupping (
A) is a cultural practice, not abuse.

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