A client is on intravenous heparin to treat a pulmonary embolism. The client's most recent partial thromboplastin time (PTT) was 25 seconds. What action should the nurse anticipate?

Correct Answer: B

Rationale: The correct answer is B: Increase the heparin rate. A PTT of 25 seconds indicates that the client's blood is not adequately anticoagulated, as the therapeutic range for PTT is typically around 60-80 seconds for heparin therapy. Therefore, the nurse should anticipate increasing the heparin rate to achieve the desired anticoagulant effect and prevent further clot formation. Incorrect choices: A: Decreasing the heparin rate would further decrease the anticoagulant effect, potentially putting the client at risk for thrombus progression. C: No change to the heparin rate would not address the subtherapeutic PTT level and could lead to inadequate anticoagulation. D: Stopping heparin and starting warfarin is not appropriate at this time as warfarin takes time to reach therapeutic levels, whereas heparin provides immediate anticoagulation for acute situations like a pulmonary embolism.

Correct Answer: B

Rationale: The correct answer is B because coordinating discharge planning for home safety is not directly related to interdisciplinary work. The other choices (A, C, D) involve active collaboration and communication with different disciplines to ensure comprehensive client care. Consulting with other disciplines, participating in client rounding, and sharing care plans all demonstrate a high priority on interdisciplinary work by fostering teamwork and integration of various perspectives to enhance patient outcomes. In contrast, coordinating discharge planning for home safety is more focused on individual patient needs and safety rather than interdisciplinary collaboration.

Correct Answer: D

Rationale: The correct answer is D: Experimenting on patients. The IOM report emphasizes the importance of evidence-based practice, collaboration, and patient-centered care to ensure nurses are practicing at their highest levels of competency. Experimenting on patients is unethical and not a part of competent nursing practice. Nurses should rely on established evidence and best practices rather than experimenting on patients. Assessing nurses' competency in collaborating with teams, implementing evidence-based care, and providing family-focused care aligns with the IOM's recommendations for quality nursing practice.

Correct Answer: A

Rationale: The correct answer is A: Cost-saving measures. When utilizing evidence-based practice, the nurse should prioritize providing care based on research findings, considering client preferences, and leveraging their expertise. Cost-saving measures should not be the primary factor influencing care decisions as the focus should be on delivering the most effective and appropriate care based on evidence. Ignoring research findings, client preferences, or the nurse's expertise could compromise the quality of care provided. Thus, cost-saving measures are not a factor to consider when planning care with evidence-based practice.

Correct Answer: A

Rationale: The correct answer is A, as the pain of MI is often accompanied by shortness of breath due to decreased oxygen supply to the heart muscle, whereas stable angina typically does not present with this symptom. Shortness of breath in MI is due to the heart's inability to pump effectively. Choices B, C, and D are incorrect because feelings of fear or anxiety, duration of pain, and response to nitroglycerin are not definitive differentiating factors between MI and stable angina.