RN299 Module 9 Exam 2022: Nursing Capstone

RN299 Module 9 Exam 2022: Nursing Capstone A client is receiving a continuous IV infusion of heparin for the treatment of deep vein thrombosis. The client’s activated partial thromboplastin time (aPTT) level is 88 seconds (88 seconds). The client’s baseline before the initiation of therapy was 30 seconds (30 seconds). Which action does the nurse anticipate is needed? Increasing the rate of the heparin infusion Decreasing the rate of the heparin infusion Correct! Leaving the rate of the heparin infusion as is Shutting off the heparin infusion Module 9 Exam: RN299 - Nursing Capstone 3/7/21, 1:16 AM Rationale: The normal aPTT varies between 25 and 35 seconds (25 and 35 seconds), depending on the type of activator used in testing. The therapeutic dose of heparin for treatment of deep vein thrombosis is designed to keep the aPTT between 1.5 and 2.5 times normal. Therefore the client’s aPTT is somewhat increased but does not indicate a critical value. The infusion rate should be slowed and the aPTT rechecked as prescribed. A persistently increased aPTT indicates a risk for bleeding. Test-Taking Strategy: Focus on the data in the question. To answer this question accurately, it is necessary to be familiar with both the normal aPTT level and the therapeutic level needed after the institution of heparin therapy. Noting that the client’s baseline before the initiation of therapy was 30 seconds and recalling that the therapeutic dose for this client is intended to keep the aPTT between 1.5 and 2.5 times normal will direct you to the correct option. Review the content related to heparin therapy. Level of Cognitive Ability: Synthesizing Client Needs: Physiological Integrity Integrated Process: Nursing Process/Analysis Pharmacology: Cardiovascular Medications Giddens Concepts: Clinical Judgment, Evidence HESI Concepts: Clinical Decision Making/Clinical Judgment, Evidence Based Practice/Evidence References: Hodgson, B., & Kizior, R. (2015). Saunders nursing drug handbook 2015. (pp. 568-570) St. Louis: Saunders. Lewis, S., Dirksen, S., Heitkemper, M., & Bucher, L. (2014). Medical-surgical nursing: Assessment and management of clinical problems (9 ed., p. 627). St. Louis: Mosby. @ Rationale: The normal aPTT varies between 25 and 35 seconds (25 and 35 seconds), depending on the type of activator used in testing. The therapeutic dose of heparin for treatment of deep vein thrombosis is designed to keep the aPTT between 1.5 and 2.5 times normal. Therefore the client’s aPTT is somewhat increased but does not indicate a critical value. The th Module 9 Exam: RN299 - Nursing Capstone 3/7/21, 1:16 AM somewhat increased but does not indicate a critical value. The infusion rate should be slowed and the aPTT rechecked as prescribed. A persistently increased aPTT indicates a risk for bleeding. Test-Taking Strategy: Focus on the data in the question. To answer this question accurately, it is necessary to be familiar with both the normal aPTT level and the therapeutic level needed after the institution of heparin therapy. Noting that the client’s baseline before the initiation of therapy was 30 seconds and recalling that the therapeutic dose for this client is intended to keep the aPTT between 1.5 and 2.5 times normal will direct you to the correct option. Review the content related to heparin therapy. Level of Cognitive Ability: Synthesizing Client Needs: Physiological Integrity Integrated Process: Nursing Process/Analysis Pharmacology: Cardiovascular Medications Giddens Concepts: Clinical Judgment, Evidence HESI Concepts: Clinical Decision Making/Clinical Judgment, Evidence Based Practice/Evidence References: Hodgson, B., & Kizior, R. (2015). Saunders nursing drug handbook 2015. (pp. 568-570) St. Louis: Saunders. Lewis, S., Dirksen, S., Heitkemper, M., & Bucher, L. (2014). Medical-surgical nursing: Assessment and management of clinical problems (9 ed., p. 627). St. Louis: Mosby. th Question 2 1 / 1 pts The nurse is providing education about the importance of proper foot care to a patient who has diabetes mellitus. Which primary goal is the nurse trying to achieve? Module 9 Exam: RN299 - Nursing Capstone 3/7/21, 1:16 AM Prevention of foot fungus Prevention of neuropathy Prevention of amputation Correct! Prevention of plantar warts Foot ulceration is the most common single precursor to lower extremity amputations among persons with diabetes. Prevention of plantar warts and foot fungus are important but not the primary goal. Neuropathy is a degeneration of the peripheral nerves usually due to poor control of blood glucose levels; it is not a direct result of foot care. Question 3 1 / 1 pts A client has made an appointment to for her annual Papanicolaou test (a.k.a. Pap smear). The nurse who schedules the appointment should provide which information to the client? The test cannot be performed while the client is menstruating Correct! Spicy foods should not be eaten on the day of the test Vaginal douching is required an hour before the test The test has absolutely no discomfort associated with it Module 9 Exam: RN299 - Nursing Capstone 3/7/21, 1:16 AM Rationale: A Pap smear cannot be performed with accurate results during menstruation. The test is usually painless but may be slightly uncomfortable during placement of the speculum or while the cervical scraping is obtained. The client should not douche for at least 24 hours before the test. There is no reason to restrict consumption of spicy foods on the day of the test. Test-Taking Strategy: Focus on the subject, client preparation for the Papanicolaou test. Eliminate the option indicating that spicy foods should not be eaten on the day of the test first, because this is unrelated to the test in question. Eliminate the option that states that the test has absolutely no discomfort associated with it next because of the close-ended words “absolutely no” in that option. To choose between the remaining options, recall that douching and menstruation can interfere with accurate test results. Review client preparation for the Papanicolaou test. Level of Cognitive Ability: Applying Client Needs: Physiological Integrity Integrated Process: Nursing Process/Implementation Content Area: Fundamentals of Care: Diagnostic Tests Giddens Concepts: Client Teaching, Clinical Judgment HESI Concepts: Clinical Decision Making/Clinical Judgment, Teaching and Learning/Patient Education Reference: Ignatavicius, D., & Workman, M. (2013). Medicalsurgical nursing: Patient-centered collaborative care. (7 ed., p. 1581 ). St. Louis: Saunders. th Question 4 1 / 1 pts Module 9 Exam: RN299 - Nursing Capstone 3/7/21, 1:16 AM A client has been scheduled for magnetic resonance imaging (MRI). For which condition, a contraindication to MRI, does the nurse check the client’s medical history? Pancreatitis Type 1 diabetes mellitus Chronic airway limitation Pacemaker insertion Correct! Module 9 Exam: RN299 - Nursing Capstone 3/7/21, 1:16 AM Rationale: The candidate for MRI must be free of metal devices or implants. A careful history is conducted to determine whether any such metal objects, such as orthopedic hardware, pacemakers, artificial heart valves, aneurysm clips, and intrauterine devices, are inside the client. These may heat up in the magnetic field generated by the MRI device, become dislodged, or malfunction during the procedure. The other medical problems listed do not pose a risk or contraindication for this procedure. Test-Taking Strategy: Note that each of the incorrect options are comparable or alike and are medical disorders. The correct option is the name of a procedure in which a device is implanted into the client. Remember that it is crucial to ensure that there are no metal objects in the vicinity of the MRI machine. Review contraindications to MRI Level of Cognitive Ability: Analyzing Client Needs: Physiological Integrity