BSN 266 SHERPATHS EXAM
WITH CORRECT ANSWERS
2025 GRADED A+
Venous Thromboembolism:
Question 1 of 10
Why is a patient who leads a sedentary lifestyle at increased risk for
developing a venous thromboembolism (VTE)?
Platelet aggregation is increased during inactivity.
A sedentary lifestyle causes damage to the vein endothelium.
Muscles that are inactive have a higher incidence of venous stasis.
Inactivity leads to dysfunctional valves and a change in the unidirectional
blood flow. ( correct answers ) Muscles that are inactive have a higher
incidence of venous stasis.
Venous stasis can occur when the muscles of the extremities are inactive.
Venous stasis is a risk factor in Virchow's triad.
Question 2 of 10
Which patient is showing clinical manifestations of a lower extremity venous
thromboembolism (VTE)?
The patient with a palpable subcutaneous cordlike vein with itchiness
The patient with unilateral leg edema with tenderness and warm skin
The patient with lower extremity pain during walking that is relieved by rest
The patient with shortness of breath, chest pressure, and low oxygen
saturation ( correct answers ) The patient with unilateral leg edema with
tenderness and warm skin
,Not all patients with lower extremity VTE will experience symptoms.
However, when present, patients will present with unilateral leg edema, pain,
paresthesia erythema, and warm skin and fever.
Question 3 of 10
A patient presents to the emergency department with shortness of breath.
Which laboratory finding would be most concerning to the nurse?
D-dimer 441 mcg/L
WBC 7800 cells/mcL
Troponin <0.01 ng/mL
Brain Natriuretic Peptide (BNP) 10 pg/mL ( correct answers ) D-dimer 441
mcg/L
This D-dimer level would be most concerning. An elevated D-dimer can aid in
the diagnosis of suspected pulmonary embolism (PE). Further assessment is
needed for this patient immediately.
Question 4 of 10
The patient with a history of venous thromboembolism (VTE) has been taking
warfarin long-term and presents to the clinic with frequent nosebleeds.
Which laboratory value should cause the nurse to contact the ordering health
care provider?
Platelet count 275,000/mm3
Prothrombin time (PT) 18.2 seconds
International normalized ratio (INR) 6.3
Activate Partial Thromboplastin Time (aPTT) 34 seconds ( correct answers )
International normalized ratio (INR) 6.3
This finding would indicate the warfarin dosing needs adjustment. An INR
level of 4.3 is above the therapeutic range, putting the patient at risk for
hemorrhage. The nurse should communicate this finding to the ordering
health care provider.
Question 5 of 10
, The patient with a lower extremity venous thromboembolism (VTE) is
receiving heparin sodium intravenously (IV) and is scheduled for emergency
surgery. Which action will the nurse anticipate?
Administer intravenous protamine.
Administer intramuscular (IM) Vitamin K.
Monitor international nationalized ratio (INR) level.
Communicate with perioperative nurse to monitor for bleeding. ( correct
answers ) Administer intravenous protamine.
Protamine is the reversal agent of heparin and should be administered as
ordered to prepare the patient for surgery. If the aPTT remains high during
surgery, the patient is at risk for hemorrhage.
Question 6 of 10
The nurse is caring for a patient with venous thromboembolism (VTE) on
bedrest. Which nursing intervention is most appropriate?
Assess the patient's mobility status with the physical therapist.
Teach the patient to flex and extend their legs and feet every four to six
hours.
Apply small graduate compression stockings to ensure appropriate
compression.
Delegate to the unlicensed assistant personnel (UAP) to reposition the
patient every two hours. ( correct answers ) Delegate to the unlicensed
assistant personnel (UAP) to reposition the patient every two hours.
Patients on bedrest with VTE should be repositioned at least every two hours
to prevent skin breakdown and further development of VTE.
Question 7 of 10
The surgical patient is receiving heparin sodium subcutaneously every eight
hours. Which laboratory value would cause the nurse to contact the ordering
health care provider?
Hemoglobin 13 g/dL
Platelet count 75,000/mm3
WITH CORRECT ANSWERS
2025 GRADED A+
Venous Thromboembolism:
Question 1 of 10
Why is a patient who leads a sedentary lifestyle at increased risk for
developing a venous thromboembolism (VTE)?
Platelet aggregation is increased during inactivity.
A sedentary lifestyle causes damage to the vein endothelium.
Muscles that are inactive have a higher incidence of venous stasis.
Inactivity leads to dysfunctional valves and a change in the unidirectional
blood flow. ( correct answers ) Muscles that are inactive have a higher
incidence of venous stasis.
Venous stasis can occur when the muscles of the extremities are inactive.
Venous stasis is a risk factor in Virchow's triad.
Question 2 of 10
Which patient is showing clinical manifestations of a lower extremity venous
thromboembolism (VTE)?
The patient with a palpable subcutaneous cordlike vein with itchiness
The patient with unilateral leg edema with tenderness and warm skin
The patient with lower extremity pain during walking that is relieved by rest
The patient with shortness of breath, chest pressure, and low oxygen
saturation ( correct answers ) The patient with unilateral leg edema with
tenderness and warm skin
,Not all patients with lower extremity VTE will experience symptoms.
However, when present, patients will present with unilateral leg edema, pain,
paresthesia erythema, and warm skin and fever.
Question 3 of 10
A patient presents to the emergency department with shortness of breath.
Which laboratory finding would be most concerning to the nurse?
D-dimer 441 mcg/L
WBC 7800 cells/mcL
Troponin <0.01 ng/mL
Brain Natriuretic Peptide (BNP) 10 pg/mL ( correct answers ) D-dimer 441
mcg/L
This D-dimer level would be most concerning. An elevated D-dimer can aid in
the diagnosis of suspected pulmonary embolism (PE). Further assessment is
needed for this patient immediately.
Question 4 of 10
The patient with a history of venous thromboembolism (VTE) has been taking
warfarin long-term and presents to the clinic with frequent nosebleeds.
Which laboratory value should cause the nurse to contact the ordering health
care provider?
Platelet count 275,000/mm3
Prothrombin time (PT) 18.2 seconds
International normalized ratio (INR) 6.3
Activate Partial Thromboplastin Time (aPTT) 34 seconds ( correct answers )
International normalized ratio (INR) 6.3
This finding would indicate the warfarin dosing needs adjustment. An INR
level of 4.3 is above the therapeutic range, putting the patient at risk for
hemorrhage. The nurse should communicate this finding to the ordering
health care provider.
Question 5 of 10
, The patient with a lower extremity venous thromboembolism (VTE) is
receiving heparin sodium intravenously (IV) and is scheduled for emergency
surgery. Which action will the nurse anticipate?
Administer intravenous protamine.
Administer intramuscular (IM) Vitamin K.
Monitor international nationalized ratio (INR) level.
Communicate with perioperative nurse to monitor for bleeding. ( correct
answers ) Administer intravenous protamine.
Protamine is the reversal agent of heparin and should be administered as
ordered to prepare the patient for surgery. If the aPTT remains high during
surgery, the patient is at risk for hemorrhage.
Question 6 of 10
The nurse is caring for a patient with venous thromboembolism (VTE) on
bedrest. Which nursing intervention is most appropriate?
Assess the patient's mobility status with the physical therapist.
Teach the patient to flex and extend their legs and feet every four to six
hours.
Apply small graduate compression stockings to ensure appropriate
compression.
Delegate to the unlicensed assistant personnel (UAP) to reposition the
patient every two hours. ( correct answers ) Delegate to the unlicensed
assistant personnel (UAP) to reposition the patient every two hours.
Patients on bedrest with VTE should be repositioned at least every two hours
to prevent skin breakdown and further development of VTE.
Question 7 of 10
The surgical patient is receiving heparin sodium subcutaneously every eight
hours. Which laboratory value would cause the nurse to contact the ordering
health care provider?
Hemoglobin 13 g/dL
Platelet count 75,000/mm3
