NURS 4000 Exam 1 with answers,

NURS 4000 Exam 1 with answers |\ |\ |\ |\ |\




A nurse is caring for a patient with a diagnosis of deep
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venous thrombosis (DVT). The patient has an order to
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receive 30 mg enoxaparin (Lovenox). Which injection site
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should the nurse use to administer this medication
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safely?
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A. Buttock, upper outer quadrant
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B. Abdomen, anterior-lateral aspect
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C. Back of the arm, 2 inches away from a mole
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D. Anterolateral thigh, with no scar tissue nearby -
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CORRECT ANSWERS ✔✔B. Abdomen, anterior-lateral|\ |\ |\ |\ |\



aspect |\




Enoxaparin (Lovenox) is a low-molecular-weight (LMW) |\ |\ |\ |\ |\ |\



heparin that is given as a deep subcutaneous injection in
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the right and left anterolateral abdomen. All
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subcutaneous injections should be given away from scars, |\ |\ |\ |\ |\ |\ |\



lesions, or moles.
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The nurse is preparing to administer a scheduled dose of
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enoxaparin (Lovenox) 30 mg subcutaneously. What |\ |\ |\ |\ |\ |\



should the nurse do to administer this medication
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correctly?
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A. Remove the air bubble in the prefilled syringe.
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,B. Aspirate before injection to prevent IV administration.
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C. Rub the injection site after administration to enhance
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absorption. |\




D. Pinch the skin between the thumb and forefinger
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before inserting the needle. - CORRECT ANSWERS ✔✔D.
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Pinch the skin between the thumb and forefinger before
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inserting the needle. |\ |\ |\




The nurse should gather together or "bunch up" the skin
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between the thumb and the forefinger before inserting |\ |\ |\ |\ |\ |\ |\ |\



the needle into the subcutaneous tissue. The nurse
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should not remove the air bubble in the prefilled syringe,
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aspirate, nor rub the site after injection. |\ |\ |\ |\ |\ |\




The nurse is admitting a 68-year-old preoperative patient
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with a suspected abdominal aortic aneurysm (AAA). The
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medication history reveals that the patient has been |\ |\ |\ |\ |\ |\ |\ |\



taking warfarin (Coumadin) on a daily basis. Based on this
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history and the patient's admission diagnosis, the nurse
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should prepare to administer which medication?
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A. Vitamin K
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B. Cobalamin
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C. Heparin sodium
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D. Protamine sulfate - CORRECT ANSWERS ✔✔A. Vitamin
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K |\

,Coumadin is a Vitamin K antagonist anticoagulant that|\ |\ |\ |\ |\ |\ |\ |\



could cause excessive bleeding during surgery if clotting
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times are not corrected before surgery. For this reason,
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vitamin K is given as the antidote for warfarin
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(Coumadin).


The nurse is caring for a patient who has been receiving
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warfarin (Coumadin) and digoxin (Lanoxin) as treatment
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for atrial fibrillation. Because the warfarin has been
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discontinued before surgery, the nurse should diligently |\ |\ |\ |\ |\ |\ |\



assess the patient for which complication early in the
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postoperative period until the medication is resumed? |\ |\ |\ |\ |\ |\


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A. Decreased cardiac output
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B. Increased blood pressure
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C. Cerebral or pulmonary emboli
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D. Excessive bleeding from incision or IV sites - CORRECT
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ANSWERS ✔✔C. Cerebral or pulmonary emboli |\ |\ |\ |\ |\ |\




Warfarin is an anticoagulant that is used to prevent
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thrombi from forming on the walls of the atria during
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atrial fibrillation. Once the medication is terminated,
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thrombi could again form. If one or more thrombi detach
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from the atrial wall, they could travel as cerebral emboli
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from the left atrium or pulmonary emboli from the right
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atrium.

, The nurse is reviewing the laboratory test results for a 68-
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year-old patient whose warfarin (Coumadin) therapy was
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terminated during the preoperative period. The nurse
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concludes that the patient is in the most stable condition
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for surgery after noting which INR (international
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normalized ratio) result? |\ |\


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A. 1.0
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B. 1.8
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C. 2.7
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D. 3.4 - CORRECT ANSWERS ✔✔A. 1.0
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The therapeutic range for INR is 2.0 to 3.0 for many
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clinical diagnoses. The larger the INR number, the greater
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the amount of anticoagulation. For this reason, the safest
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value before surgery is 1.0, meaning that the
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anticoagulation has been reversed. |\ |\ |\




The nurse would determine that a postoperative patient is
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not receiving the beneficial effects of enoxaparin
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(Lovenox) after noting what during a routine shift
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assessment?
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A. Generalized weakness and fatigue
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B. Crackles bilaterally in the lung bases
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C. Pain and swelling in lower extremity
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