Mastering Progressive Care RN A: Verified Answers and Rationale

1. A patient with a pulmonary embolism is started on a heparin
infusion. Which lab value should the nurse monitor closely?
A. PT/INR
B. aPTT
C. Platelet count
D. D-dimer
Answer and Rationale:
B. aPTT
Rationale: Heparin therapy is monitored using aPTT levels to ensure
therapeutic anticoagulation.


2. A patient receiving total parenteral nutrition (TPN) has a glucose
level of 250 mg/dL. What is the nurse’s priority intervention?
A. Notify the healthcare provider.
B. Administer insulin as prescribed.
C. Slow the TPN infusion rate.
D. Recheck the glucose level in 1 hour.
Answer and Rationale:
B. Administer insulin as prescribed.
Rationale: Hyperglycemia is a common complication of TPN and
should be managed with insulin to maintain glucose control.

,3. The nurse notes that a patient receiving a blood transfusion develops
a fever, chills, and low back pain. What is the nurse’s priority action?
A. Slow the infusion rate.
B. Stop the transfusion immediately.
C. Administer acetaminophen.
D. Notify the healthcare provider.
Answer and Rationale:
B. Stop the transfusion immediately.
Rationale: These symptoms indicate a possible transfusion reaction,
which requires stopping the transfusion to prevent further
complications.


4. A patient on a progressive care unit reports a sudden headache and
blurry vision. The nurse notes a blood pressure of 220/110 mmHg.
What is the priority action?
A. Administer a prescribed antihypertensive IV medication.
B. Recheck the blood pressure in 15 minutes.
C. Notify the healthcare provider immediately.
D. Place the patient in a semi-Fowler's position.
Answer and Rationale:
A. Administer a prescribed antihypertensive IV medication.

, Rationale: Hypertensive emergencies require immediate lowering of
blood pressure to prevent organ damage.


5. A patient with deep vein thrombosis is prescribed enoxaparin. What
is the nurse’s priority assessment?
A. Platelet count
B. INR levels
C. Pain scale
D. Lung sounds
Answer and Rationale:
A. Platelet count
Rationale: Monitoring for thrombocytopenia is crucial to detect HIT, a
potential complication of enoxaparin therapy.


6. A patient on digoxin presents with nausea, blurred vision, and a
heart rate of 48 bpm. What is the most appropriate nursing action?
A. Administer atropine.
B. Check digoxin levels.
C. Hold the next dose of digoxin.
D. Notify the healthcare provider.
Answer and Rationale:
B. Check digoxin levels.