NUR 242 Exam 1 – 4 Questions With Verified
Answers Latest Updated 2024
A 4-year-old child develops thrombocytopenia after vaccination. The nurse would
suspect which vaccination may be responsible? - ANSWER-Measles, mumps, and
rubella virus vaccine (MMR)
Which task can be delegated safely by the registered nurse (RN) to unlicensed
nursing personnel (UNP) for a client with thrombocytopenia? - ANSWER-
Positioning the client
Which finding would be of most concern when the nurse is assessing a client with
pulmonary embolism diagnosis who is receiving intravenous heparin? - ANSWER-
Client reports stools are black
A postpartum client receiving a continuous heparin infusion for a deep vein
thrombosis has an activated partial thromboplastin time (aPTT) of 98 seconds.
Which action would the nurse take in response to this situation? - ANSWER-
Interrupt the infusion and notify the primary health care provider of the APTT
result.
,To prevent excessive bruising when administering subcutaneous heparin, which
technique will the nurse employ? - ANSWER-Avoid massaging the injection site
after the injection
A client who has atrial fibrillation with rapid ventricular response is started on a
continuous heparin infusion. Which clinical finding enables the nurse to conclude
that the heparin therapy is effective? - ANSWER-An activated partial
thromboplastin time (aPTT) is twice the usual value
A client develops thrombophlebitis in the right calf. Bed rest is prescribed, and an
intravenous (IV) infusion of heparin is initiated. Which drug action will the nurse
include when describing the purpose of this medication to the client? - ANSWER-It
prevents extension of the clot
A client is admitted to the hospital with a diagnosis of deep vein thrombosis, and
intravenous (IV) heparin sodium is prescribed. If the client experiences excessive
bleeding, which medication will the nurse be prepared to administer? - ANSWER-
Protamine sulfate
A client with a continuous intravenous (IV) heparin drip is prescribed IV
vancomycin every 12 hours. Which action will the nurse take when it is time to
administer the vancomycin? - ANSWER-Start a second IV line for the vancomycin
and continue the heparin as prescribed
,Warfarin is prescribed for a client who has been receiving intravenous (IV)
heparin for a partial occlusion of the left common carotid artery. The client
expresses concern about why both medications are needed at the same time.
Which rationale would the nurse include to address the client's concern? -
ANSWER-Heparin provides anticoagulant effects until warfarin reaches
therapeutic levels.
The nurse manager is teaching the licensed practical nurse (LPN) the evidence-
based practice regarding use of normal saline and low-dose heparin flush
solutions for capped angiocatheters. Which statements by the LPN indicate they
understood the teaching? Select all that apply. One, some, or all responses may be
correct. - ANSWER-The use of heparin flushes disappeared in the late 1990s.", The
use of high doses of heparin solutions is not recommended in adults.
The nurse is administering 5000 units of heparin to a prenatal client on prolonged
bed rest. The label indicates there are 20,000 units of heparin in each milliliter of
solution. How much solution would the nurse give the client?___ mL - ANSWER-
0.25 ml
A pregnant client is prescribed heparin to prevent the risk of thromboembolism.
Which adverse effects would the nurse anticipate with this medication? Select all
that apply. One, some, or all responses may be correct. - ANSWER-Osteoporosis,
Compression fractures of the spine
, Which adverse effect of heparin would the nurse assess a client for during
pregnancy? - ANSWER-Osteoporosis
A client needs a continuous intravenous infusion of heparin at a rate of 1000 units
per hour. There are 25,000 units of heparin in 500 mL of 5% dextrose solution.
The nurse will set the infusion control device to deliver how many milliliters per
hour?___ mL/h - ANSWER-20 ml/hr
A client is receiving heparin sodium intravenously at 1500 units/h. The
concentration in the bag is 25,000 units/500 milliliters. How many milliliters will
infuse during the nurse's 8-hour shift?___ mL - ANSWER-240 ml
A health care provider prescribes heparin 6000 units subcutaneously daily. The
pharmacy dispenses a vial containing 10,000 units per milliliter. How many
milliliters of heparin will the nurse administer?_____ mL - ANSWER-0.6 ml
Which laboratory value would the nurse use to determine whether a client is
receiving a therapeutic dose of intravenous heparin? - ANSWER-Activated partial
thromboplastin time (APTT) is 70 seconds
When a client with a venous thrombosis is receiving warfarin, which test result
would the nurse use to determine whether the daily dose of warfarin is
therapeutic? - ANSWER-INR
Answers Latest Updated 2024
A 4-year-old child develops thrombocytopenia after vaccination. The nurse would
suspect which vaccination may be responsible? - ANSWER-Measles, mumps, and
rubella virus vaccine (MMR)
Which task can be delegated safely by the registered nurse (RN) to unlicensed
nursing personnel (UNP) for a client with thrombocytopenia? - ANSWER-
Positioning the client
Which finding would be of most concern when the nurse is assessing a client with
pulmonary embolism diagnosis who is receiving intravenous heparin? - ANSWER-
Client reports stools are black
A postpartum client receiving a continuous heparin infusion for a deep vein
thrombosis has an activated partial thromboplastin time (aPTT) of 98 seconds.
Which action would the nurse take in response to this situation? - ANSWER-
Interrupt the infusion and notify the primary health care provider of the APTT
result.
,To prevent excessive bruising when administering subcutaneous heparin, which
technique will the nurse employ? - ANSWER-Avoid massaging the injection site
after the injection
A client who has atrial fibrillation with rapid ventricular response is started on a
continuous heparin infusion. Which clinical finding enables the nurse to conclude
that the heparin therapy is effective? - ANSWER-An activated partial
thromboplastin time (aPTT) is twice the usual value
A client develops thrombophlebitis in the right calf. Bed rest is prescribed, and an
intravenous (IV) infusion of heparin is initiated. Which drug action will the nurse
include when describing the purpose of this medication to the client? - ANSWER-It
prevents extension of the clot
A client is admitted to the hospital with a diagnosis of deep vein thrombosis, and
intravenous (IV) heparin sodium is prescribed. If the client experiences excessive
bleeding, which medication will the nurse be prepared to administer? - ANSWER-
Protamine sulfate
A client with a continuous intravenous (IV) heparin drip is prescribed IV
vancomycin every 12 hours. Which action will the nurse take when it is time to
administer the vancomycin? - ANSWER-Start a second IV line for the vancomycin
and continue the heparin as prescribed
,Warfarin is prescribed for a client who has been receiving intravenous (IV)
heparin for a partial occlusion of the left common carotid artery. The client
expresses concern about why both medications are needed at the same time.
Which rationale would the nurse include to address the client's concern? -
ANSWER-Heparin provides anticoagulant effects until warfarin reaches
therapeutic levels.
The nurse manager is teaching the licensed practical nurse (LPN) the evidence-
based practice regarding use of normal saline and low-dose heparin flush
solutions for capped angiocatheters. Which statements by the LPN indicate they
understood the teaching? Select all that apply. One, some, or all responses may be
correct. - ANSWER-The use of heparin flushes disappeared in the late 1990s.", The
use of high doses of heparin solutions is not recommended in adults.
The nurse is administering 5000 units of heparin to a prenatal client on prolonged
bed rest. The label indicates there are 20,000 units of heparin in each milliliter of
solution. How much solution would the nurse give the client?___ mL - ANSWER-
0.25 ml
A pregnant client is prescribed heparin to prevent the risk of thromboembolism.
Which adverse effects would the nurse anticipate with this medication? Select all
that apply. One, some, or all responses may be correct. - ANSWER-Osteoporosis,
Compression fractures of the spine
, Which adverse effect of heparin would the nurse assess a client for during
pregnancy? - ANSWER-Osteoporosis
A client needs a continuous intravenous infusion of heparin at a rate of 1000 units
per hour. There are 25,000 units of heparin in 500 mL of 5% dextrose solution.
The nurse will set the infusion control device to deliver how many milliliters per
hour?___ mL/h - ANSWER-20 ml/hr
A client is receiving heparin sodium intravenously at 1500 units/h. The
concentration in the bag is 25,000 units/500 milliliters. How many milliliters will
infuse during the nurse's 8-hour shift?___ mL - ANSWER-240 ml
A health care provider prescribes heparin 6000 units subcutaneously daily. The
pharmacy dispenses a vial containing 10,000 units per milliliter. How many
milliliters of heparin will the nurse administer?_____ mL - ANSWER-0.6 ml
Which laboratory value would the nurse use to determine whether a client is
receiving a therapeutic dose of intravenous heparin? - ANSWER-Activated partial
thromboplastin time (APTT) is 70 seconds
When a client with a venous thrombosis is receiving warfarin, which test result
would the nurse use to determine whether the daily dose of warfarin is
therapeutic? - ANSWER-INR
