Free NCLEX-RN Exam Braindumps (page: 233)

Page 233 of 431

A client takes warfarin (Coumadin) 15 mg po daily. To evaluate the medication's effectiveness, the nurse should monitor the:

  1. prothrombin time (PT)
  2. partial thromboplastin time (PTT)
  3. PTT-C
  4. Fibrin split products

Answer(s): A

Explanation:

(A) PT evaluates adequacy of extrinsic clotting pathway. Adequacy of warfarin therapy is monitored by PT. (B) PTT evaluates adequacy of intrinsic clotting pathway. Adequacy of heparin therapy is monitored by PTT. (C) There is no such laboratory test. (D) Fibrin split products indicate fibrinolysis. This is a screening test for disseminated intravascular coagulation. Heparin therapy may increase fibrin split products.



A client takes warfarin (Coumadin) 15 mg po daily. To evaluate the medication's effectiveness, the nurse should monitor the:

  1. prothrombin time (PT)
  2. partial thromboplastin time (PTT)
  3. PTT-C
  4. Fibrin split products

Answer(s): A

Explanation:

(A) PT evaluates adequacy of extrinsic clotting pathway. Adequacy of warfarin therapy is monitored by PT. (B) PTT evaluates adequacy of intrinsic clotting pathway. Adequacy of heparin therapy is monitored by PTT. (C) There is no such laboratory test. (D) Fibrin split products indicate fibrinolysis. This is a screening test for disseminated intravascular coagulation. Heparin therapy may increase fibrin split products.



Diagnostic assessment findings for an infant with possible coarctation of the aorta would include:

  1. A third heart sound
  2. A diastolic murmur
  3. Pulse pressure difference between the upper extremities
  4. Diminished or absent femoral pulses

Answer(s): D

Explanation:

(A) S1 and S2 in an infant with coarctation of the aorta are usually normal. S3 and S4 do not exist with this diagnosis. (B) Either no murmur will be heard or a systolic murmur from an associated cardiac defect will be heard along the left upper sternal border. A diastolic murmur is not associated with coarctation of the aorta. (C) Pulse pressure differences of>20 mm Hg exist between the upper extremities and the lower extremities. It is important to evaluate the upper and lower extremities with the appropriate- sized cuffs. (D) Femoral and pedal pulses will be diminished or absent in infants with coarctation of the aorta.



Diagnostic assessment findings for an infant with possible coarctation of the aorta would include:

  1. A third heart sound
  2. A diastolic murmur
  3. Pulse pressure difference between the upper extremities
  4. Diminished or absent femoral pulses

Answer(s): D

Explanation:

(A) S1 and S2 in an infant with coarctation of the aorta are usually normal. S3 and S4 do not exist with this diagnosis. (B) Either no murmur will be heard or a systolic murmur from an associated cardiac defect will be heard along the left upper sternal border. A diastolic murmur is not associated with coarctation of the aorta. (C) Pulse pressure differences of>20 mm Hg exist between the upper extremities and the lower extremities. It is important to evaluate the upper and lower extremities with the appropriate- sized cuffs. (D) Femoral and pedal pulses will be diminished or absent in infants with coarctation of the aorta.



Page 233 of 431



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