NRNP 6566 Week 5 Knowledge Check latest update 2021/2022 /
NRNP6566 Week 5 Knowledge Check GRADED A+
• Question 1
Renee is a 56-year-old female that fell about a week ago and sprained her R ankle. She
states she has been taking it easy and laying around her home for most of the last week
so it would heal. Yesterday she noticed that her calf was sorer than it had been, and her R
foot and ankle were more swollen than they had been. She came to urgent care today
because she was afraid that the injury was worse than she thought it was.
T 99.2 BP 128/77 HR 88 RR 18 Wt 126 pounds
Heart S1S2 regular rate and rhythm, Lungs clear, Abdomen soft
R ankle is swollen but not discolored. 1-2+ edema noted Dorsiflexion causes some
discomfort in the ankle and calf area.
Pedal pulses equal bilaterally
The APRN orders a duplex ultrasound of the right leg. Radiology reports that the
ultrasound is positive for a deep vein thrombosis. How would you manage this patient
(include labs and meds)?
Correct
Answer: It is appropriate to treat her on an outpatient basis with appropriate
education and support.
Obtain baseline PT/INR, PTT, CBC
labs Begin Xarelto 15 mg po bid
Patient education on medication and potential complications – return to
emergency department for new onset shortness of breath
• Question 2
A 26-year-old female is currently on Lovenox 80 mg subq daily. What labs should the
APRN order to monitor this patient?
Correct
Answer: Enoxaparin (Lovenox) is a form of heparin but its action does not affect any of
the clotting studies (PTT or PT/INR) so there is no value in monitoring them.
Low molecular weight heparin and fractionated heparin can cause heparin
induced thrombocytopenia (HIT), Monitoring for enoxaparin (Lovenox) would
include platelet counts to assess for HIT which can occur as soon as 3 days
after the medication is initiated.
• Question 3
A 64-year man is recovering from a transurethral resection of the prostate for treatment
of benign prostate hyperplasia. The patient is receiving intravenous antibiotics for the
urinary tract infection. The post-operative course has been smooth and the APRN is
removing the 3-way Foley catheter when there is a sudden release of bright red blood
NRNP 6566 Week 5 Knowledge Check latest update 2021/2022 /
NRNP6566 Week 5 Knowledge Check GRADED A+
, NRNP 6566 Week 5 Knowledge Check latest update 2021/2022 /
NRNP6566 Week 5 Knowledge Check GRADED A+
with many blood clots in the Foley bag. The patient becomes hypotensive, tachycardic
and the APRN notes new ecchymoses on the patient’s arms and legs. The patient was
immediately transferred to the surgical intensive care unit (SICU) and a stat hematology
consult was conducted. Stat CBC, d-dimer, peripheral blood smear, partial thromboplastin
time, Prothrombin time/international normalization ratio (INR), and fibrinogen labs were
drawn. Results were:
NRNP 6566 Week 5 Knowledge Check latest update 2021/2022 /
NRNP6566 Week 5 Knowledge Check GRADED A+
NRNP6566 Week 5 Knowledge Check GRADED A+
• Question 1
Renee is a 56-year-old female that fell about a week ago and sprained her R ankle. She
states she has been taking it easy and laying around her home for most of the last week
so it would heal. Yesterday she noticed that her calf was sorer than it had been, and her R
foot and ankle were more swollen than they had been. She came to urgent care today
because she was afraid that the injury was worse than she thought it was.
T 99.2 BP 128/77 HR 88 RR 18 Wt 126 pounds
Heart S1S2 regular rate and rhythm, Lungs clear, Abdomen soft
R ankle is swollen but not discolored. 1-2+ edema noted Dorsiflexion causes some
discomfort in the ankle and calf area.
Pedal pulses equal bilaterally
The APRN orders a duplex ultrasound of the right leg. Radiology reports that the
ultrasound is positive for a deep vein thrombosis. How would you manage this patient
(include labs and meds)?
Correct
Answer: It is appropriate to treat her on an outpatient basis with appropriate
education and support.
Obtain baseline PT/INR, PTT, CBC
labs Begin Xarelto 15 mg po bid
Patient education on medication and potential complications – return to
emergency department for new onset shortness of breath
• Question 2
A 26-year-old female is currently on Lovenox 80 mg subq daily. What labs should the
APRN order to monitor this patient?
Correct
Answer: Enoxaparin (Lovenox) is a form of heparin but its action does not affect any of
the clotting studies (PTT or PT/INR) so there is no value in monitoring them.
Low molecular weight heparin and fractionated heparin can cause heparin
induced thrombocytopenia (HIT), Monitoring for enoxaparin (Lovenox) would
include platelet counts to assess for HIT which can occur as soon as 3 days
after the medication is initiated.
• Question 3
A 64-year man is recovering from a transurethral resection of the prostate for treatment
of benign prostate hyperplasia. The patient is receiving intravenous antibiotics for the
urinary tract infection. The post-operative course has been smooth and the APRN is
removing the 3-way Foley catheter when there is a sudden release of bright red blood
NRNP 6566 Week 5 Knowledge Check latest update 2021/2022 /
NRNP6566 Week 5 Knowledge Check GRADED A+
, NRNP 6566 Week 5 Knowledge Check latest update 2021/2022 /
NRNP6566 Week 5 Knowledge Check GRADED A+
with many blood clots in the Foley bag. The patient becomes hypotensive, tachycardic
and the APRN notes new ecchymoses on the patient’s arms and legs. The patient was
immediately transferred to the surgical intensive care unit (SICU) and a stat hematology
consult was conducted. Stat CBC, d-dimer, peripheral blood smear, partial thromboplastin
time, Prothrombin time/international normalization ratio (INR), and fibrinogen labs were
drawn. Results were:
NRNP 6566 Week 5 Knowledge Check latest update 2021/2022 /
NRNP6566 Week 5 Knowledge Check GRADED A+
