NRNP 6566 / NRNP6566 Advanced Care of Adults in Acute
Settings I Week 5 Knowledge Check | Questions and
Verified Answers | Latest
• Question 1
R enee is a 56-year-old female that fell about a week ag o and s prained her R ank le. S he
states s he has been taking it eas y and laying around her home for mos t of the las t week
so it would heal. Yes terday s he noticed that her calf was sorer than it had been, and her R
foot and ank le were more s wollen than they had been. S he came to urg ent care today
becaus e s he was afraid that the injury was wors e than s he thoug ht it was.
T 99.2 BP 128/77 H R 88 R R 18 W t 126 pou nds
H eart S 1S 2 reg ular rate and rhyth m, L ungs clear, A bdo me n s oft
R ank le is s wolle n but not dis colored. 1-2+ edema noted Dorsiflexion caus es s ome
dis comfort in the ank le and calf area.
Pedal puls es equal bilaterally
T he A PR N orders a duplex ultras ound of the rig ht leg. R adiolog y reports that the
ultrasound is positiv e for a deep v ein thrombosis. H ow wou ld you manag e this patient
(include labs and meds)?
Correct
Answ er: It is appropriate to treat her on an outpatient basis with appropriate
education and s upport.
Obtain bas eline PT /I NR, PT T, CBC labs
Begin Xarelto 15 mg po bid
Patient education on medication and potential complications – return to
emerg ency department for new ons et s hortness of breath
• Question 2
A 26-year-old female is currently on Lov enox 80 mg s ubq daily. W hat labs s hould the
A PR N order to monitor this patient?
Correct
Answ er: Enox aparin (L ov enox) is a form of heparin but its action does not affect any of
the clotting s tudies (PT T or PT /I NR) s o there is no v alue in monitoring them.
Low mole cular weig ht heparin and fractionated heparin can caus e heparin
induced thrombocytopenia (HI T), M onitoring for enoxaparin (L ov enox) would
include platelet counts to ass ess for HI T which can occur as s oon as 3 days
after the medication is initiated.
• Question 3
A 64-year man is recov ering from a trans urethral res ection of the pros tate for treatment
of benig n prostate hyperplasia. T he patient is receiv ing intrav enous antibiotics for the
urinary tract infection. T he post-operativ e cours e has been s mooth and the A PR N is
removing the 3-way Foley catheter when there is a s udden releas e of brig ht red blood
with many blood clots in the Foley bag. T he patient becomes hypotensiv e, tachycardic
and the A PR N notes new ec chymos es on the patient’s arms and legs. T he patient was
immediately transferred to the s urgical intensiv e care unit (SI CU) and a s tat hematolog y
This study source was downloaded by 100000851066238 from CourseHero.com on 0 8-23-2022 04:47:58 GMT -05:00
https://www.coursehero.com/file/60383223/Week-5-knowledge-checkdocx/
, NRNP 6566 / NRNP6566 Advanced Care of Adults in Acute
Settings I Week 5 Knowledge Check | Questions and
Verified Answers | Latest
cons ult was conducted. S tat CBC, d-dimer, peripheral blood s mear, partial thromboplas tin
time, Prothrombin time/international normalization ratio (I NR), and fibrinog en labs were
drawn. R es ults were:
This study source was downloaded by 100000851066238 from CourseHero.com on 0 8-23-2022 04:47:58 GMT -05:00
https://www.coursehero.com/file/60383223/Week-5-knowledge-checkdocx/
Settings I Week 5 Knowledge Check | Questions and
Verified Answers | Latest
• Question 1
R enee is a 56-year-old female that fell about a week ag o and s prained her R ank le. S he
states s he has been taking it eas y and laying around her home for mos t of the las t week
so it would heal. Yes terday s he noticed that her calf was sorer than it had been, and her R
foot and ank le were more s wollen than they had been. S he came to urg ent care today
becaus e s he was afraid that the injury was wors e than s he thoug ht it was.
T 99.2 BP 128/77 H R 88 R R 18 W t 126 pou nds
H eart S 1S 2 reg ular rate and rhyth m, L ungs clear, A bdo me n s oft
R ank le is s wolle n but not dis colored. 1-2+ edema noted Dorsiflexion caus es s ome
dis comfort in the ank le and calf area.
Pedal puls es equal bilaterally
T he A PR N orders a duplex ultras ound of the rig ht leg. R adiolog y reports that the
ultrasound is positiv e for a deep v ein thrombosis. H ow wou ld you manag e this patient
(include labs and meds)?
Correct
Answ er: It is appropriate to treat her on an outpatient basis with appropriate
education and s upport.
Obtain bas eline PT /I NR, PT T, CBC labs
Begin Xarelto 15 mg po bid
Patient education on medication and potential complications – return to
emerg ency department for new ons et s hortness of breath
• Question 2
A 26-year-old female is currently on Lov enox 80 mg s ubq daily. W hat labs s hould the
A PR N order to monitor this patient?
Correct
Answ er: Enox aparin (L ov enox) is a form of heparin but its action does not affect any of
the clotting s tudies (PT T or PT /I NR) s o there is no v alue in monitoring them.
Low mole cular weig ht heparin and fractionated heparin can caus e heparin
induced thrombocytopenia (HI T), M onitoring for enoxaparin (L ov enox) would
include platelet counts to ass ess for HI T which can occur as s oon as 3 days
after the medication is initiated.
• Question 3
A 64-year man is recov ering from a trans urethral res ection of the pros tate for treatment
of benig n prostate hyperplasia. T he patient is receiv ing intrav enous antibiotics for the
urinary tract infection. T he post-operativ e cours e has been s mooth and the A PR N is
removing the 3-way Foley catheter when there is a s udden releas e of brig ht red blood
with many blood clots in the Foley bag. T he patient becomes hypotensiv e, tachycardic
and the A PR N notes new ec chymos es on the patient’s arms and legs. T he patient was
immediately transferred to the s urgical intensiv e care unit (SI CU) and a s tat hematolog y
This study source was downloaded by 100000851066238 from CourseHero.com on 0 8-23-2022 04:47:58 GMT -05:00
https://www.coursehero.com/file/60383223/Week-5-knowledge-checkdocx/
, NRNP 6566 / NRNP6566 Advanced Care of Adults in Acute
Settings I Week 5 Knowledge Check | Questions and
Verified Answers | Latest
cons ult was conducted. S tat CBC, d-dimer, peripheral blood s mear, partial thromboplas tin
time, Prothrombin time/international normalization ratio (I NR), and fibrinog en labs were
drawn. R es ults were:
This study source was downloaded by 100000851066238 from CourseHero.com on 0 8-23-2022 04:47:58 GMT -05:00
https://www.coursehero.com/file/60383223/Week-5-knowledge-checkdocx/
