Page 1805 - Saunders Comprehensive Review For NCLEX-RN

aPTT of 28 seconds is eliminated because this result indicates that the client is
receiving no therapeutic effect from the continuous heparin infusion. Finally, the
aPTT greater than 120 seconds can be eliminated because this value is beyond the
therapeutic range and the client is at risk for bleeding.
Level of Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Evaluation
Content Area: Pharmacology: Cardiovascular Medications: Anticoagulants
Health Problem: Adult Health: Cardiovascular: Dysrhythmias
Priority Concepts: Clotting; Safety
References: Gahart, Nazareno (2015), pp. 620-621, 624; Ignatavicius, Workman
(2016), pp. 607-608.

626. Answer: 4

Rationale: Aspirin-containing products need to be avoided when a client is taking
this medication. Alcohol consumption should be avoided by a client taking warfarin
sodium. Taking the prescribed medication at the same time each day increases client
compliance. The MedicAlert bracelet provides health care personnel with emergency
information.
Test-Taking Strategy: Note the strategic words, need for further teaching. These
words indicate a negative event query and ask you to select an option that is an
incorrect statement. Recalling that warfarin is an anticoagulant and that coated
aspirin is an aspirin-containing product will direct you to the correct option.
Level of Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Pharmacology: Cardiovascular Medications: Anticoagulants
Health Problem: Adult Health: Cardiovascular: Dysrhythmias
Priority Concepts: Client Education; Safety
Reference: Hodgson, Kizior (2015), pp. 89, 1289-1290.

627. Answer: 4

Rationale: The optimal therapeutic range for digoxin is 0.5 to 2.0 ng/mL (0.63 to
2.56 nmol/L). If the client is experiencing symptoms such as anorexia and is
experiencing hypokalemia as evidenced by a low potassium level, digoxin toxicity is
a concern. Therefore, option 4 is correct because it is outside of the therapeutic level
and elevated.
Test-Taking Strategy: Focus on the subject, a digoxin level outside of the
therapeutic range. Additionally, determine if an abnormality exists. Note that the
client is experiencing anorexia and has a low serum potassium level. Therefore, it is
best to select the option that identifies the highest level. Recall that in hypokalemia,
the client is at greater risk for digoxin toxicity.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment

1805