It takes about 3-5 days of scheduled doses to start achieving a therapeutic INR level. ), Medications that are damaging to the vein. Last Updated/Verified: Aug 25, 2020. To improve patient outcomes nurses should focus on preventing DVT. Patients who’ve had joint replacement surgery are at risk for blood clots due to stasis of venous circulation etc. Over 200 free NCLEX-RN exam practice test questions with thorough rationales for explanation of answers to help give you a leg up for the special day. Copyright © 2021 RegisteredNurseRN.com. These common NCLEX questions are difficult to answer but with enough practice using the questions below, youâll ace them! Sequential Easy First Hard First. mt6399. The risk factors associated with deep vein thrombosis are oral contraceptive use, obesity, hormone replacement therapy, hypercoagulable states, old age, type A blood, multiparity, not nulliparity, and among clients who have had major surgery and/or prolonged immobility. A. fibrin degradation fragment; positive for a blood clot, B. platelet degradation protein; negative for a blood clot, C. clotting factors; positive for a blood clot, D. fibrin degradation fragment; negative for a blood clot. As the nurse, you will want to be familiar with the prevention of a blood clot (venous thromboembolism VTE), management of a DVT, and anticoagulation therapy. Why are the other options wrong? If it does this the blood will start to clump up (due to the present of platelets) and form a clot. Deep vein thrombosis (DVT) occurs when a blood clot forms in a deep vein in the leg or arm. Play as. The only time a patient should not wear the SCDs is when theyâre ambulating. Endothelial damage to the vein: This endothelial is a layer of cells that lines the inside of the vein. With NCLEX-style practice questions, essential nursing content organized according to the test plans and reinforcement activities, you'll be well on your way to success. 3. The platelets start to collect at the edges of the vessel, usually within the cusps of the vein’s valve. A patient, who is receiving continuous IV Heparin for the treatment of a DVT, has an aPTT of 110 seconds. Difficulty. A 55-year-old male with hyperlipidemia and diabetes. Nurse Plus is â¦ Veins located in the pelvis, lower leg (calf), and thighs. Start studying NCLEX questions DVT/PE/CF. Leg circumference measurement (calf)…measure about 10 cm or 4 inches below tibial tuberosity…watch out for a 3 cm circumference or more measurement when compared to the non-affected calf. There are two types of veins in the leg: superficial veins which lie just below the skin and can be seen on the surface, and deep veins which lie deep within the leg muscles. This is a quizz on general knowledge of risks, treatment and preventative measure of Venous Thromboembolism ... From which vein is a DVT considered to be proximal? It is very common that a patient will be on Heparin while taking Warfarin until INR levels are therapeutic. The Nurse Plus Academy is designed to help you pass your NCLEX Exam. Learn vocabulary, terms, and more with flashcards, games, and other study tools. So think of anything that damages the lining inside the vessel. Gravity. Deep Vein Thrombosis (DVT) NCLEX Review. Deep vein thrombosis (DVT) occurs when a blood clot (thrombus) forms in one or more of the deep veins in your body, usually in your legs. A. DVT Deep Vein Thrombosis Nursing Diagnosis Interventions NCELX Review and Care Plans. Regardless of the factor(s) contributing to the blood clot, as identified by Virchow’s Triad, platelets are involved. Questions. What are some conditions that cause stasis of blood flow? How does a clot form and what substances are involved? Text Mode â Text version of the exam 1. What are the risk factors for developing a deep vein thrombosis (DVT)? NCLEX Study Guide. Questions to ask if you suspect DVT â¢ If the patient complains of lower leg or calf pain, do a further assessment of the extremity. sudden shortness of breath, decreased oxygen saturation, fast heart rate, chest pain, very anxious, sweating, coughing, Fitted and applied properly as prescribed. Is A 74-year-old Obese Hispanic Woman Who Is In The Third Postoperative Day After An Open Reduction Internal Fixation (ORIF), For Repair Of A Left Femoral Neck Fracture After A Fall At Home. Registered Nurse, Free Care Plans, Free NCLEX Review, Nurse Salary, and much more. Feedback. Used to diagnose blood clots or Disseminated Intravascular Coagulation (DIC). What are some conditions that cause damage the endothelial lining? Used in combination with Warfarin until INR is therapeutic and then Heparin is discontinued. What is it? Application and regular usage of pneumatic compression devices like (SCDs) Sequential Compression Device per MD order. Registered Nurse, Free Care Plans, Free NCLEX Review, Nurse Salary, and much more. Youâre educating a patient about Warfarin (Coumadin) and how it is used to treat blood clots. We strive for 100% accuracy, but nursing procedures and state laws are constantly changing. Exam Mode â Questions and choices are randomly arranged, time limit of 1min per question, answers and grade will be revealed after finishing the exam. Retrieved 1 November 2019, from https://www.cdc.gov/ncbddd/dvt/diagnosis-treatment.html, Venous Thromboembolism | National Heart, Lung, and Blood Institute (NHLBI). What are some conditions that cause an increased risk of forming a clot within the vessel? Pulmonary Embolism Pathophysiology Nursing Pulmonary embolism (PE) occurs when a pulmonary artery becomes blockedâusually by a blood clot that has broken free from its site of origin and embolized or migrated to the lungs. Compression stockings per MD order: provides a specific amount of compression to help decrease risk of blood clot development. 3,500+ NCLEX-RN Practice Questions for Free â Thousands of practice questions for different nursing concepts and topics to help you review for the NCLEX-RN. Any aPTT value greater than 80 seconds places the patient at risk for bleeding. | CDC. Take them off when the patient is walking. What is the therapeutic INR range for this medication? Therefore, the blood has to flow back to the heart via the veins, and it does this with the assistance of healthy vein valves and the muscles within the extremity. Don’t forget to check out the other NCLEX review quizzes in this series and to watch the lecture on deep vein thrombosis before taking the quiz. A patient is prescribed Warfarin (Coumadin) for the treatment of a blood clot. Flashcards. This is because vein valves and walls became damaged due to the clot…blood doesn’t flow in the right directions (back to the heart). See our full. If the aPTT is less than 60 seconds, the dose would need to be increased and a bolus may be needed. Remember “SHE”: Stasis of Venous Blood, Hypercoagulability (means excessive coagulability), Endothelial damage. A patient’s D-dimer result is <500 ng/mL. 6,000 Practice NCLEX Questions; Join Now. Based on Virchow’s Triad, select which patients below are at RISK for the development of a deep vein thrombosis? 9. The nurse will apply sequential compression devices (SCDs) per physicianâs order to the patient’s lower extremities every night at bedtime. What veins are most susceptible for a DVT? C. A 25-year-old male who uses intravenous drugs. Once a DVT has developed it could result in a pulmonary embolism (PE). Read Chapter 37 From Your Text Book II. A D-dimer doesn’t tell us where the clot is located, so it will need to be further investigated by the MD. This is a blood test that assesses for fibrin degradation fragment (d-dimer), it’s a fibrin degradation product. Question: I. Below are recent practice questions under UNIT 1 -Medical-Surgical Nursing for Hematological Disorders. Do you think you could pass the NCLEX? Prophylactic medications: after surgery (post-op), especially joint replacement surgery like the hip… Example: Enoxaparin (subq injection), Don’t rub or massage affected extremity (can dislodge clot), Elevate the affected extremity above heart level (promotes blood return and decreases swelling), Compresses (warm/moist) helps pain and circulation. This quiz is copyright RegisteredNurseRn.com. aPTT values should be around 60-80 seconds to achieve a therapeutic response for Heparin. Prevention…very simple but so beneficial…nurses play a HUGE role with this! 2. A nurse is advising a patient with Chronic Fatigue Syndrome on infection control procedures. So we’ve seen how a clot forms now let’s talk about what you can see in your patient that may have a DVT. The answers are B, C, and D. Virchow’s Triad details the THREE factors for blood clot formation within the vessel. Teach patient to perform exercises by flexing and extending feet and legs every hour while awake. Therefore, the patient has a high risk of forming a blood clot. We strive for 100% accuracy, but nursing procedures and state laws are constantly changing. Which statement below is incorrect about a deep vein thrombosis (DVT)? Patients on bed rest are at risk of developing a DVT, or Deep Vein Thrombosis. The other type of VTE is a pulmonary embolism, which is where a deep vein thrombosis breaks off within the vein and goes to the lungs. The other type of VTE is a pulmonary embolism, which is where a deep vein thrombosis breaks off within the vein and goes to the lungs. It’s the formation of a clot within a deep vein. Diagnosis and Treatment of Venous Thromboembolism | CDC. The answer is A. Correct answer: C loomâs level: Evaluate NCLEX Plan category: Health Promotion Question 5 A nurse is teaching a client the appropriate way to use a metered dose inhaler. Enter your email address below and hit "Submit" to receive free email updates and nursing tips. Checking your knowledge of deep vein thrombosis is possible thanks to this quiz/worksheet combo. “Veins that are most susceptible to a deep vein thrombosis are the peroneal, posterior tibial, popliteal and superficial femoral.”, B. This causes WBCs, RBCs, and platelets to stick together within the vein. The patient reports pain when the foot is manually plantarflexed. Spell. 6. Also, a normal d-dimer is <500 ng/mL (FEU). Select all that apply: A. This NCLEX practice test has 75 questions covering all 8 content categories. Also, a positive result doesn’t necessarily mean the patient has a clot because some disease processes can cause a false positive. What nursing intervention below would the nurse NOT include in the patient’s plan of care to prevent DVT formation? “DVTs tend to mostly occur in the lower extremities but can occur in the upper extremities too.”, C. “A deep vein thrombosis in the lower extremity has a low probability of becoming a pulmonary embolism.”, D. “A DVT is a type of venous thromboembolism (VTE), which is a blood clot that starts in the vein.”, The answer is C. This option is INCORRECT. A patient is receiving continuous IV Heparin for anticoagulation therapy for the treatment of a DVT. There are two types of veins in the leg: superficial veins which lie just below the skin and can be seen on the surface, and deep veins which lie deep within the leg muscles. Join the nursing revolution. (2019). It done by manually (forced) dorsiflexing the patientâs foot (bending it up towards the shin) and if it causes the patient pain it considered a positive Homan’s Sign. 5. *Disclaimer: While we do our best to provide students with accurate and in-depth study quizzes, this quiz/test is for educational and entertainment purposes only. A. ... A client is being discharged home from the hospital after being treated for a deep vein thrombosis (DVT). Therefore, the nurse would NOT just apply them at bedtime but during the day too. A. DVT NCLEX Questions. If you find benefit from our efforts here, check out our premium quality NCLEX study guide to take your studying to the next level. The therapeutic INR range is 2-3. This test doesn’t tell us where the clot may be (so it not specific) so it will need to be further investigated by the MD and a positive result doesn’t necessarily mean the patient has a clot because some disease processes can cause a false positive. 10. What is your next nursing action per protocol? These devices can come unplugged from wall and quit working. You can view your scores and the answers to all the questions by clicking on the SHOW RESULT red button at the end of the question. The answers are B, D, G. Nursing interventions for this patient include: measuring leg circumference, elevating affected extremity above heart level, and monitoring aPTT level (for Heparin therapy). This forms a clot and it continues to grow, which can eventually break off and enter venous circulation. Mometrix Academy is a completely free resource provided by Mometrix Test Preparation. If it causes the patient pain, it considered a Positive Homan’s Sign. 12. A pulmonary embolism is a risk from the development of a DVT. These devices wrap around the legs and inflate and deflate to help move blood flow (similar to walking). Also, make sure they are changed and cleaned regularly (they can become sweaty and smelly). If the aPTT is too low, blood clots can form.Â If the aPTT is too high, bleeding can occur. NCLEX Review Questions Chapter 37 From Evolve Resources III. The answer is A. Homanâs Sign is NOT reliable because of false positives, but know for exams how to elicit a response. You’re developing a plan of care for a patient who is at risk for the development of a deep vein thrombosis after surgery. Deep vein thrombosis can cause leg pain or swelling, but also can occur with no symptoms.Deep vein thrombosis can develop if you have certain medical conditions that affect how your blood clots. 7. Make sure they’re plugged in, actually inflating and deflating (ask the patient). It’s a type of venous thromboembolism (VTE), which is a blood clot that starts in the vein. This website provides entertainment value only, not medical advice or nursing protocols. The site provides NCLEX-RN and NCLEX-PN questions that are based on the materials developed by 2020 National Council of State Boards of Nursing and are similar to those youâll find on the official exam. B. Select all the nursing interventions that are appropriate for this patient: A. Choose from four different subscription lengths to maximize your learning. Now test your knowledge by taking the Deep Vein Thrombosis NCLEX Questions quiz. DVT (Deep Vein Thrombosis) NCLEX Questions DVT (deep vein thrombosis) NCLEX questions for nursing students! C. The patient experiences pain when the leg is extended. â¦ Itâs a type of venous thromboembolism (VTE), which is a blood clot that starts in the vein. However, DVTs in the lower extremities tend to have a higher chance of breaking off and turning into a PE (pulmonary embolism). The answers are C, D, E, and F. Signs and symptoms of a DVT include: redness, swelling, warm extremity, pain, positive Homan’s Sign, and swelling (which can be unilateral…meaning there is more swelling in one extremity compared to the other). The patient reports pain when the foot is manually dorsiflexed. Copyright © 2021 RegisteredNurseRN.com. Settings. One of the two subsections of the Safe and Effective Care Environment category is âManagement of Care.â True or False: Assessment of Homan’s Sign is the most reliable indicator of a deep vein thrombosis. Start. Deep Vein Thrombosis (DVT) NCLEX review for nursing students! Please do not copy this quiz directly; however, please feel free to share a link to this page with students, friends, and others. Topics: Peripheral Vascular â¦ Increase the drip rate per protocol because the aPTT is too low. Learn. NCLEX-PN Practice Test Questions. Some labs have a cutoff <250 ng/mL (D-DU). 1. During the Quiz End of Quiz. Enter your email address below and hit "Submit" to receive free email updates and nursing tips. This website provides entertainment value only, not medical advice or nursing protocols. Enhances the activity of antithrombin III, which will inhibit thrombin and the conversion of fibrinogen to fibrin. The nurse is preparing to educate the client on the new prescription for an anti-thrombotic medication. Option A: WARM compresses should be used, NOT cool (this will help with pain and circulation), Option C: this could dislodge the clot (NEVER massage or rub the site), Option E: the patient needs bed rest…ambulation could dislodge the clot, Option F: INR level is used to monitor Warfarin NOT Heparin, Option H: SCDs are NOT applied to an extremity with a clot because it could dislodge the clotâ¦they are used to PREVENT blood clots. Blood cannot just hang out and become static within a vessel. Example: Liver disease, MI, surgery (heart), cancer, pregnancy. Compression stockings may prevent PTS (post-thrombotic syndrome), which happens sometimes after the development of a DVT. 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Which statements by the patient require you to re-educate them about how this medication works? Since it’s a Vitamin K antagonist, it will work to inhibit clotting factors from using Vitamin K. Slow onset….takes 3-5 day for patient to become therapeutic, Monitor PT/INR…therapeutic INR is 2-3 (less than 2…not therapeutic) and greater than 3 at risk for bleeding). Fibrin causes the big problem in terms of a clot developing because fibrin is like strands of mesh. According to Virchow’s Triad, a blood clot can form within the vein for several reasons. However, it depends on how the lab reports the assay cut-off value for the d-dimer. Nursing Prioritization, Delegation and Assignment #2 | 15 Questions; (NOTE: When you hit submit, it will refresh this same page. This Quiz has 12 questions. It may be slightly higher if a patient is at a high risk for clot formationâ¦. Some topics on the quiz include using ultrasounds for this condition and the D-dimer test. Deep vein thrombosis (DVT) occurs when a blood clot forms in a deep vein in the leg or arm. Slow blood circulation (confinement to bed, limited movement, paralysis, sitting for extended periods, especially with crossed legs) 3. A. Created by. Practice Mode â Questions and choices are randomly arranged, the answer is revealed instantly after each question, and there is no time limit for the exam. A 70-year-old female with severe sepsis. The answer is FALSE. The nurse knows that the D-dimer assesses _______ and this result means? The venous system is responsible for taking deoxygenated blood BACK to the heart. B. 1. 4. This can lead to a pulmonary embolism, heart attack, or stroke.Â Warfarin (Coumadin) does NOT start working immediately. If misdiagnosed, unrecognized, or untreated, PE can cause death quicklyâwithin just an hour. The nurse notes these laboratory findings: prothrombin time (PTT) 12.5 seconds, INR 2.0 seconds, platelets 50,000/µL. A deep vein thrombosis is a type of venous thromboembolism (VTE). Nursing Exam Cram Sheet for NCLEX-RN â This downloadable guide contains condensed facts about â¦ Deep Vein Thrombosis (DVT) NCLEX review for nursing students!. Make sure the patient is wearing them while sitting or in bed. "The calf is touched for temperature and firmness, and observed for redness," says Curran Krupar , RN, ED nurse at EMH Medical Center in Elyria, OH. Retrieved 1 November 2019, from https://www.nhlbi.nih.gov/health-topics/venous-thromboembolism, What is Venous Thromboembolism? To answer that question, we must review Virchow’s Triad. All Rights Reserved. In this 20-item NCLEX style exam, you knowledge about the different Peripheral Vascular Diseases will be challenged. If the blood clot becomes bigger it may break off and travel in blood circulation. This test is designed to help you prepare for either the NCLEX-RN exam or the NCLEX-PN exam. Damage to this layer can be from a direct or indirect cause, but regardless it stimulates platelets and the coagulation process. Text Mode â Text version of the exam 1. The answer is C. An Â aPTT should be 1.5-2.5 times the normal value range for Heparin to achieve a therapeutic effect in a patient to prevent blood clots. The main reason for this is due to a disease process, but it can be due to other reasons. Many times this is placed for patient who can’t take anticoagulants. What is it? Continue with the infusion because no change is needed based on this aPTT. Which option below is considered a positive Homan’s Sign for the assessment of a deep vein thrombosis (DVT)? Scroll down to see your results.). Deep Vein Thrombosis (DVT) NCLEX Review. Anyone can develop a deep vein thrombosis, especially if these risk factors are present. If the vein’s valves are damaged or the muscles aren’t working (or being used) blood isn’t going to flow back very well and a blood clot can develop. Hypercoagulability: let the name of this factor help you…hyper means increase or high and coagul refers to the coagulation process in the body (hence forming a clot). Please refer to the latest NCLEX review books for the latest updates in nursing. Quiz Flashcard. All the other statements are true about a DVT. What signs and symptoms below would possibly indicate a deep vein thrombosis is present? A deep vein thrombosis (DVT) is a blood clot that forms within the vein. Extend the patient’s leg and manually dorsiflex the patient’s foot (bend it up towards the shin). Practice Mode â Questions and choices are randomly arranged, the answer is revealed instantly after each question, and there is no time limit for the exam. Key Concepts: Terms in this set (13) 1. This is the first of our 3 free practice tests. However, <500 ng/mL (FEU) is equivalent to <250 ng/mL (D-DU). They’re NOT to be applied to the extremity that has an active DVT (can lead to dislodgement). Patients who use IV drugs damage the endothelial lining of the veins and this can lead to blood clot formation. Peroneal and posterior tibial in the calves (found in the lower leg), Popliteal and superficial femoral (found in the thighs), Traveling for long hours without moving extremities, Heart failure (left ventricular dysfunction), IV drug usage ( also venipuncture…drawing blood from a vein), Indwelling devices (central line catheter, IV line, or heart valves etc. Try this amazing Quiz: NCLEX Nursing Questions On Cardiovascular System quiz which has been attempted 3674 times by avid quiz takers. So, when they start to work within the vessel it recruits other chemicals called clotting factors. Yes, the nurse would apply SCDs per MD order to help prevent DVTs, BUT they are to be applied and worn by the patient anytime they are in bed or sitting. Deep vein thrombosis is a condition in which - 1/12. Pulmonary embolism due to deep vein thrombosis (DVT). The patient will eat all meals out of the bed daily by sitting in the bedside chair. A. It can lead to FALSE positives. Which of the following medications is an anti-thrombotic? (acts fast) given IV or subq…weight-based, Monitor aPTT (activated partial thromboplastin time): 1.5 to 2.5 times normal ranges, >80 seconds risk for bleeding….dose decreased, <60 seconds NOT therapeutic…risk for clots and may need dosage increased. Most Heparin protocols dictate that the nurse would hold the infusion for 1 hour and to decrease the rate of infusion. It prevents blood clots from forming, and if one is present, it will help prevent it from becoming bigger. This quiz will test your knowledge on DVT (deep vein thrombosis) in preparation for the NCLEX exam. It is important that youâre familiar with the signs and symptoms, preventive measures, treatment, and pathophysiology for a DVT. So this means a clot has formed and has started to break down. This NCLEX review video is on preventing DVTs. This includes: DVTs tend to occur in the lower extremities (legs), but can occur in the upper extremities as well. Apply cool compresses to affected extremity, D. Elevate affected extremity above heart level, H. Apply sequential compression device (SCD) to the affected extremity. Injury to a vein (fracture, severe muscle injury, major surgery) 2.