Certified Medical-Surgical Registered Nurse Practice Exam

Which stat order for Mr. Palmer should the nurse question?

1. Oxygen per nasal cannula at 4 L per minute.

2. Enoxaparin (Lovenox) 40 mg subcutaneously.

3. Troponin level.

4. Computed tomography (CT) angiogram.

The correct answer is: Enoxaparin (Lovenox) 40 mg subcutaneously.

In this scenario, the nurse should question the order for Enoxaparin (Lovenox) 40 mg subcutaneously due to safety considerations. Lovenox is a low molecular weight heparin used for thromboprophylaxis and treatment of deep vein thrombosis and pulmonary embolism. Before administering Lovenox, it is crucial to assess the patient's coagulation status, including recent platelet counts, as Lovenox can pose risks, particularly in patients with a history of heparin-induced thrombocytopenia or compromised renal function. Administering Lovenox without proper assessment could lead to adverse effects such as increased bleeding risk. In contrast, the orders for oxygen therapy, troponin level testing, and a CT angiogram are all standard practices that support immediate patient care and assessment in a potentially critical situation. Oxygen delivery via a nasal cannula can be essential for patients experiencing respiratory distress, while monitoring troponin levels is important for diagnosing myocardial injury. A CT angiogram can be critical for evaluating vascular conditions, such as pulmonary embolism and aortic dissection, ensuring proper and timely medical intervention.