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Discussion

Help with understanding question rationale

I am reviewing rationales for questions from Practice Exam 1 in Exam Cram NCLEX-RN Practice Questions, Second Edition, and need some help understanding the correct answer for question 11 (I won't post the exact question or answers here since I understand they're copyrighted):

The question asks which statement made by the graduate nurse indicates a LACK of understanding of heparin.

I answered: the nurse states that s/he will aspirate when giving heparin.

Correct answer: the nurse states that s/he will check the PTT before administering heparin.

I was under the impression that we should NOT aspirate when giving heparin (so saying that you'd do so indicates a lack of understanding).

Also, I know that PTT is the test used to determine the correct dose of heparin but I thought this is checked 4 hours prior to administration so I can see why that answer would be wrong (PTT doesn't need to be checked directly prior to administering the medication so stating that you'd do so indicates a lack of understanding).

Should I assume that NCLEX-RN wants nurses to aspirate when giving heparin?

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    Are you sure you read that properly? PTT is what they check for heparin dosing.

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    Maybe they took it out of the third addition of Exam cram Nclex RN, because that questions not in my copy. Maybe it is a error. Because "the nurse states that s/he will aspirate when giving heparin" is not appropriate for heparin administration. Pulling from Person's Pharmacology reviews and rationales 3rd edition. "SubQ administration of heparin requires site rotation; do not aspirate or rub injection site." (P.128)

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    It might be a mistake. I have one of those books too and found a few type-o's... Such as all 4 multiple choice answers being "incorrect" and not telling me the correct one. Good luck!

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    GrnTea, yes, I'm sure that I read it properly. I read and re-read and re-read some more to make sure I wasn't just misreading or misinterpreting the question.

    RLtinker, thanks for the information. I looked this up too and found multiple sources that say not to aspirate with subq heparin administration so I'm going to assume that that's the correct practice according to NCLEX.

    cll72089 and RLtinker, I agree with you that it may be a mistake. The bad news is I spent a lot of time thinking about this, but the good news is that I learned a lot in the process!

    Thanks everyone for your help and suggestions! Just wanted to make sure I wasn't overlooking something.

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    maybe its this. aspirate has to do with the administration of heparin, not heparin itself. the question didn't ask about administration. just my thoughts and thinking outside the box.

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