A client with a deep vein thrombosis has been receiving warfarin sodium 2.5 mg PO daily. The client's International Normalized Ratio (INR) is 5.0. The nurse is aware that the medication dose needs to be:

increased.

given as prescribed.

cut in half.

held.

Answer and Explanation

The Correct Answer is D

A.   An INR of 5.0 indicates that the blood is significantly thinner than the therapeutic range (typically 2.0 to 3.0 for DVT treatment). Increasing the dose of warfarin would further increase the risk of bleeding.
B.   Continuing with the prescribed dose of 2.5 mg is not appropriate at this time. The INR is above the safe therapeutic range, indicating a need for adjustment, not maintenance of the current dose.
C.   While reducing the dose may be necessary, cutting it in half may not adequately address the high INR. The more appropriate action would involve holding the dose or significantly adjusting it based on the INR and clinical guidelines.
D.   An INR of 5.0 is a critical value that suggests the client is at an increased risk of bleeding. The appropriate action in this case is to hold the warfarin dose and notify the healthcare provider for further evaluation and management. Depending on clinical protocols, the provider may recommend administering vitamin K to reverse the effects of warfarin, especially if there are signs of bleeding or if the INR is critically high.

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Correct Answer is C

Explanation

A. While taking vital signs can provide useful information about the client's overall condition, it does not address the immediate concern of potential hypoglycemia. The priority is to assess blood glucose levels directly.
B. Glucagon can be administered in cases of severe hypoglycemia where the patient is unable to ingest glucose orally. However, before administering glucagon, the nurse should first check the blood glucose level to confirm hypoglycemia.
C. Checking the blood glucose level will provide immediate information about whether the client is experiencing hypoglycemia. If the blood glucose is low, appropriate treatment (such as administering glucose or a fast-acting carbohydrate) can be initiated. If it’s within normal limits, other causes for the symptoms can be explored.
D. While it may be necessary to notify the physician depending on the outcome of the blood glucose reading or if the client’s condition worsens, it is not the first action. Immediate assessment of the blood glucose level is essential to determine the correct course of action.

A. taking prescribed tamsulosin for benign prostatic hyperplasia B. having urinary retention due to bladder atony C. jogging for 2 miles (3.2 km) D. drinking 3 12 oz. (360 mL) bottles of beer in 2 hours E. taking metoprolol XL 50 mg

Correct Answer is ["C","D","E"]

Explanation

A. Tamsulosin primarily affects urinary function and is not directly related to glucose metabolism or insulin action. It does not significantly contribute to hypoglycemic events.
B. While urinary retention can lead to discomfort and potential complications, it does not have a direct impact on blood glucose levels or increase the risk of hypoglycemia. However, if it results in increased stress or medication changes, it could indirectly affect glucose management.
C. Physical activity, such as jogging, can increase the risk of hypoglycemia in individuals with Type 1 diabetes, especially if they do not adjust their insulin or carbohydrate intake accordingly. Exercise can enhance insulin sensitivity and cause blood glucose levels to drop.
D. Alcohol can increase the risk of hypoglycemia, particularly in individuals with diabetes, because it can inhibit gluconeogenesis (the liver's ability to produce glucose). Drinking a significant amount of alcohol, especially without food, can lead to dangerously low blood sugar levels.
E. Metoprolol, a beta-blocker, can mask the symptoms of hypoglycemia (such as increased heart rate and tremors), making it more difficult for the individual to recognize when they are hypoglycemic. This can lead to delayed treatment and increased risk of severe hypoglycemia.

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A client with a deep vein thrombosis has been receiving warfarin sodium 2.5 mg PO daily. The client's International Normalized Ratio (INR) is 5.0. The nurse is aware that the medication dose needs to be:

Nursing Test Bank

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A client on glipizide, a sulfonylurea, reports to the nurse feeling anxious, sweaty & has a headache. The nurse's initial action is to:

Correct Answer is C

Explanation

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Correct Answer is ["C","D","E"]

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A client with a deep vein thrombosis has been receiving warfarin sodium 2.5 mg PO daily. The client's International Normalized Ratio (INR) is 5.0. The nurse is aware that the medication dose needs to be: