A client with a history of atrial fibrillation is prescribed warfarin. Which laboratory value should the nurse monitor to assess the medication’s effectiveness?

Platelet count

International normalized ratio (INR)

Hemoglobin level

Serum potassium

Answer and Explanation

The Correct Answer is B

Choice A reason: Platelet count assesses bleeding risk but does not measure warfarin’s anticoagulant effect. Warfarin inhibits clotting factors, monitored by INR. Platelet counts are relevant for antiplatelet drugs, not anticoagulants, making INR the priority for evaluating warfarin efficacy in atrial fibrillation.

Choice B reason: INR measures warfarin’s anticoagulant effect by assessing prothrombin time, reflecting vitamin K-dependent clotting factor inhibition. In atrial fibrillation, therapeutic INR (2.0–3.0) prevents thromboembolism. Monitoring INR ensures effective anticoagulation, making it the critical lab value for warfarin therapy management.

Choice C reason: Hemoglobin level detects bleeding, a warfarin side effect, but does not assess its therapeutic effect. INR directly evaluates anticoagulation, ensuring stroke prevention in atrial fibrillation. Hemoglobin is secondary, monitored for complications, not efficacy, making INR the priority lab value.

Choice D reason: Serum potassium is unrelated to warfarin’s anticoagulant action. Electrolyte imbalances may affect cardiac rhythm in atrial fibrillation, but INR measures warfarin’s effect on clotting factors, ensuring therapeutic anticoagulation, making it the essential value to monitor for medication efficacy.

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Correct Answer is A

Explanation

Choice A reason: Sexual dysfunction is a common SSRI side effect, as increased serotonin inhibits sexual arousal and orgasm. Monitoring is critical, as it affects adherence in depression treatment, requiring dose adjustments or alternative therapies, making it the priority side effect to assess.

Choice B reason: Hypotension is less common with SSRIs, though orthostatic changes may occur. Sexual dysfunction is more frequent, impacting quality of life and treatment adherence in depression, making it the priority to monitor, as it directly affects patient compliance and outcomes.

Choice C reason: Hyperglycemia is not a typical SSRI side effect, though metabolic changes are rare. Sexual dysfunction is a prevalent issue, reducing adherence in depression treatment, making it the priority to monitor, as it significantly impacts patient satisfaction and therapy continuation.

Choice D reason: Peripheral edema is rare with SSRIs, which primarily affect serotonin pathways. Sexual dysfunction is a common side effect, compromising adherence in depression management, making it the priority to monitor, as it directly influences treatment success and patient well-being.

A. Replace the gauze with a transparent dressing B. Apply a hydrocolloid gel dressing C. Leave the dressing off until consulting with the healthcare provider D. Increase the frequency of the dressing changes

Correct Answer is B

Explanation

Choice A reason: Transparent dressings are semi-permeable, suitable for superficial wounds with minimal exudate. Stage 3 pressure injuries, with deeper tissue damage and granulation, require moisture-retentive dressings to support healing. Transparent dressings may not provide the moist environment needed for optimal granulation tissue formation and epithelialization in deeper wounds.

Choice B reason: Hydrocolloid gel dressings maintain a moist wound environment, ideal for stage 3 pressure injuries with granulation tissue. They promote autolytic debridement, support epithelialization, and protect the wound. This is the best choice, as gauze may adhere to granulation tissue, causing trauma during removal, unlike hydrocolloids, which foster healing.

Choice C reason: Leaving the dressing off exposes the wound to infection and drying, which impairs granulation tissue and delays healing. Stage 3 pressure injuries require a moist, protected environment. Consulting the provider may be appropriate for complex cases, but immediate dressing application is standard to maintain optimal wound conditions.

Choice D reason: Increasing dressing change frequency may disrupt granulation tissue and delay healing, especially with gauze, which can adhere to the wound bed. Stage 3 pressure injuries benefit from stable, moist environments provided by advanced dressings like hydrocolloids, not frequent changes that risk trauma and infection.

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A client with a history of atrial fibrillation is prescribed warfarin. Which laboratory value should the nurse monitor to assess the medication’s effectiveness?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with a history of depression who is prescribed a selective serotonin reuptake inhibitor (SSRI). Which side effect should the nurse monitor for?

Correct Answer is A

Explanation

The nurse is performing a routine dressing change for a client with a stage 3 pressure injury that is red with significant granulation. The wound has a gauze dressing covering the area. Which action should the nurse implement?

Correct Answer is B

Explanation

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