A nurse is assessing a preoperative client. The client has a history of atrial fibrillation and is taking warfarin daily. Which test order will the nurse request from the provider?
A serum sodium (Na)
A radiological examination of the chest
A blood urea nitrogen (BUN)
An international normalized ratio (INR)
The Correct Answer is D
A. Serum sodium levels are typically assessed to evaluate electrolyte balance and hydration status. While important for overall health assessment, it is not specifically related to monitoring the effects of warfarin therapy.
B. This could be ordered for various reasons such as assessing lung status or identifying any abnormalities in the chest. It is not directly related to monitoring warfarin therapy.
C. BUN levels are measured to assess kidney function and hydration status. While important for overall health assessment, it is not specifically related to monitoring the effects of warfarin therapy.
D. The INR is a standardized measurement of the blood's ability to clot. Warfarin works by inhibiting vitamin K-dependent clotting factors, thereby prolonging the time it takes for blood to clot. The INR is used to monitor and adjust warfarin dosage to maintain therapeutic anticoagulation levels, especially in patients with conditions like atrial fibrillation who are at risk of blood clots.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Thrombocytopenia (low platelet count) predisposes the client to spontaneous bleeding. This can manifest as petechiae (small red or purple spots on the skin), purpura (larger areas of purple discoloration), mucosal bleeding (such as nosebleeds or bleeding gums), or internal bleeding (such as gastrointestinal or intracranial bleeding). Monitoring for signs of bleeding is essential to promptly intervene and prevent complications.
B. While infections can occur in any client, a low platelet count does not directly predispose the client to infection. Thrombocytopenia primarily affects hemostasis rather than immune function.
C. Oliguria refers to decreased urine output, typically less than 400 mL/day in adults. It is not directly related to thrombocytopenia but may occur in conditions affecting kidney function or fluid balance.
D. Hyperactive deep tendon reflexes can indicate neurological conditions or electrolyte imbalances but are not associated with thrombocytopenia.
Correct Answer is A
Explanation
A. Troponin is a protein found in cardiac muscle cells. When there is damage to the heart muscle, such as during a myocardial infarction (heart attack), troponin is released into the bloodstream. Therefore, elevated troponin levels in the blood indicate myocardial injury or damage.
B. Troponin is not an enzyme; it is a protein. While there are enzymes such as creatine kinase (CK) and lactate dehydrogenase (LDH) that can indicate damage to various tissues including heart and skeletal muscles, troponin specifically indicates cardiac muscle damage.
C. Troponin is not involved in oxygen transport. Hemoglobin, found in red blood cells, is the protein responsible for oxygen transport in the body.
D. Troponin is not a lipid; it is a protein. Lipids include substances like cholesterol and triglycerides. Troponin levels do not reflect the risk for coronary artery disease; rather, they indicate acute damage to the heart muscle.
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