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)

Answer and Explanation

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.

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Correct Answer is A

Explanation

A. Furosemide can increase serum uric acid levels, leading to hyperuricemia. This occurs due to the drug's effects on renal excretion of uric acid. Hyperuricemia can predispose the client to gouty arthritis or kidney stones.
B. Furosemide typically leads to sodium loss (natriuresis) rather than hypernatremia. It is a loop diuretic that inhibits sodium and chloride reabsorption in the ascending loop of Henle in the kidneys, promoting diuresis and reducing fluid overload.
C. Furosemide-induced diuresis can cause loss of chloride ions along with sodium, potentially leading to hypochloremia rather than hyperchloremia. Hyperchloremia is less common unless there are other contributing factors such as concurrent administration of saline solutions or underlying conditions.
D. Furosemide does not typically cause hypercalcemia. In fact, it can lead to mild hypocalcemia due to increased urinary calcium excretion. Loop diuretics like furosemide impair calcium reabsorption in the kidneys, which can lead to calcium wasting.

Correct Answer is ["300"]

Explanation

To calculate the volume of IV fluids infused from 0330 to 0600, you would determine the number of hours that have passed.

From 0330 to 0600 is 2.5 hours. Since the IV is infusing at 120 mL/hr, you would multiply the infusion rate by the number of hours. So, 120 mL/hr * 2.5 hours = 300 mL.

Therefore, the nurse should record 300 mL of IV fluids on the intake record at 0600.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has heart failure and is receiving IV furosemide. The nurse should monitor the client for which of the following electrolyte imbalances?

Correct Answer is A

Explanation

A nurse is caring for a client who had IV fluids initiated at 0330. The IV fluids are infusing at 120 mL/hr. The nurse should record how many mL of IV fluids on the intake record at 0600?

Correct Answer is ["300"]

Explanation

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