A nurse is assessing the therapeutic International Normalized Ratio (INR) range for a patient receiving Warfarin. Which INR range below is therapeutic?
2.0-3.0
4.0-5.0
1.0-2.0
3.0-4.9
The Correct Answer is A
Choice A reason : The therapeutic INR range for a patient on Warfarin, especially for conditions such as atrial fibrillation, venous thromboembolism, and for the prevention of thrombosis in patients with prosthetic heart valves, is typically 2.0-3.0. This range balances the risk of clotting with the risk of bleeding. An INR of 2.0-3.0 means that the blood is taking twice to three times as long as normal blood to clot, which is the desired effect of the medication in preventing harmful clots.
Choice B reason : An INR range of 4.0-5.0 is generally considered too high for most therapeutic purposes and increases the risk of bleeding complications. This range might be appropriate in very specific clinical situations, such as for patients with mechanical heart valves who may require a slightly higher INR, but it is not the standard therapeutic range.
Choice C reason : An INR range of 1.0-2.0 is below the therapeutic range for patients on Warfarin. This range would not provide sufficient anticoagulation and would leave the patient at risk for thrombotic events.
Choice D reason : An INR range of 3.0-4.9 is higher than the standard therapeutic range and could lead to an increased risk of bleeding. While some patients with mechanical heart valves in the mitral position may require an INR up to 3.5, an INR higher than this is usually not necessary and could be dangerous.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason : A hemoglobin (Hgb) level of 16 g/dL is within the normal range for adults, which typically falls between 13.8 to 17.2 g/dL for men and 12.1 to 15.1 g/dL for women. Therefore, this value does not warrant reporting to the provider as it does not indicate an immediate concern.
Choice B reason : A prothrombin time (PT) of 45 seconds is significantly higher than the normal range of 11 to 13.5 seconds for individuals not on anticoagulation therapy. For patients on warfarin, the target PT is usually 1.5 to 2 times the normal value, depending on the indication for therapy. However, a PT of 45 seconds suggests a high risk of bleeding and requires immediate medical attention.
Choice C reason : The activated partial thromboplastin time (aPTT) of 36 seconds is within the normal range of approximately 21 to 35 seconds⁸. This result indicates that the blood's intrinsic clotting pathway is functioning within expected parameters and does not need to be reported.
Choice D reason : A platelet count of 190,000/mm is within the normal range, which is typically 150,000 to 450,000 platelets/mm. This value is not concerning and does not need to be reported to the provider.
Correct Answer is A
Explanation
Choice A reason: Walking is a highly beneficial activity for individuals with peripheral vascular disease (PVD). It helps improve circulation, which can be compromised in PVD due to narrowed or blocked blood vessels. Regular walking can lead to the development of collateral circulation, which is the formation of new blood vessels that bypass the blockages and improve blood flow to the affected areas. This can help alleviate symptoms such as pain and cramping during walking, known as claudication. Walking should be done at a pace that is comfortable and should be stopped if pain occurs. Over time, walking can increase the distance a person with PVD can walk without pain.
Choice B reason: Compression stockings are often recommended for individuals with PVD to help improve blood flow. Knee-length stockings exert pressure on the lower legs, helping to reduce edema and discomfort associated with PVD. They can also help prevent deep vein thrombosis, a potential complication of PVD.
Choice C reason: Elevating the legs can help reduce swelling and improve venous return in clients with PVD. It is recommended to elevate the legs above the level of the heart to maximize the effect. This can be done by placing pillows under the legs while lying down.
Choice D reason: Shopping for shoes in the morning is advised because feet can swell throughout the day, especially in clients with PVD. Fitting shoes in the morning can help ensure a more accurate fit, reducing the risk of pressure points that could lead to skin breakdown and ulcers.
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