A nurse is caring for a client who has atrial fibrillation and is receiving warfarin therapy to prevent thromboembolism formation. The nurse should monitor which of the following laboratory values to determine the effectiveness of the medication?

Activated partial thromboplastin time (aPTT)

Prothrombin time (PT)

International normalized ratio (INR)

Platelet count.

Answer and Explanation

The Correct Answer is C

Warfarin is an anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors. The INR is a standardized measure of the prothrombin time (PT), which reflects the degree of anticoagulation. The therapeutic range for INR is 2 to 3 for most conditions, and higher for some mechanical heart valves.

Choice A) Activated partial thromboplastin time (aPTT) is wrong because it is used to monitor heparin therapy, not warfarin therapy.

Heparin is another anticoagulant that works by activating antithrombin III, which inhibits thrombin and factor Xa. The therapeutic range for aPTT is 1.5 to 2.5 times the normal value, which is 30 to 40 seconds.

Choice B) Prothrombin time (PT) is wrong because it is not a standardized measure of the warfarin effect.

The PT can vary depending on the reagents and methods used by different laboratories. The INR was developed to eliminate this variability and provide a consistent measure of the warfarin effect.

Choice D) Platelet count is wrong because it is not affected by warfarin therapy.

Warfarin does not affect the number or function of platelets, only the clotting factors. Platelet count can be used to monitor other conditions that affect hemostasis, such as thrombocytopenia or thrombocytosis.

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Correct Answer is A

Explanation

Omeprazole is a proton pump inhibitor (PPI) that reduces the production of stomach acid.

Dabigatran is an anticoagulant that prevents blood clots from forming.

Both drugs can increase the risk of bleeding in the gastrointestinal tract, especially in clients with peptic ulcer disease.Therefore, they should not be used together unless absolutely necessary.

Choice B. Ranitidine is wrong because ranitidine is a histamine-2 receptor antagonist (H2RA) that also reduces the production of stomach acid, but to a lesser extent than PPIs.Ranitidine does not interact significantly with dabigatran and does not increase the risk of bleeding.

Choice C. Sucralfate is wrong because sucralfate is a mucosal protectant that forms a barrier over ulcers and protects them from acid and enzymes.Sucralfate does not affect the coagulation system and does not increase the risk of bleeding.

Choice D. Misoprostol is wrong because misoprostol is a synthetic prostaglandin that inhibits gastric acid secretion and increases bicarbonate and mucus production.

Misoprostol is used to prevent ulcers in clients who take NSAIDs, which can cause ulcers and bleeding.

Misoprostol does not interact with dabigatran and does not increase the risk of bleeding.

A. Ibuprofen B. Naproxen C. Acetaminophen D. Aspirin.

Correct Answer is C

Explanation

The patient reports having frequent headaches and asks for an over-the-counter pain reliever.The nurse will recommend acetaminophen, which is the safest pain reliever while taking warfarin.Acetaminophen does not interfere with the anticoagulant effect of warfarin and does not increase the risk of bleeding.

Choice A is wrong because ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can enhance the anticoagulant effect of warfarin and increase the likelihood of harmful bleeding.

NSAIDs can also cause stomach ulcers, kidney damage, and high blood pressure.

Choice B is wrong because naproxen is another NSAID that has the same risks as ibuprofen.

Naproxen should be avoided by patients taking warfarin.

Choice D is wrong because aspirin is also an anticoagulant that can increase the risk of bleeding when taken with warfarin.

Aspirin can also cause stomach irritation, ulcers, and allergic reactions.

The normal range for INR is 2 to 3 for patients with atrial fibrillation who are taking warfarin.

An INR of 2.5 indicates that the patient’s blood is taking longer to clot than normal, but not too long.

The patient should have regular blood tests to monitor their INR and adjust their warfarin dose if needed.

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A nurse is caring for a client who has atrial fibrillation and is receiving warfarin therapy to prevent thromboembolism formation. The nurse should monitor which of the following laboratory values to determine the effectiveness of the medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medication list of a client who is prescribed dabigatran and has a history of peptic ulcer disease. The nurse should recognize that which of the following medications can increase the risk of bleeding in this client?

Correct Answer is A

Explanation

A patient who has atrial fibrillation is taking warfarin and has an INR of 2.5.The patient reports having frequent headaches and asks for an over-the-counter pain reliever.The nurse will recommend which medication?

Correct Answer is C

Explanation

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A nurse is caring for a client who has atrial fibrillation and is receiving warfarin therapy to prevent thromboembolism formation. The nurse should monitor which of the following laboratory values to determine the effectiveness of the medication?