A nurse is preparing to administer testosterone gel to a client who has hypogonadism. Which of the following actions should the nurse take?

Choice A reason: Bleeding time assesses platelet function, not warfarin’s anticoagulant effect. Warfarin inhibits vitamin K-dependent clotting factors, unrelated to platelets. Monitoring bleeding time does not reflect therapeutic anticoagulation levels, making it irrelevant for adjusting warfarin doses to prevent thrombosis or bleeding.
Choice B reason: Factor VIII, deficient in hemophilia A, is not affected by warfarin, which targets vitamin K-dependent factors (II, VII, IX, X). Measuring Factor VIII does not indicate warfarin’s efficacy, as it is unrelated to the drug’s mechanism, making it unsuitable for dose monitoring.
Choice C reason: aPTT monitors heparin’s effect on the intrinsic clotting pathway, not warfarin’s action on vitamin K-dependent factors. Warfarin requires INR for therapeutic monitoring, as aPTT is insensitive to its effects, making it inappropriate for assessing warfarin’s anticoagulation range in patients.
Choice D reason: INR standardizes prothrombin time, measuring warfarin’s effect on vitamin K-dependent clotting factors. It ensures therapeutic anticoagulation (e.g., INR 2-3), preventing thrombosis or bleeding. INR is the gold standard for warfarin monitoring, guiding dose adjustments for safe and effective therapy.

Choice A reason: Changing the stoma pouch 30 minutes after meals is not recommended, as meal timing does not dictate pouch changes. Pouches are typically changed every 3-7 days or if leaking, to prevent skin irritation. This statement reflects a misunderstanding, as it suggests an incorrect schedule unrelated to stoma care needs.
Choice B reason: Cutting the pouch opening 1/8 inch larger than the stoma ensures a snug fit, preventing leakage while protecting peristomal skin from irritation by digestive enzymes. Proper sizing maintains skin integrity and pouch adherence, supporting effective ostomy management. This statement demonstrates correct understanding of stoma care techniques.
Choice C reason: Cleaning the stoma with moisturizing soap is incorrect, as soaps with oils or fragrances can irritate peristomal skin and impair pouch adhesion. Mild, non-residue soap and water are recommended to maintain skin integrity. This statement indicates a misunderstanding of proper stoma cleaning practices.
Choice D reason: Expecting the stoma to be blistered is incorrect, as a healthy stoma should be pink, moist, and free of irritation. Blistering indicates complications like infection or poor pouch fit. This statement reflects a misunderstanding of normal stoma appearance and care, suggesting potential issues requiring intervention.