A nurse is reporting a client’s laboratory tests to the provider to obtain a prescription for the client’s daily warfarin.
Which of the following laboratory tests should the nurse plan to report to obtain the prescription for the warfarin?
INR.
Fibrinogen level.
aPTT.
Platelet count.
The Correct Answer is A
Warfarin is a vitamin K antagonist that inhibits the synthesis of factors II, VII, IX, and X in the liver. These factors are part of the extrinsic and common pathways of coagulation, which are measured by the prothrombin time (PT) and the international normalized ratio (INR). The INR is a standardized way of reporting the PT that accounts for the variability of different reagents and instruments. The INR is used to monitor the therapeutic effect of warfarin and to adjust the dose accordingly. The target INR range depends on the indication for warfarin, but it is usually between 2 and 3 for most conditions.
Choice B is wrong because fibrinogen level is not affected by warfarin.
Fibrinogen is a precursor of fibrin, which forms the final step of the coagulation cascade.
Fibrinogen level can be decreased in conditions such as disseminated intravascular coagulation (DIC), liver disease, or severe bleeding.
Choice C is wrong because aPTT is not affected by warfarin.
aPTT measures the intrinsic and common pathways of coagulation, which are mainly dependent on factors VIII, IX, XI, and XII.
These factors are not inhibited by warfarin.
aPTT is used to monitor the effect of heparin, a direct antithrombin agent that inhibits thrombin and factor Xa.
Choice D is wrong because platelet count is not affected by warfarin.
Platelets are cell fragments that adhere to damaged blood vessels and form aggregates to initiate hemostasis.
Platelet count can be decreased in conditions such as immune thrombocytopenia (ITP), heparin-induced thrombocytopenia (HIT), or bone marrow suppression.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is d. “Your desire to be an organ donor must be documented in writing.”
Rationale for Choice a:
- Statement:“Your name cannot be removed once you are listed on the organ donor list.”
- Rationale:This statement is incorrect.Individuals have the right to change their minds about organ donation at any time.They can have their names removed from the organ donor list by contacting the appropriate registry or organization.It's essential for nurses to provide accurate information to ensure informed consent and respect for patient autonomy.
Rationale for Choice b:
- Statement:“You must be at least 21 years of age to become an organ donor.”
- Rationale:This statement is also incorrect.The age requirement for organ donation varies by jurisdiction.In many places,individuals under 18 years of age can register as organ donors with parental consent.Nurses should be familiar with local regulations to provide accurate guidance.
Rationale for Choice c:
- Statement:“I cannot be a witness for your consent to donate.”
- Rationale:While it's true that nurses generally cannot act as witnesses for organ donation consent,the focus of the response should be on directing the client to the appropriate channels for documentation.Nurses can play a role in facilitating the process by providing information and resources to clients who express interest in organ donation.
Rationale for Choice d:
- Statement:“Your desire to be an organ donor must be documented in writing.”
- Rationale:This is the correct response.To ensure clarity and legal validity,organ donation preferences must be documented in writing.This documentation can be done through various means,such as registering with an organ donor registry,indicating preferences on a driver's license,or completing an advance directive.Nurses should emphasize the importance of written documentation to protect the client's wishes.
Correct Answer is B
Explanation
Fish is a good source of protein and omega-3 fatty acids, which can help lower blood pressure, reduce inflammation, and prevent blood clots. Fish is also low in sodium, which is important for people with hypertension, as excess sodium can raise blood pressure by retaining fluid in the body. Fish is part of the DASH diet, which stands for Dietary Approaches to Stop Hypertension, and is a healthy eating plan that emphasizes fruits, vegetables, whole grains, low-fat dairy, nuts, seeds, legumes, and lean meats.
Choice A. Cheese is wrong because cheese is high in sodium and saturated fat, which can increase blood pressure and cholesterol levels.
Cheese should be limited or avoided by people with hypertension.
Choice C. Red meat is wrong because red meat is also high in sodium and saturated fat, as well as cholesterol, which can contribute to hypertension and heart disease.
Red meat should be eaten sparingly or replaced by leaner sources of protein like fish, poultry, or beans.
Choice D. Canned black beans are wrong because canned black beans are high in sodium, as most canned foods are preserved with salt. Canned black beans should be rinsed well before eating or replaced by dried or cooked black beans, which are lower in sodium and high in fiber, potassium, magnesium, and calcium, which are beneficial for blood pressure control.
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