A nurse is reviewing laboratory results for a client who is taking warfarin. Which of the following laboratory tests determines if the dose of medication is within the recommended target range?

Choice A reason: Frequent nosebleeds are not linked to coarctation of the aorta, a congenital aortic narrowing. They may result from hypertension or nasal issues, but coarctation causes differential blood pressure, with high upper body pressure, not nasal vasculature changes, making this an unrelated finding.
Choice B reason: Weak femoral pulses are expected in coarctation of the aorta, as the narrowing restricts blood flow to the lower extremities. This creates a pressure gradient, with stronger upper body pulses, detectable in infants, guiding diagnosis and management of this cardiovascular defect.
Choice C reason: Increased intracranial pressure is not associated with coarctation, which affects cardiovascular dynamics, not cranial pressure. It may occur in neurological conditions, but coarctation’s primary effect is hypertension above the narrowing, not brain-related changes, making this an irrelevant finding in this context.
Choice D reason: Upper extremity hypotension is incorrect, as coarctation causes hypertension in the upper extremities due to restricted aortic flow. Blood pressure is higher above the narrowing, with strong brachial pulses, while lower extremities experience reduced flow, opposite to hypotension in the upper body.

Choice A reason: Comparing the medication label to the provider’s prescription three times is a safety step during administration, not reconciliation. Reconciliation verifies the client’s home medications against new orders to prevent errors like omissions or duplications. This action occurs post-reconciliation, focusing on administration accuracy, not the initial verification of the medication list.
Choice B reason: Medication reconciliation involves comparing the client’s home medication list to admission prescriptions to ensure continuity and accuracy. This process identifies discrepancies, such as missed medications or incorrect doses, preventing adverse drug events. It requires verifying with the client or family and cross-checking provider orders, making it the cornerstone of safe transitions in care settings.
Choice C reason: Administering medications to treat a condition to the actual prescriptions is unclear and not part of reconciliation. Reconciliation focuses on verifying and documenting medications, not administering them. This option does not align with the systematic process of ensuring all medications are correctly prescribed upon admission, making it incorrect.
Choice D reason: Ensuring administration within 3 hours of the scheduled time relates to medication administration protocols, not reconciliation. Reconciliation verifies the accuracy of the medication list before administration. This step is about timing, not the verification process critical to preventing errors during care transitions, rendering it irrelevant to the task.