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?
Bleeding time
Factor VIII
aPTT
INR
The Correct Answer is D
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: A pain level of 1 on a 0-10 scale indicates well-controlled pain, which does not directly impair wound healing. Adequate pain management supports mobility and recovery, reducing stress responses that could delay healing. This finding is not a risk factor for delayed wound healing in post-surgical clients.
Choice B reason: An oxygen saturation of 92% on room air is slightly low but not critically hypoxic. Wound healing requires adequate oxygenation, but levels above 90% are generally sufficient for tissue repair. This finding alone does not significantly indicate a risk for delayed wound healing compared to nutritional deficits.
Choice C reason: An albumin level of 2.5 g/dL (normal: 3.5-5.0 g/dL) indicates malnutrition, a major risk for delayed wound healing. Albumin is essential for tissue repair, collagen synthesis, and immune function. Low levels impair fibroblast activity and wound strength, increasing infection risk and slowing recovery in post-surgical clients.
Choice D reason: A body mass index of 22 is within the normal range (18.5-24.9) and does not indicate malnutrition or obesity, both of which can impair wound healing. Normal BMI supports adequate nutritional status for tissue repair, making this finding not a risk factor for delayed wound healing.
Correct Answer is A
Explanation
Choice A reason: A subdural hematoma increases complication risk during electroconvulsive therapy (ECT) due to elevated intracranial pressure. ECT-induced seizures can worsen bleeding or cause herniation, posing significant neurological risks. This condition requires careful evaluation, making it the critical risk factor for complications.
Choice B reason: Hyperthyroidism may increase heart rate or metabolic demand but is not a primary risk for ECT complications. With proper management, it poses minimal risk compared to intracranial issues, so this is not the most concerning condition, making it incorrect.
Choice C reason: Renal calculi do not directly impact ECT safety, as they are unrelated to neurological or cardiovascular risks during seizures. This condition is manageable and not a significant complication risk, so it is incorrect for this scenario.
Choice D reason: Diabetes mellitus requires monitoring during ECT due to fasting or medication effects, but it is not a primary risk for complications. With proper glucose management, risks are minimal, so this is incorrect compared to a subdural hematoma’s impact.
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