A nurse is reviewing the laboratory results of a client who has atrial fibrillation and a prescription for warfarin. After informing the provider that the INR is 2.5, the nurse should expect which of the following prescriptions?

Withhold the medication.

Decrease the dose of the medication.

Increase the dose of the medication.

Administer the current dose of the medication.

Answer and Explanation

The Correct Answer is D

A. Withhold the medication: An INR of 2.5 is generally within the therapeutic range for many conditions, including atrial fibrillation. Withholding the medication might lead to a decreased INR, potentially increasing the risk of clotting.
B. Decrease the dose of the medication: If the INR is above the therapeutic range (usually 2.0-3.0 for atrial fibrillation), the provider might consider decreasing the dose. However, an INR of 2.5 is within the typical therapeutic range, so a decrease in dose might not be warranted.
C. Increase the dose of the medication: An INR of 2.5 is generally within the therapeutic range for many conditions. Increasing the dose in this situation could elevate the INR further, potentially leading to an increased risk of bleeding.
D. Administer the current dose of the medication: Since the INR is within the therapeutic range, the nurse should expect the provider to maintain the current dose of warfarin. Adjustments to the dose might be considered if the INR deviates significantly from the target range.

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Correct Answer is A

Explanation

A. Hydromorphone: This is a potent opioid analgesic and is commonly used for the management of severe pain, especially in cancer patients. It provides strong pain relief and is often used in situations where other pain medications are not sufficient.
B. Aspirin: Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) with anti-inflammatory and analgesic properties. While it may be used for pain relief in some situations, it is not typically the first choice for severe pain in pancreatic cancer.
C. Acetaminophen (Caldoler): Acetaminophen is a non-opioid analgesic and antipyretic. It is not as potent as opioids and may not be sufficient for managing severe pain, especially in the context of advanced cancer.

D. Meloxicam: Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) and is not the first-line choice for severe pain, particularly in cancer patients. Opioid analgesics are generally preferred for managing severe pain in cancer.

A. Simvastatin 40 mg PO at bedtime B. Morphine 4 mg IV every 4 hr PRN for pain C. Levothyroxine 100 mcg PO every morning D. Acetaminophen 500 mg every 4 hr PRN for fever

Correct Answer is B

Explanation

A. Simvastatin 40 mg PO at bedtime: This prescription is clear and specifies the medication (Simvastatin), the dose (40 mg), route (PO – oral), and timing (at bedtime). There is no need for clarification.
B. Morphine 4 mg IV every 4 hr PRN for pain: The need for clarification arises here because "PRN" (pro re nata) means "as needed," and prescribing an IV medication on an as-needed basis might need further clarification regarding the specific indications and circumstances for administering the medication.
C. Levothyroxine 100 mcg PO every morning: This prescription is clear and specifies the medication (Levothyroxine), the dose (100 mcg), route (PO – oral), and timing (every morning). There is no need for clarification.
D. Acetaminophen 500 mg every 4 hr PRN for fever: Similar to option B, there might be a need for clarification regarding the specific indications and circumstances for administering acetaminophen on an as-needed basis. However, in many cases, PRN for fever is reasonable, so it may not be as critical as in the case of an IV pain medication.

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A nurse is reviewing the laboratory results of a client who has atrial fibrillation and a prescription for warfarin. After informing the provider that the INR is 2.5, the nurse should expect which of the following prescriptions?

Nursing Test Bank

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