A nurse is reviewing the laboratory results of a client who has been taking warfarin for 3 months. Which of the following laboratory results Indicates that the medication has been effective?
Hgb 14 g/dL
WBC count 10,000/mm3
INR 2.0
Platelets 150,000/mm3
The Correct Answer is C
A. Hemoglobin level: The hemoglobin level measures the amount of hemoglobin, the oxygen-carrying protein in red blood cells, in the blood. Warfarin is not directly responsible for increasing or decreasing the hemoglobin level. While warfarin can lead to bleeding complications in some cases, it does not specifically target the hemoglobin level, so it is not a direct indicator of the medication's effectiveness.
B. Platelet count: The platelet count measures the number of platelets in the blood, which are essential for blood clotting. Warfarin does not directly affect platelet production or count. It works by inhibiting the production of certain clotting factors, not by affecting platelets. Monitoring the platelet count is important, but it is not an indicator of warfarin's effectiveness in preventing excessive clotting.
C. Prothrombin time (PT) or activated partial thromboplastin time (aPTT): Prothrombin time (PT) and activated partial thromboplastin time (aPTT) are coagulation tests used to assess different types of anticoagulant medications, such as heparin. Warfarin's effect is measured using the International Normalized Ratio (INR). PT and aPTT are not specific to warfarin therapy and are not used to monitor its effectiveness. The INR is the appropriate laboratory test for assessing the efficacy of warfarin therapy.
D. International Normalized Ratio (INR): This is the correct answer. The International Normalized Ratio (INR) is the laboratory test used to monitor the effectiveness of warfarin therapy. The INR measures the time it takes for the blood to clot and reflects the anticoagulant effect of warfarin. A therapeutic INR within the target range (e.g., INR = 2.0 to 3.0 for most indications) indicates that warfarin has been effective in preventing excessive clotting and reducing the risk of complications associated with blood clots.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["0.12"]
Explanation
To calculate the rate at which the IV pump should be set to deliver dopamine, we need to determine the total amount of dopamine in the infusion and divide it by the desired dose per minute.
Given:
Dopamine concentration: 400 mg in 250 mL
Desired dose: 5 mcg/kg/min
Patient weight: 220 lb
First, we need to convert the patient's weight from pounds to kilograms:
220 lb ÷ 2.2 = 100 kg
Next, we need to calculate the total amount of dopamine needed per minute:
5 mcg/kg/min × 100 kg = 500 mcg/min
Now, we need to convert the dopamine dose from mcg to mg:
500 mcg/min ÷ 1000 = 0.5 mg/min
To determine the infusion rate in mL/hr, we divide the dose in mg/min by the dopamine concentration in the infusion solution:
0.5 mg/min ÷ 250 mL = 0.002 mL/min
Finally, we convert the infusion rate from mL/min to mL/hr by multiplying by 60:
0.002 mL/min × 60 min = 0.12 mL/hr
Therefore, the nurse should set the IV pump to deliver 0.12 mL/hr.
Correct Answer is B
Explanation
A nurse who is caring for a preschooler should question a prescription for tetracycline. Tetracycline is contraindicated in children under 8 years of age due to its potential to cause permanent discoloration and damage to developing teeth and bones. This adverse effect is known as tooth staining or dental hypoplasia.
Let's go through the other options:
A. Azithromycin: Azithromycin is an appropriate antibiotic for use in preschool-age children and is commonly prescribed for various bacterial infections. It does not pose the same risk of tooth staining as tetracycline, making it a safe option for this age group.
C. Cefuroxime: Cefuroxime is another antibiotic that is safe for use in preschoolers. It belongs to the cephalosporin class of antibiotics and is commonly prescribed for respiratory tract infections, skin infections, and other bacterial infections.
D. Gentamicin: While gentamicin is an effective antibiotic, its use in preschool-age children should be carefully monitored. Gentamicin can have potential ototoxic and nephrotoxic effects (damage to the inner ear and kidneys, respectively). However, its use is not strictly contraindicated in this age group, and it can be prescribed when necessary with appropriate monitoring.
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