A patient has been receiving warfarin sodium 2.5 mg PO daily for four days and the International Normalized Ratio (INR) is 1.9. What should be the nurse’s next step?

Place the patient back on the heparin infusion and redraw laboratory values.

Ask the healthcare provider if the patient’s medication can be changed to rivaroxaban.

Notify the healthcare provider and ask if the dose of warfarin can be increased.

Prepare to administer a dose of Vitamin K subcutaneously.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Placing the patient back on the heparin infusion and redrawing laboratory values would not be the appropriate next step. The INR of 1.9 is below the therapeutic range of 2.0 - 3.0 for most patients on warfarin. Therefore, the warfarin therapy is not yet fully effective, and there is no need to revert to heparin.

Choice B rationale

Asking the healthcare provider if the patient’s medication can be changed to rivaroxaban would not be the appropriate next step. Rivaroxaban is a different type of anticoagulant and would not necessarily be more effective in this situation.

Choice C rationale

Notifying the healthcare provider and asking if the dose of warfarin can be increased would be the appropriate next step. The INR of 1.9 is below the therapeutic range of 2.0 - 3.0 for most patients on warfarin. Therefore, an increase in the warfarin dose may be necessary to achieve therapeutic anticoagulation.

Choice D rationale

Preparing to administer a dose of Vitamin K subcutaneously would not be the appropriate next step. Vitamin K is used to reverse the effects of warfarin and would be counterproductive in this situation.

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Correct Answer is C

Explanation

Choice A rationale

While it is true that warfarin’s effectiveness can be affected by vitamin K, found in green leafy vegetables, it is not necessary to completely omit these from the diet. Instead, maintaining a consistent intake of vitamin K can help keep INR levels stable.

Choice B rationale

Over-the-counter pain relief medications, especially those that are nonsteroidal anti- inflammatory drugs (NSAIDs), can increase the risk of bleeding when taken with warfarin. Therefore, this advice is not correct.

Choice C rationale

Regular laboratory tests, specifically the International Normalized Ratio (INR), are crucial when taking warfarin to monitor its effectiveness and adjust the dosage if necessary.

Choice D rationale

Using an electric razor can help prevent cuts and bleeding, which is important because warfarin is a blood thinner. However, this information is not as critical as obtaining regular laboratory tests.

Choice E rationale

Obtaining a medical alert bracelet can be beneficial for individuals taking warfarin, as it can alert healthcare professionals in an emergency situation about the individual’s use of a blood thinner. However, this information is not as critical as obtaining regular laboratory tests.

A. Fewer doses of insulin may be required B. It assists in gaining control over glucose levels C. Other health problems will be minimized D. It is the most cost-efficient method for glucose control .

Correct Answer is B

Explanation

Choice A rationale

Fewer doses of insulin may not necessarily be required with frequent self-monitoring of blood glucose. The need for insulin is determined by blood glucose levels, not the frequency of monitoring.

Choice B rationale

Frequent self-monitoring of blood glucose assists in gaining control over glucose levels. It can immediately tell you the effects of food choices, physical activity, and medication on blood glucose control.

Choice C rationale

While good blood glucose control can help minimize other health problems, frequent self- monitoring of blood glucose does not directly minimize other health problems.

Choice D rationale

Frequent self-monitoring of blood glucose is not necessarily the most cost-efficient method for glucose control. The cost efficiency depends on various factors, including the cost of testing supplies and the frequency of testing.

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A patient has been receiving warfarin sodium 2.5 mg PO daily for four days and the International Normalized Ratio (INR) is 1.9. What should be the nurse’s next step?

Choice B rationale

Choice C rationale

Choice D rationale

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing teaching to a client who is being discharged with a prescription for warfarin. Which information should be included in the teaching for this medication?

Correct Answer is C

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

Choice E rationale

The nurse explains to a patient diagnosed with diabetes mellitus that the major benefit of frequent self-monitoring of blood glucose is that:

Correct Answer is B

Explanation

Choice B rationale

Choice C rationale

Choice D rationale

The nurse receives an order to administer cefazolin to a client diagnosed with a urinary tract infection. The nurse withholds the medication and notifies the health care provider because the client:

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