A patient who has atrial fibrillation is taking warfarin and has an INR of 2.5.The patient reports having frequent headaches and asks for an over-the-counter pain reliever.The nurse will recommend which medication?
Ibuprofen
Naproxen
Acetaminophen
Aspirin.
The Correct Answer is C
The patient reports having frequent headaches and asks for an over-the-counter pain reliever. The nurse will recommend acetaminophen, which is the safest pain reliever while taking warfarin. Acetaminophen does not interfere with the anticoagulant effect of warfarin and does not increase the risk of bleeding.
Choice A is wrong because ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can enhance the anticoagulant effect of warfarin and increase the likelihood of harmful bleeding.
NSAIDs can also cause stomach ulcers, kidney damage, and high blood pressure.
Choice B is wrong because naproxen is another NSAID that has the same risks as ibuprofen.
Naproxen should be avoided by patients taking warfarin.
Choice D is wrong because aspirin is also an anticoagulant that can increase the risk of bleeding when taken with warfarin.
Aspirin can also cause stomach irritation, ulcers, and allergic reactions.
The normal range for INR is 2 to 3 for patients with atrial fibrillation who are taking warfarin.
An INR of 2.5 indicates that the patient’s blood is taking longer to clot than normal, but not too long.
The patient should have regular blood tests to monitor their INR and adjust their warfarin dose if needed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
This statement indicates that the patient understands that rivaroxaban (Xarelto) is an anticoagulant that can increase the risk of bleeding and bruising.The patient should avoid activities that may cause injury, such as contact sports, sharp objects, or falls.
Choice A is wrong because aspirin is also an antiplatelet drug that can further increase the risk of bleeding when taken with rivaroxaban.The patient should not take aspirin or any other nonsteroidal anti-inflammatory drugs (NSAIDs) without consulting the prescriber.
Choice C is wrong because rivaroxaban can be taken with or without food.The patient does not need to take the medication with food to prevent stomach upset or absorption problems.
Choice D is wrong because rivaroxaban should be taken as prescribed and not stopped abruptly without consulting the prescriber.Stopping the medication can increase the risk of blood clots and stroke.The patient should not stop taking the medication even if they feel better or have no symptoms.
Correct Answer is A
Explanation
Omeprazole is a proton pump inhibitor (PPI) that reduces the production of stomach acid.
Dabigatran is an anticoagulant that prevents blood clots from forming.
Both drugs can increase the risk of bleeding in the gastrointestinal tract, especially in clients with peptic ulcer disease.Therefore, they should not be used together unless absolutely necessary.
Choice B. Ranitidine is wrong because ranitidine is a histamine-2 receptor antagonist (H2RA) that also reduces the production of stomach acid, but to a lesser extent than PPIs.Ranitidine does not interact significantly with dabigatran and does not increase the risk of bleeding.
Choice C. Sucralfate is wrong because sucralfate is a mucosal protectant that forms a barrier over ulcers and protects them from acid and enzymes.Sucralfate does not affect the coagulation system and does not increase the risk of bleeding.
Choice D. Misoprostol is wrong because misoprostol is a synthetic prostaglandin that inhibits gastric acid secretion and increases bicarbonate and mucus production.
Misoprostol is used to prevent ulcers in clients who take NSAIDs, which can cause ulcers and bleeding.
Misoprostol does not interact with dabigatran and does not increase the risk of bleeding.
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