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
Argatroban is a direct thrombin inhibitor (DTI) that is used as an alternative anticoagulant for patients with heparin-induced thrombocytopenia (HIT) who require urgent surgery. Argatroban has a half-life of about 40 to 50 minutes and is cleared by the liver.The infusion should be stopped at least 4 hours before the surgery to allow adequate time for the anticoagulant effect to wear off.The activated partial thromboplastin time (aPTT) should be monitored before and after the infusion to assess the degree of anticoagulation.
Choice A is wrong because 2 hours is not enough time to stop the argatroban infusion before surgery.
The patient may still have a high risk of bleeding if the aPTT is prolonged.
Choice C is wrong because 6 hours is longer than necessary to stop the argatroban infusion before surgery.
The patient may have a higher risk of thrombosis if the anticoagulation effect is too low.
Choice D is wrong because 8 hours is much longer than necessary to stop the argatroban infusion before surgery.
The patient may have a very low level of anticoagulation and a high risk of thrombosis if the infusion is stopped for too long.
Correct Answer is ["B"]
Explanation
Alteplase is a fibrinolytic agent that dissolves blood clots and restores blood flow.However, it also increases the risk of bleeding from any site, such as the nose, gums, injection sites, or internal organs.Therefore, the nurse should monitor the client for signs of bleeding, such as bruising, hematuria, hematemesis, melena, or decreased hemoglobin and hematocrit levels.
Choice A is wrong because hypotension is not a common adverse effect of alteplase.Hypotension may occur due to blood loss from bleeding or other causes, such as dehydration, sepsis, or cardiac dysfunction.
Choice C is wrong because dysrhythmias are not a common adverse effect of alteplase.Dysrhythmias may occur due to pulmonary embolism itself, which can cause hypoxia, acidosis, and increased pulmonary artery pressure.
Choice D is wrong because nausea is not a common adverse effect of alteplase.Nausea may occur due to other factors, such as anxiety, pain, or medications.
Choice E is wrong because fever is not a common adverse effect of alteplase.Fever may occur due to infection, inflammation, or other causes.
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