An older adult patient has been prescribed warfarin (coumadin). The nurses primary intervention involves daily review of the patient's:

reflex tone

body for bruising

serum creatinine level

prothrombin time

Answer and Explanation

The Correct Answer is D

A.   Reflex tone refers to the neurological response of the body to stimuli and is not directly related to the action or monitoring of anticoagulant therapy. While assessing reflexes might be important for overall patient health, it is not specifically relevant to monitoring the effects of warfarin. Reflex tone does not provide information on the anticoagulation status or risk of bleeding associated with warfarin therapy.
B.   Checking the body for bruising helps assess the safety of warfarin therapy and may indicate the need for dosage adjustments or further investigation if bruising is excessive. However, while monitoring for bruising is essential, it is not the primary method for assessing the effectiveness and safety of anticoagulant therapy.
C.   While monitoring kidney function is relevant for overall medication management, it is not the primary focus for directly assessing the effectiveness or safety of warfarin therapy. Kidney function is more related to adjusting doses and avoiding potential complications.
D.   Regularly reviewing PT is crucial for managing warfarin therapy because it directly reflects the anticoagulation effect of the medication. The International Normalized Ratio (INR), derived from PT, is used to ensure the patient is within the therapeutic range for effective anticoagulation while minimizing the risk of bleeding.

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Correct Answer is C

Explanation

A. While these symptoms can be associated with alcohol withdrawal, they are not as indicative of an immediate medical emergency as tachycardia and hypertension.
B. While these symptoms may suggest cognitive impairment, they are not as indicative of impending alcohol withdrawal syndrome as tachycardia and hypertension.
C. Alcohol withdrawal can lead to various physiological changes, including increased heart rate and blood pressure. A pulse of 118 beats/min and a blood pressure of 160/90 indicate a significant increase in both vital signs, which could be a sign of impending alcohol withdrawal syndrome.
D. These vital signs are within normal limits and do not indicate a significant risk of alcohol withdrawal syndrome.

A. protect the kidneys function B. have a well-defined therapeutic window C. can be given when liver function is compromised D. are more effective than other drugs in the same class

Correct Answer is A

Explanation

A. Angiotensin II receptor blockers (ARBs) are a class of medications used to treat high blood pressure. They work by blocking the effects of angiotensin II, a hormone that constricts blood vessels and causes the kidneys to retain sodium and water. This can lead to increased blood pressure and damage to the kidneys.

B. While ARBs do have a well-defined therapeutic window, this is not the primary reason why they are especially useful in older adults.
C. ARBs should be used with caution in patients with liver problems, as they can be metabolized by the liver.
D. ARBs are generally considered to be as effective as other antihypertensive medications, such as angiotensin-converting enzyme (ACE) inhibitors.

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An older adult patient has been prescribed warfarin (coumadin). The nurses primary intervention involves daily review of the patient's:

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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