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Choice B is wrong because prothrombin time (PT) is the laboratory test used to monitor the anticoagulant effect of warfarin, not heparin. Warfarin inhibits the synthesis of vitamin K-dependent clotting factors, such as factor II, VII, IX, and X. The PT should be maintained at 1.5 to 2 times the normal range, which is usually 11 to 13 seconds.

Choice C is wrong because international normalized ratio (INR) is a standardized way of reporting the PT results, which are affected by different reagents and methods. The INR is used to monitor warfarin therapy, not heparin therapy. The INR should be maintained at 2 to 3 for most indications of warfarin therapy.

Choice D is wrong because platelet count is not a direct measure of the anticoagulant effect of heparin, but rather a potential complication of heparin therapy. Heparin can cause heparin-induced thrombocytopenia (HIT), a serious condition that causes low platelet count and increased risk of thrombosis. Platelet count should be monitored regularly during heparin therapy to detect HIT, which usually occurs within 5 to 10 days of exposure. The normal platelet count range is 150,000 to 450,000 per microliter of blood.

Choice A is wrong because aspirin is not contraindicated with enoxaparin. Aspirin is also an antiplatelet agent that can prevent thrombosis, and it may be used in combination with enoxaparin for certain indications, such as acute coronary syndrome.

Choice B is wrong because ibuprofen is not contraindicated with enoxaparin. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can reduce pain and inflammation, and it may be used with enoxaparin for certain conditions, such as arthritis. However, NSAIDs can also increase the risk of bleeding, so patients should use them with caution and inform their provider if they are taking them.

Choice D is wrong because enoxaparin does not need to be taken with food. Enoxaparin is given by subcutaneous injection, so food does not affect its absorption or efficacy. Patients should follow the instructions on how to inject enoxaparin properly and store it at room temperature.

Warfarin works by inhibiting the synthesis of vitamin K-dependent clotting factors, so the client should monitor their intake of vitamin K, but not avoid it completely.

Warfarin can be taken with or without food, so choice B is not correct.

Aspirin is also an anticoagulant and can increase the risk of bleeding when taken with warfarin, so the client should avoid taking it unless prescribed by the provider

Choice A is wrong because the client should not avoid foods that are high in vitamin K, but rather keep their intake of vitamin K consistent. Vitamin K is needed for the production of clotting factors and warfarin works by blocking its action. If the client changes their vitamin K intake, it can affect the effectiveness of warfarin and increase the risk of clotting or bleeding.

Choice B is wrong because warfarin can be taken with or without food. Food does not affect the absorption or metabolism of warfarin.

Choice D is wrong because the client should avoid taking aspirin while taking warfarin, unless prescribed by their provider. Aspirin is another blood thinner that works by inhibiting platelets. Taking both warfarin and aspirin can increase the risk of bleeding significantly, especially in older adults.