A client with a history of atrial fibrillation is prescribed warfarin. Which laboratory value should the nurse monitor to assess the medication’s effectiveness?

Platelet count

International normalized ratio (INR)

Hemoglobin level

Serum potassium

Answer and Explanation

The Correct Answer is B

Choice A reason: Platelet count assesses bleeding risk but does not measure warfarin’s anticoagulant effect. Warfarin inhibits clotting factors, monitored by INR. Platelet counts are relevant for antiplatelet drugs, not anticoagulants, making INR the priority for evaluating warfarin efficacy in atrial fibrillation.

Choice B reason: INR measures warfarin’s anticoagulant effect by assessing prothrombin time, reflecting vitamin K-dependent clotting factor inhibition. In atrial fibrillation, therapeutic INR (2.0–3.0) prevents thromboembolism. Monitoring INR ensures effective anticoagulation, making it the critical lab value for warfarin therapy management.

Choice C reason: Hemoglobin level detects bleeding, a warfarin side effect, but does not assess its therapeutic effect. INR directly evaluates anticoagulation, ensuring stroke prevention in atrial fibrillation. Hemoglobin is secondary, monitored for complications, not efficacy, making INR the priority lab value.

Choice D reason: Serum potassium is unrelated to warfarin’s anticoagulant action. Electrolyte imbalances may affect cardiac rhythm in atrial fibrillation, but INR measures warfarin’s effect on clotting factors, ensuring therapeutic anticoagulation, making it the essential value to monitor for medication efficacy.

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Correct Answer is A

Explanation

Choice A reason: Age over 40 increases cholelithiasis risk due to reduced gallbladder motility and increased bile cholesterol saturation, promoting gallstone formation. Aging alters bile composition, with higher lithogenic potential, making older adults more susceptible to cholesterol gallstones, a primary type in Western populations.

Choice B reason: Daily walking of 2 to 3 miles reduces cholelithiasis risk by promoting physical activity, which enhances gallbladder motility and reduces bile stasis. Exercise lowers cholesterol levels in bile, decreasing stone formation, making this a protective factor rather than a risk.

Choice C reason: A low-fat diet decreases cholelithiasis risk by reducing dietary cholesterol intake, which lowers bile cholesterol saturation. This promotes healthier bile composition, reducing the likelihood of cholesterol gallstone formation, making it a protective dietary habit rather than a risk factor.

Choice D reason: Male gender is associated with a lower risk of cholelithiasis compared to females, who have higher estrogen levels that increase bile cholesterol. Men have less lithogenic bile, making gender a protective factor, not a significant risk, unlike age-related changes.

A. Increased urine output B. Elevated blood pressure C. Increased heart rate D. Weight gain

Correct Answer is A

Explanation

Choice A reason: Furosemide, a loop diuretic, promotes urine output by inhibiting sodium reabsorption in the kidneys, reducing fluid overload in heart failure. Increased urine output indicates effective diuresis, alleviating pulmonary and peripheral edema, making it the primary sign of therapeutic efficacy.

Choice B reason: Elevated blood pressure is not an expected effect of furosemide, which reduces preload and blood volume, often lowering pressure. Effective diuresis is shown by increased urine output, as this directly reflects fluid removal, critical for heart failure management.

Choice C reason: Increased heart rate is not a direct indicator of furosemide efficacy. Diuresis reduces cardiac workload, potentially stabilizing heart rate, but urine output is the primary measure, as it confirms fluid excretion, the medication’s main action in heart failure.

Choice D reason: Weight gain indicates fluid retention, the opposite of furosemide’s goal. Effective diuresis causes weight loss due to fluid excretion. Increased urine output is the key sign, as it directly measures the diuretic’s action in reducing heart failure-related fluid overload.

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A client with a history of atrial fibrillation is prescribed warfarin. Which laboratory value should the nurse monitor to assess the medication’s effectiveness?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is reviewing risk factors for cholelithiasis in a client’s history. Which factor most significantly increases the client’s risk for developing gallstones?

Correct Answer is A

Explanation

A client with a history of heart failure is prescribed furosemide. Which assessment finding indicates the medication is effective?

Correct Answer is A

Explanation

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