A nurse is assessing the therapeutic International Normalized Ratio (INR) range for a patient receiving Warfarin. Which INR range below is therapeutic?

2.0-3.0

4.0-5.0

1.0-2.0

3.0-4.9

Answer and Explanation

The Correct Answer is A

Choice A reason : The therapeutic INR range for a patient on Warfarin, especially for conditions such as atrial fibrillation, venous thromboembolism, and for the prevention of thrombosis in patients with prosthetic heart valves, is typically 2.0-3.0. This range balances the risk of clotting with the risk of bleeding. An INR of 2.0-3.0 means that the blood is taking twice to three times as long as normal blood to clot, which is the desired effect of the medication in preventing harmful clots.

Choice B reason : An INR range of 4.0-5.0 is generally considered too high for most therapeutic purposes and increases the risk of bleeding complications. This range might be appropriate in very specific clinical situations, such as for patients with mechanical heart valves who may require a slightly higher INR, but it is not the standard therapeutic range.

Choice C reason : An INR range of 1.0-2.0 is below the therapeutic range for patients on Warfarin. This range would not provide sufficient anticoagulation and would leave the patient at risk for thrombotic events.

Choice D reason : An INR range of 3.0-4.9 is higher than the standard therapeutic range and could lead to an increased risk of bleeding. While some patients with mechanical heart valves in the mitral position may require an INR up to 3.5, an INR higher than this is usually not necessary and could be dangerous.

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Correct Answer is D

Explanation

Choice A reason : The statement that the test will be complete in 30 to 60 minutes is incorrect. An ECG is a quick, non-invasive procedure that typically takes only a few minutes to perform.

Choice B reason : The statement about feeling a slight tingling is not accurate for an ECG. This test does not cause any sensations, as it simply records the electrical activity of the heart.

Choice C reason : The mention of radioactivity from dye is not applicable to an ECG. This test does not involve the use of any dyes or radioactive substances. Dyes are typically used in imaging tests like CT scans or MRIs, not ECGs.

Choice D reason : This is the correct statement. For an ECG, electrodes are placed on the patient's chest and extremities to record the electrical activity of the heart. This allows the healthcare provider to assess the heart's rhythm, identify any irregularities, and diagnose conditions.

A. Thickened toenails B. Shiny, thin skin on the lower extremities C. Dusky, red color of the feet when dangling D. Pitting edema

Correct Answer is D

Explanation

Choice A reason : Thickened toenails are often associated with fungal infections and are not a direct symptom of venous insufficiency. However, they can appear in patients with chronic venous insufficiency due to poor circulation that affects the health of the toenails.

Choice B reason : Shiny, thin skin on the lower extremities is more characteristic of arterial insufficiency, where there is a reduction in blood flow and oxygen to the tissues. In venous insufficiency, the skin may instead appear thickened and discolored due to stasis and buildup of hemosiderin from the breakdown of red blood cells.

Choice C reason : A dusky, red color of the feet when dangling can be a sign of dependent rubor, which is associated with arterial insufficiency. This occurs when there is a severe decrease in arterial blood flow to the lower extremities. Venous insufficiency may cause a different color change, typically a brownish discoloration due to hemosiderin deposition.

Choice D reason : Pitting edema is a hallmark sign of venous insufficiency. It occurs due to the accumulation of fluid in the tissues, which is a result of increased pressure in the veins. This pressure causes fluid to leak into the surrounding tissues, leading to swelling that retains an indentation when pressed.

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A nurse is assessing the therapeutic International Normalized Ratio (INR) range for a patient receiving Warfarin. Which INR range below is therapeutic?

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