A nurse is caring for a patient who has a new prescription for warfarin.
Which of the following diagnostic test results should the nurse use to monitor the therapy’s effect?
Platelet count.
White blood cell count (WBC).
Prothrombin time (PT).
Activated partial thromboplastin time (aPTT).
The Correct Answer is C
Platelet count is not the primary diagnostic test used to monitor the therapy’s effect of warfarin. Platelets are involved in the clotting process, but warfarin specifically works by inhibiting the synthesis of vitamin K-dependent clotting factors, which does not directly involve platelets.
Choice B rationale
The white blood cell count (WBC) is not used to monitor the effect of warfarin therapy. WBC is typically used to monitor for infection or inflammation, not the coagulation status of a patient.
Choice C rationale
Prothrombin time (PT) is the correct answer. Warfarin therapy is monitored using the PT, which is reported as the International Normalized Ratio (INR). Warfarin inhibits the synthesis of vitamin K-dependent clotting factors, which include Factors II, VII, IX, and X, and Proteins C and S. The PT/INR is sensitive to changes in these factors. An elevated INR indicates a higher risk of bleeding, while a lower INR suggests a higher risk of clotting.
Choice D rationale
Activated partial thromboplastin time (aPTT) is not typically used to monitor warfarin therapy. The aPTT test evaluates the intrinsic and common pathways of coagulation, which includes factors XII, XI, IX, VIII, X, V, II (prothrombin), and I (fibrinogen). Warfarin affects the extrinsic pathway and common pathway, not the intrinsic pathway. Therefore, aPTT is not the best test to monitor the effects of warfarin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Changing gloves between tasks on the same client is a key infection control practice. This prevents cross-contamination between different body sites and reduces the risk of spreading infection.
Choice B rationale
Washing hands with alcohol-based hand rubs when caring for a client who has Clostridium difficile is not recommended. Clostridium difficile spores are not killed by alcohol-based hand rubs. Handwashing with soap and water is more effective.
Choice C rationale
Using alcohol-based hand rubs before administering eye drops for a client is a good practice, but it is not the most important information to reinforce. Hand hygiene is crucial in all aspects of patient care to prevent the spread of infection.
Choice D rationale
Keeping artificial nails trimmed short is a good practice, but it is not the most important information to reinforce. Artificial nails can harbor bacteria and other pathogens, increasing the risk of infection transmission.
Correct Answer is A
Explanation
Choice A rationale
Allowing the client to rest in a supine position during feeding should prompt the charge nurse to intervene. The client should be in an upright position during feedings and for an hour afterwards to prevent aspiration.
Choice B rationale
Irrigating the NG tube with tap water after feeding is a standard practice. This helps to keep the tube patent and prevent blockages.
Choice C rationale
Administering the feeding through a syringe barrel by gravity is a common method for giving intermittent tube feedings. This method allows for controlled administration of the feeding.
Choice D rationale
Initiating the feeding after aspirating 50 ml of gastric residual is a standard practice. Checking gastric residual volume before feedings helps to assess gastric emptying and tolerance to the feeding.
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