A nurse is preparing to administer warfarin to a client with a mechanical valve replacement. The client's INR is 2.7. Which action should the nurse implement?

Hold the medication and notify the HCP

Administer the medication as ordered.

Prepare to administer vitamin K (AquaMephyton).

Assess the client for abnormal bleeding.

Fat embolism

Answer and Explanation

The Correct Answer is B

A. Hold the medication and notify the HCP: This is unnecessary. An INR of 2.7 is within the therapeutic range for a client with a mechanical valve replacement (2.5 to 3.5). No intervention is required.

B. Administer the medication as ordered: The INR of 2.7 is within the desired therapeutic range for clients on warfarin with mechanical valve replacements, so the nurse should proceed with the prescribed dose.

C. Prepare to administer vitamin K (AquaMephyton): Vitamin K is used to reverse the effects of warfarin if the INR is too high (usually greater than 5).

D. Assess the client for abnormal bleeding: While important, this is not the first action. The INR is within the therapeutic range, so the priority is to administer the medication.

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Correct Answer is D

Explanation

A. Subdural hematoma: Subdural hematomas develop more slowly and typically present a higher risk for delayed deterioration, but not usually within the first 24 hours.

B. Diffuse axonal injury: While severe, diffuse axonal injury typically causes a prolonged coma rather than immediate fatality within 24 hours.

C. Intracranial hemorrhage: This is severe but often depends on the size and location of the bleed.

D. Epidural hematoma: Epidural hematomas are associated with arterial bleeding and rapid deterioration due to increased intracranial pressure, making them the most fatal within 24 hours.

A. It decreases spasm of the coronary arteries B. It increases the force of myocardial contraction C. It helps prevent clotting in the coronary arteries. D. It reduces the "fight or flight" response.

Correct Answer is A

Explanation

A. It decreases spasm of the coronary arteries: Amlodipine is a calcium channel blocker that relaxes vascular smooth muscle, making it effective in treating coronary artery spasms in Prinzmetal's angina.

B. It increases the force of myocardial contraction: Amlodipine does not increase myocardial contractility; it primarily affects vascular tone.

C. It helps prevent clotting in the coronary arteries: Amlodipine is not an anticoagulant or antiplatelet agent.

D. It reduces the "fight or flight" response: Beta-blockers, not amlodipine, are typically associated with reducing the sympathetic nervous system response.

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A nurse is preparing to administer warfarin to a client with a mechanical valve replacement. The client's INR is 2.7. Which action should the nurse implement?

Nursing Test Bank

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