A nurse is reporting a client’s laboratory tests to the provider to obtain a prescription for the client’s daily warfarin.
Which of the following laboratory tests should the nurse plan to report to obtain the prescription for the warfarin?
INR.
Fibrinogen level.
aPTT.
Platelet count.
The Correct Answer is A
Warfarin is a vitamin K antagonist that inhibits the synthesis of factors II, VII, IX, and X in the liver. These factors are part of the extrinsic and common pathways of coagulation, which are measured by the prothrombin time (PT) and the international normalized ratio (INR). The INR is a standardized way of reporting the PT that accounts for the variability of different reagents and instruments. The INR is used to monitor the therapeutic effect of warfarin and to adjust the dose accordingly. The target INR range depends on the indication for warfarin, but it is usually between 2 and 3 for most conditions.
Choice B is wrong because fibrinogen level is not affected by warfarin.
Fibrinogen is a precursor of fibrin, which forms the final step of the coagulation cascade.
Fibrinogen level can be decreased in conditions such as disseminated intravascular coagulation (DIC), liver disease, or severe bleeding.
Choice C is wrong because aPTT is not affected by warfarin.
aPTT measures the intrinsic and common pathways of coagulation, which are mainly dependent on factors VIII, IX, XI, and XII.
These factors are not inhibited by warfarin.
aPTT is used to monitor the effect of heparin, a direct antithrombin agent that inhibits thrombin and factor Xa.
Choice D is wrong because platelet count is not affected by warfarin.
Platelets are cell fragments that adhere to damaged blood vessels and form aggregates to initiate hemostasis.
Platelet count can be decreased in conditions such as immune thrombocytopenia (ITP), heparin-induced thrombocytopenia (HIT), or bone marrow suppression.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is choice D. Positioning both hands on the grips with his elbows slightly flexed.
Choice A rationale:
Moving both crutches with the stronger leg forward first is not correct because in a three-point gait, the two crutches and the affected leg move together, followed by the stronger leg.
Choice B rationale:
Supporting body weight while leaning on the axillary crutch pads is incorrect as this can cause nerve damage under the arms. Weight should be supported by the hands while using crutches.
Choice C rationale:
Stepping with the affected leg first when going up stairs is incorrect. When ascending stairs, the unaffected (stronger) leg should be moved first, followed by the affected leg and crutches.
Choice D rationale:
Positioning both hands on the grips with elbows slightly flexed is correct as it allows for proper weight distribution through the arms and hands, which is essential for balance and safety while using crutches.
Correct Answer is D
Explanation
This is because the nurse should assess the client’s level of mobility, strength, and coordination before repositioning them to prevent injury and promote comfort. The nurse should also use appropriate assistive devices, such as a drawsheet, a trapeze bar, or a mechanical lift, to facilitate safe repositioning and reduce the risk of skin breakdown and pressure ulcers.
Choice A is wrong because raising the side rails on both sides of the client’s bed during repositioning can increase the risk of falls and entrapment.
The nurse should only raise the side rail on the opposite side of the bed from where they are working and lower it when they are done.
Choice B is wrong because repositioning the client without assistive devices can cause strain and injury to both the nurse and the client.
The nurse should use assistive devices that are appropriate for the client’s condition and weight.
Choice C is wrong because discussing the client’s preferences for determining a repositioning schedule is not a priority action when preparing to reposition a client who had a stroke.
The nurse should follow the facility’s protocol for repositioning frequency, which is usually every 2 hours, and adjust it according to the client’s needs and comfort.
The nurse should also involve the client in the care plan and respect their preferences whenever possible.
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