A nurse on a telemetry unit is reviewing the laboratory results for a client who has atrial fibrillation and is taking warfarin. Which of the following laboratory values should the nurse report to the provider?

Hemoglobin (Hgb) : 16 g/dL

Prothrombin Time (PT) : 45 seconds

Activated Partial Thromboplastin Time (aPTT) : 36 seconds

Platelets : 190,000/mm

Answer and Explanation

The Correct Answer is B

Choice A reason : A hemoglobin (Hgb) level of 16 g/dL is within the normal range for adults, which typically falls between 13.8 to 17.2 g/dL for men and 12.1 to 15.1 g/dL for women. Therefore, this value does not warrant reporting to the provider as it does not indicate an immediate concern.

Choice B reason : A prothrombin time (PT) of 45 seconds is significantly higher than the normal range of 11 to 13.5 seconds for individuals not on anticoagulation therapy. For patients on warfarin, the target PT is usually 1.5 to 2 times the normal value, depending on the indication for therapy. However, a PT of 45 seconds suggests a high risk of bleeding and requires immediate medical attention.

Choice C reason : The activated partial thromboplastin time (aPTT) of 36 seconds is within the normal range of approximately 21 to 35 seconds⁸. This result indicates that the blood's intrinsic clotting pathway is functioning within expected parameters and does not need to be reported.

Choice D reason : A platelet count of 190,000/mm is within the normal range, which is typically 150,000 to 450,000 platelets/mm. This value is not concerning and does not need to be reported to the provider.

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Correct Answer is B

Explanation

Choice A reason : S1 represents the sound made by the closure of the atrioventricular valves (mitral and tricuspid valves) and is not the sound associated with the closure of the aortic and pulmonic valves.

Choice B reason : S2 is the sound heard when the aortic and pulmonic valves close. It is often described as a "dub" and occurs at the end of ventricular systole.

Choice C reason : S3 is a rare extra heart sound that follows S2 and usually indicates an increase in left ventricular filling pressure, which can be found in conditions such as heart failure.

Choice D reason : S4 is another extra heart sound that occurs just before S1. It is typically associated with a stiff or hypertrophic ventricle and is not related to the closure of the aortic and pulmonic valves

A. Set your goal body weight within 25% of your ideal body weight. B. Limit alcohol consumption to two drinks a day for men and one drink a day for women when hypertensive. C. Plan to lower sodium intake to less than 2,300 mg each day. D. Plan to have potassium blood levels checked when taking thiazide diuretics.

Correct Answer is C

Explanation

Choice A reason : Setting a goal body weight within 25% of the ideal body weight can be misleading. The ideal body weight should be determined based on body mass index (BMI), considering the individual's height and weight. A BMI of 18.5 to 24.9 is considered normal.

Choice B reason : This is a general guideline for alcohol consumption, but for individuals with hypertension, it is often recommended to limit alcohol intake even further to help manage blood pressure

Choice C reason : This is a key recommendation for managing hypertension. Reducing sodium intake helps lower blood pressure and is a widely accepted guideline

Choice D reason : Monitoring potassium levels is crucial when taking thiazide diuretics because these medications can decrease potassium levels in the blood, leading to hypokalemia.

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A nurse on a telemetry unit is reviewing the laboratory results for a client who has atrial fibrillation and is taking warfarin. Which of the following laboratory values should the nurse report to the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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