A patient on warfarin therapy presents with bruising and nosebleeds. Which laboratory test result would be most indicative of warfarin overdose?
An elevated platelet count
An elevated aPTT level
An elevated lipid panel
An elevated INR level
Petechiae
The Correct Answer is D
Choice A reason: An elevated platelet count does not indicate warfarin overdose, which prolongs clotting time by inhibiting vitamin K-dependent factors, not platelet function. Normal or low platelets may cause bleeding, but INR is the key indicator, making this incorrect for assessing overdose.
Choice B reason: Elevated aPTT reflects heparin’s effect, not warfarin, which primarily affects prothrombin time and INR. While bleeding may occur, aPTT is not the primary test for warfarin overdose, making this incorrect, as INR directly monitors warfarin’s anticoagulant effect and overdose risk.
Choice C reason: An elevated lipid panel is unrelated to warfarin overdose, which causes bleeding by inhibiting clotting factors. Lipid levels affect atherosclerosis, not coagulation, making this incorrect, as INR is the specific test to assess warfarin’s therapeutic and overdose effects in bleeding patients.
Choice D reason: An elevated INR level indicates warfarin overdose, as warfarin inhibits vitamin K-dependent clotting factors, prolonging prothrombin time and increasing bleeding risk like bruising and nosebleeds. Monitoring INR is critical, making this the correct test to identify overdose in this patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["0.8"]
Explanation
Step 1 is to recognize that Lanoxin elixir contains 100 mcg/mL (common formulation)
Step 2 is to calculate: (80 ÷ 100) = 0.8
Final answer = 0.8 mL
Correct Answer is A
Explanation
Choice A reason: Increasing dietary potassium intake enhances diuretic effectiveness, especially with potassium-losing diuretics, by maintaining electrolyte balance and supporting blood pressure reduction. Foods like bananas help, making this the correct recommendation to improve hypertension management in a 69-year-old patient.
Choice B reason: High-intensity exercise is not advised for a 69-year-old on diuretics, as it risks dehydration or orthostatic hypotension. Moderate exercise is safer, making this incorrect, as the nurse should recommend appropriate activity levels to support, not strain, cardiovascular health.
Choice C reason: A high-sodium diet counteracts diuretics by promoting fluid retention, raising blood pressure. A low-sodium diet enhances diuretic efficacy, making this incorrect, as the nurse should recommend sodium restriction to improve hypertension control and medication effectiveness.
Choice D reason: Limiting fluid intake to 500 mL daily risks dehydration in a patient on diuretics, worsening hypotension or renal function. Adequate hydration is needed, making this incorrect, as the nurse should encourage balanced fluid intake to support safe diuretic therapy.
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