An older adult patient has been prescribed warfarin (coumadin). The nurses primary intervention involves daily review of the patient's:

reflex tone

body for bruising

serum creatinine level

prothrombin time

Answer and Explanation

The Correct Answer is D

A.   Reflex tone refers to the neurological response of the body to stimuli and is not directly related to the action or monitoring of anticoagulant therapy. While assessing reflexes might be important for overall patient health, it is not specifically relevant to monitoring the effects of warfarin. Reflex tone does not provide information on the anticoagulation status or risk of bleeding associated with warfarin therapy.
B.   Checking the body for bruising helps assess the safety of warfarin therapy and may indicate the need for dosage adjustments or further investigation if bruising is excessive. However, while monitoring for bruising is essential, it is not the primary method for assessing the effectiveness and safety of anticoagulant therapy.
C.   While monitoring kidney function is relevant for overall medication management, it is not the primary focus for directly assessing the effectiveness or safety of warfarin therapy. Kidney function is more related to adjusting doses and avoiding potential complications.
D.   Regularly reviewing PT is crucial for managing warfarin therapy because it directly reflects the anticoagulation effect of the medication. The International Normalized Ratio (INR), derived from PT, is used to ensure the patient is within the therapeutic range for effective anticoagulation while minimizing the risk of bleeding.

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Correct Answer is A

Explanation

A. In Korean culture, silence and avoiding eye contact can be seen as signs of respect and deference, especially towards individuals perceived as having authority or expertise. Therefore, the patient's behavior is likely not a sign of dissatisfaction or discomfort, but rather a cultural expression of respect for the nurse.
B. While it is possible for the patient to be dissatisfied with his care, the nurse should not assume this based solely on his behavior. It's important to consider cultural factors and use other communication strategies to assess the patient's needs and concerns.
C. This is not necessarily the case. The patient may simply be uncomfortable speaking up or asking questions in a language that is not his native tongue.
D. While it is possible for the patient to be uncomfortable discussing personal matters, the nurse should not assume this based solely on his behavior. It's important to consider cultural factors and use other communication strategies to assess the patient's needs and concerns.

A. assesses the patient for functional limitations B. arranges for the needed UAP provided services C. assumes the roles of case manager and patient advocate D. evaluates the competency of the UAP staff

Correct Answer is D

Explanation

A. While assessing the patient's functional limitations is important for determining the appropriate level of care needed, it does not directly address the competency of the UAP staff.
B. Arranging for UAP services is important, but it does not guarantee the quality of care provided. Evaluating the competency of the UAP staff is essential to ensure that the patient receives safe and effective care.
C. While the nurse may play a role in case management and advocacy, it's important to ensure that the UAP staff is competent to provide the necessary care.
D. To ensure the quality of care and safety of an older adult patient who requires in-home UAP assistance, it's crucial to evaluate the competency of the UAP staff. This involves assessing their skills, knowledge, and ability to provide safe and effective care.

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An older adult patient has been prescribed warfarin (coumadin). The nurses primary intervention involves daily review of the patient's:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

While caring for an older Korean patient, the nurse notes that the patient answers questions regarding health history when asked but is otherwise silent and does not maintain eye contact. Being culturally sensitive, the nurse recognizes that the patients actions are most likely a(n):

Correct Answer is A

Explanation

To best assure both the quality of care and the safety of the older adult patient who requires in home unlicensed assistive personal (UAP) assistance, the geriatric nurse:

Correct Answer is D

Explanation

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