Order: Ascorbic Acid 200 mg IM every day.

Available: Ampule containing Ascorbic Acid 500 mg/2mL.

How many mL's will be given?

Include mL in answer

A. "I will use this as needed for acute symptoms.": Montelukast is not a rescue medication and should not be used for acute asthma attacks. It is a leukotriene receptor antagonist intended for daily maintenance therapy to prevent bronchoconstriction. Using it for sudden symptoms could delay appropriate treatment.

B. "I will need to have periodic laboratory tests while taking this medication.": Routine lab monitoring is generally not required for montelukast, as it does not significantly affect kidney, liver, or blood parameters in most patients. Ordering unnecessary labs indicates a misunderstanding of the medication’s safety profile.

C. “I will take one tablet daily at bedtime.": This statement demonstrates correct understanding, as montelukast is taken once daily, typically in the evening, to provide optimal control of nocturnal symptoms.

D. "I will begin participating in a smoking cessation program at work.": Engaging in smoking cessation is appropriate and beneficial for respiratory health, complementing asthma management and montelukast therapy.

A. Continue with the current dose: An INR of 5.3 is above the therapeutic range, indicating a high risk of bleeding. Continuing the current dose without intervention could lead to serious hemorrhagic complications. Dose adjustment or reversal is necessary to ensure patient safety.

B. Administer additional warfarin: Giving more warfarin would further increase anticoagulation, greatly elevating the risk of spontaneous bleeding. This action is dangerous and contraindicated when the INR is already supratherapeutic.

C. Increase the dose of warfarin: Increasing the dose would exacerbate over-anticoagulation and heighten the risk of severe bleeding. The priority is to reduce the anticoagulant effect, not intensify it.

D. Administer vitamin K as ordered: Vitamin K acts as an antidote to warfarin by promoting clotting factor synthesis, which lowers INR and reduces bleeding risk. Administering it under provider guidance corrects over-anticoagulation safely and prevents hemorrhagic complications.