The nurse is about to administer warfarin (Coumadin). Which of the following laboratory studies would be reviewed first?

Vitamin K level

Activated Partial Thromboplastin Time (aPTT) level

International Normalized Ratio (INR) level

Fibrinogen level

Answer and Explanation

The Correct Answer is C

A. Vitamin K level is important for warfarin’s mechanism but is not routinely measured before administration.
B. aPTT monitors heparin therapy, not warfarin.
C. INR is the standardized test used to monitor warfarin’s anticoagulant effect and is the most important lab to check before giving warfarin.
D. Fibrinogen level assesses clotting factor but is not used to monitor warfarin therapy.

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Correct Answer is A

Explanation

A. Hypomagnesemia is common in chronic alcoholism and can cause increased blood pressure, hyperactive reflexes, abdominal issues, and mood changes.
B. Hypermagnesemia typically causes decreased reflexes and hypotension.
C. Hypocalcemia can cause neuromuscular irritability but is less directly associated with these symptoms in alcoholism.
D. Hypercalcemia generally causes decreased reflexes and lethargy.

A. 2 pm B. 5 am C. 10 am D. 10 pm

Correct Answer is A

Explanation

A. NPH insulin typically has an onset of 1–2 hours, peaks around 4–12 hours after administration, and lasts about 18–24 hours. Given the 7 a.m. administration, the peak effect—and thus the highest risk for hypoglycemia—would occur roughly between 11 a.m. and 7 p.m., making 2 p.m. the most likely time for hypoglycemia.
B. 5 a.m. is before the insulin peak and unlikely to cause hypoglycemia.
C. 10 a.m. is closer to the onset but may be before peak action.
D. 10 p.m. is typically after the insulin effect has declined.

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The nurse is about to administer warfarin (Coumadin). Which of the following laboratory studies would be reviewed first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who has a history of Chronic alcoholism and is experiencing increased blood pressure, hyperactive deep tendon reflexes, abdominal distention, and mood changes. Which electrolyte imbalance does the client have?

Correct Answer is A

Explanation

The nurse is caring for a client who receives an intermediate-acting insulin, Humulin N (Novolin N, Neutral Protamine Hagedorn insulin, isophane, NPH), 25 units daily at 7 a.m. When is hypoglycemia most likely to occur?

Correct Answer is A

Explanation

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