The nurse is caring for a client with a suspected pulmonary embolism. Which diagnostic test should the nurse anticipate?

Choice A reason: Topical corticosteroids reduce inflammation, scaling, and itching in psoriasis by inhibiting pro-inflammatory cytokines and immune responses in affected skin. They are first-line for plaque psoriasis with silvery scales, effectively managing burning and promoting healing of inflamed, bleeding areas on elbows and palms.

Choice B reason: Topical analgesics relieve pain but do not address psoriasis’s underlying inflammation or scaling. Psoriatic plaques are primarily inflammatory, not neuropathic. Analgesics may reduce burning temporarily but lack the anti-inflammatory action of corticosteroids, making them ineffective for managing chronic psoriatic lesions.

Choice C reason: Topical antibiotics treat bacterial infections, not psoriasis, which is an autoimmune inflammatory condition. Bleeding in psoriasis results from skin fragility, not infection. Antibiotics are unnecessary unless secondary infection is confirmed, making them inappropriate compared to corticosteroids, which target the disease’s inflammatory pathology.

Choice D reason: Colloidal oatmeal-based lotion soothes irritated skin and reduces itching but lacks anti-inflammatory properties to treat psoriasis’s scaling and inflammation. It may provide symptomatic relief but is inadequate for managing chronic plaques, unlike corticosteroids, which directly address the autoimmune-driven inflammation and scaling.

Choice A reason: Platelet count assesses bleeding risk but does not measure warfarin’s anticoagulant effect. Warfarin inhibits clotting factors, monitored by INR. Platelet counts are relevant for antiplatelet drugs, not anticoagulants, making INR the priority for evaluating warfarin efficacy in atrial fibrillation.

Choice B reason: INR measures warfarin’s anticoagulant effect by assessing prothrombin time, reflecting vitamin K-dependent clotting factor inhibition. In atrial fibrillation, therapeutic INR (2.0–3.0) prevents thromboembolism. Monitoring INR ensures effective anticoagulation, making it the critical lab value for warfarin therapy management.

Choice C reason: Hemoglobin level detects bleeding, a warfarin side effect, but does not assess its therapeutic effect. INR directly evaluates anticoagulation, ensuring stroke prevention in atrial fibrillation. Hemoglobin is secondary, monitored for complications, not efficacy, making INR the priority lab value.

Choice D reason: Serum potassium is unrelated to warfarin’s anticoagulant action. Electrolyte imbalances may affect cardiac rhythm in atrial fibrillation, but INR measures warfarin’s effect on clotting factors, ensuring therapeutic anticoagulation, making it the essential value to monitor for medication efficacy.