The nurse is caring for a client with atrial fibrillation who receives a prescription for warfarin. The international normalized ratio (INR) is 2.8. Which action should the nurse take?

Obtain another blood sample.

Give the next scheduled dose.

Monitor for signs of bleeding.

Notify the healthcare provider.

Answer and Explanation

The Correct Answer is C

A. An INR of 2.8 is within the therapeutic range for clients on warfarin, so obtaining another blood sample is not necessary.
B. An INR of 2.8 indicates that the client is within the therapeutic range, so it is appropriate to give the next scheduled dose. However, monitoring for potential bleeding complications is a higher priority.
C. Monitoring for signs of bleeding is crucial because, while an INR of 2.8 is within the therapeutic range, it is still important to watch for any bleeding complications as part of routine care.
D. Notifying the healthcare provider is not immediately necessary unless there are signs of bleeding or other concerns, as an INR of 2.8 is typically within the acceptable range for therapeutic anticoagulation.

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Correct Answer is C

Explanation

A. Insulin glargine is a long-acting insulin and is not adjusted based on before meal blood sugar readings; it's typically administered once daily at the same time each day.
B. Adjusting medication dosage for ketoacidosis is not appropriate; insulin glargine is used for baseline blood glucose control, and ketoacidosis requires specific management.
C. Insulin glargine is administered subcutaneously and requires teaching on proper self-injection techniques.
D. Insulin glargine is used for long-term glucose control, not for managing acute severe hypoglycemia, so teaching family injection for hypoglycemia is not relevant here.

A. Observe bowel movement pattern and take a stool softener. B. Watch for signs of agitation and record any insomnia. C. Take the benzodiazepine at the same time as taking the morphine. D. Do not drink grapefruit juice after taking morphine.

Correct Answer is A

Explanation

A. Morphine often causes constipation, so monitoring bowel movements and using a stool softener is an appropriate and necessary part of managing this side effect.
B. While agitation and insomnia might be side effects of morphine, they are not the most critical concerns related to its use.
C. Taking a benzodiazepine with morphine can increase the risk of severe side effects like respiratory depression and should generally be avoided unless specifically prescribed by the healthcare provider.
D. Grapefruit juice is not known to interact significantly with morphine, so this instruction is not relevant.

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The nurse is caring for a client with atrial fibrillation who receives a prescription for warfarin. The international normalized ratio (INR) is 2.8. Which action should the nurse take?

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Naxlex Comprehensive Predictor Exams

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