The nurse is providing discharge instructions to a 76-year-old male client with chronic atrial fibrillation who has a CHA2DS2-VASC score of 2. Which medication would the nurse identify as most likely to be prescribed for the client?

Propranolol

Procainamide

Aspirin

Warfarin

Answer and Explanation

The Correct Answer is D

A. Propranolol: This is a beta-blocker, which may be used to control heart rate, but it does not address the risk of thromboembolism in atrial fibrillation.

B. Procainamide: This is an antiarrhythmic used for rhythm control, but it does not address stroke prevention in atrial fibrillation.

C. Aspirin: Although aspirin is sometimes used for stroke prevention, it is generally less effective than anticoagulation therapy in clients with higher CHA2DS2-VASC scores.

D. Warfarin: A CHA2DS2-VASC score of 2 indicates a moderate risk for stroke, and warfarin (or another anticoagulant) is indicated to reduce the risk of thromboembolic events.

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Correct Answer is D

Explanation

A. Pacemaker: Pacemakers are used for bradyarrhythmias or heart block, not typically for atrial flutter.

B. Cardiac catheterization: This is used for diagnostic or interventional procedures, not for rhythm correction.

C. Pulmonary artery pressure monitoring: This is a monitoring tool for critically ill clients with heart failure or pulmonary hypertension, not a treatment for atrial flutter.

D. Cardioversion: Cardioversion is often used for atrial flutter when drug therapy fails. It delivers synchronized electrical energy to restore normal sinus rhythm.

A. Hold the medication and notify the HCP B. Administer the medication as ordered. C. Prepare to administer vitamin K (AquaMephyton). D. Assess the client for abnormal bleeding. E. Fat embolism

Correct Answer is B

Explanation

A. Hold the medication and notify the HCP: This is unnecessary. An INR of 2.7 is within the therapeutic range for a client with a mechanical valve replacement (2.5 to 3.5). No intervention is required.

B. Administer the medication as ordered: The INR of 2.7 is within the desired therapeutic range for clients on warfarin with mechanical valve replacements, so the nurse should proceed with the prescribed dose.

C. Prepare to administer vitamin K (AquaMephyton): Vitamin K is used to reverse the effects of warfarin if the INR is too high (usually greater than 5).

D. Assess the client for abnormal bleeding: While important, this is not the first action. The INR is within the therapeutic range, so the priority is to administer the medication.

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The nurse is providing discharge instructions to a 76-year-old male client with chronic atrial fibrillation who has a CHA2DS2-VASC score of 2. Which medication would the nurse identify as most likely to be prescribed for the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with new-onset atrial flutter is unresponsive to drug therapy and is scheduled to receive further treatment. Which intervention should the nurse prepare the client to receive?

Correct Answer is D

Explanation

A nurse is preparing to administer warfarin to a client with a mechanical valve replacement. The client's INR is 2.7. Which action should the nurse implement?

Correct Answer is B

Explanation

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