The practical nurse (PN) learns in the change-of-shift report that the prothrombin time (PT) and International Normalized Ratio (INR) values are prolonged for a client who is receiving warfarin. The PN should review which additional laboratory test result for the client?
Protein.
Potassium.
Hemoglobin.
White blood cell count.
The Correct Answer is C
A. Protein: Although low protein levels can influence drug binding and metabolism, they are not directly related to the anticoagulant effects or bleeding risks associated with prolonged PT/INR values. Protein monitoring is not the priority in this context.
B. Potassium: Potassium levels reflect electrolyte balance and cardiac function but are not affected by warfarin therapy. Abnormal potassium results would not explain or correlate with prolonged clotting times.
C. Hemoglobin: Prolonged PT and INR increase the risk of bleeding, which can lead to anemia. Reviewing hemoglobin levels helps determine whether the client has experienced occult or active blood loss as a result of excessive anticoagulation.
D. White blood cell count: WBC count reflects immune system activity and infection status, not coagulation function. It provides no direct information about bleeding risk or the effects of warfarin therapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Report the liquid stool to the healthcare provider: While unusual or severe diarrhea may require notification, mild watery stools are an expected effect of sodium polystyrene sulfonate as it promotes potassium excretion. Immediate reporting is not necessary unless dehydration or electrolyte imbalance occurs.
B. Withhold the medication until the diarrhea stops: Holding the medication is not indicated for mild, expected watery stools. Interrupting therapy could delay potassium removal and compromise the client’s treatment plan.
C. Recommend that the client increase fiber in the diet: Increasing dietary fiber does not counteract the expected laxative effect of sodium polystyrene sulfonate and may not be appropriate for all clients, particularly those on restricted diets or with other comorbidities.
D. Explain that this is a desired effect of the medication: Sodium polystyrene sulfonate works by exchanging sodium for potassium in the intestines, resulting in softer or watery stools. Educating the client about this expected outcome helps reduce anxiety and supports adherence to therapy.
Correct Answer is C
Explanation
A. 152: A fetal heart rate (FHR) of 152 beats per minute is within the normal range for a third-trimester fetus (110–160 bpm) and does not require immediate intervention.
B. 118: A FHR of 118 bpm is slightly on the lower end of the normal range but still considered acceptable for a healthy fetus, though monitoring may continue.
C. 180: A FHR of 180 bpm exceeds the normal range and may indicate fetal tachycardia, which can result from maternal fever, infection, hypoxia, or fetal distress. This requires immediate reporting to the RN for assessment and potential intervention.
D. 136: A FHR of 136 bpm falls within the normal range and does not necessitate urgent reporting, though routine monitoring should continue.
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