When a patient is on warfarin therapy, the prescriber monitors which of the following to determine the next appropriate dose?

aPTT.

Platelet levels.

PT/INR.

Red blood cell count.

Answer and Explanation

The Correct Answer is C

This question assesses knowledge of coagulation monitoring for vitamin K antagonists. It requires identifying the correct laboratory markers used to titrate warfarin, which is essential to achieve a therapeutic anticoagulant effect while minimizing the risk of life-threatening bleeding complications in clinical practice.

Choice A rationale

The aPTT is used to monitor the therapeutic effect of intravenous heparin therapy, which acts through the intrinsic coagulation pathway. It is not an appropriate laboratory test for monitoring the effects of warfarin, which acts on the extrinsic pathway.

Choice B rationale

While platelet levels are monitored in patients on anticoagulants to detect heparin-induced thrombocytopenia, they are not the diagnostic marker used to titrate warfarin doses. Warfarin does not significantly impact platelet counts in a way that requires dosage adjustment.

Choice C rationale

Warfarin therapy is monitored using the Prothrombin Time (PT) and the International Normalized Ratio (INR). These tests measure the time it takes for blood to clot via the extrinsic pathway, allowing for precise dosage adjustments to maintain therapeutic anticoagulation.

Choice D rationale

Red blood cell counts are used to monitor for anemia or potential hemorrhage, but they do not provide information regarding the therapeutic range of warfarin anticoagulation. They are a consequence of monitoring for safety, not a tool for medication titration.

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Correct Answer is D

Explanation

This question evaluates effective interviewing techniques during the medication reconciliation process. It requires identifying open-ended questions that encourage comprehensive patient disclosure, allowing the nurse to gather essential information regarding all prescription, over-the-counter, and herbal products currently in use by the patient.

Choice A rationale

Asking what a patient takes for pain is a closed-ended question that yields limited information only about pain management. It fails to capture data about other medications, supplements, or health practices that the patient may be utilizing for other conditions.

Choice B rationale

Asking if a patient knows the side effects of their medications is a closed-ended, leading question that results in a simple yes or no response. It does not provide the nurse with detailed information about the patient's current medication use.

Choice C rationale

Asking why medications are taken at night assumes the patient takes them at night. This is a restrictive, leading question that fails to elicit a complete, patient-centered history regarding the full range of medications taken throughout the entire day.

Choice D rationale

Asking the patient to describe their medications is an open-ended question that encourages the patient to share detailed information in their own words. This approach fosters a comprehensive assessment, ensuring all medications, including OTC and herbal supplements, are reported.

A. The patient weighs 4.54 kg. B. The physician's order is 125 mg of cefaclor per day. C. The physician's order is safe based on the recommended dosages. D. The physician's order is not safe based on the recommended dosages.

Correct Answer is C

Explanation

Step 1 is calculate the total daily dose ordered: 75 mg × 3 doses/day = 225 mg/day.

Step 2 is calculate the minimum recommended daily dose: 10 kg × 20 mg/kg/day = 200 mg/day.

Step 3 is calculate the maximum recommended daily dose: 10 kg × 40 mg/kg/day = 400 mg/day.

Step 4 is compare the ordered dose (225 mg/day) to the range (200-400 mg/day).

Step 5 is 200 mg < 225 mg < 400 mg. Final calculated answer is Choice C.

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When a patient is on warfarin therapy, the prescriber monitors which of the following to determine the next appropriate dose?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When a nurse compiles a patient's medication history, which query will obtain the most information from the patient about their medication use?

Correct Answer is D

Explanation

Order: cefaclor 75 mg PO qhrs Available: cefaclor 125 mg/5 mL Child weighs: 10 kg Recommended child's drug dosage: 20-40 mg/kg/day Which of the following is true based on the provided information above?

Correct Answer is C

Explanation

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