A client with a history of deep vein thrombosis (DVT) is receiving warfarin (Coumadin). Which laboratory value indicates a therapeutic effect of the medication?

Correct Answer: A

Rationale: The correct answer is A: INR of 2.5. INR (International Normalized Ratio) is used to monitor the effectiveness of warfarin therapy. A target INR range for DVT treatment is typically 2.0-3.0. An INR of 2.5 indicates that the client's blood is clotting within the desired therapeutic range, preventing excessive clotting while avoiding excessive bleeding. B: PTT measures the effectiveness of heparin, not warfarin. C: Hemoglobin level and D: Platelet count are not specific indicators of warfarin's therapeutic effect on clotting factors. In summary, the correct answer A is the most relevant laboratory value for monitoring the therapeutic effect of warfarin in a client with DVT.

Correct Answer: B

Rationale: The correct answer is B: Notify the healthcare provider immediately. A CVP of 15 mm Hg in a client with sepsis may indicate fluid overload or cardiac dysfunction, which require prompt medical intervention. Notifying the healthcare provider allows for timely assessment and appropriate management. Administering a fluid bolus (A) without further evaluation can exacerbate fluid overload. Administering a diuretic (C) without knowing the underlying cause can be harmful. Continuing to monitor the CVP (D) is important, but immediate action is required due to the high CVP level.

Correct Answer: C

Rationale: The correct answer is C: Methotrexate (Rheumatrex). Methotrexate is a disease-modifying antirheumatic drug commonly prescribed for managing rheumatoid arthritis. It helps reduce inflammation and pain by targeting the immune system's overactivity. Acetaminophen (A) is a mild pain reliever and does not treat the underlying inflammation in rheumatoid arthritis. Ibuprofen (B) is a nonsteroidal anti-inflammatory drug (NSAID) that can help with pain and inflammation but is not as effective in managing rheumatoid arthritis as methotrexate. Prednisone (D) is a corticosteroid that can provide quick relief from inflammation and pain, but it is typically used for short-term management due to its potential side effects.

Correct Answer: B

Rationale: The correct answer is B: The client would not be able to prove malpractice in court. In this scenario, although the nurse made an error in administering a higher dose of morphine, the client's condition improved, as evidenced by stable vital signs and pain relief. Therefore, there was no harm caused to the client due to the mistake. In malpractice cases, the client needs to prove that harm or injury resulted from the healthcare provider's actions. Since the client's condition improved, it would be difficult to establish malpractice in this situation. Choice A is incorrect because negligence requires harm or injury to occur, which is not the case here. Choice C is incorrect as the Good Samaritan Act typically applies to individuals providing emergency care in good faith at the scene of an emergency, not within a healthcare setting. Choice D is incorrect as the focus is on the nurse's error in administering the incorrect dose, not on the healthcare provider's responsibility in this context.

Correct Answer: B

Rationale: The correct answer is B: Denies having coughing spells. Benzonatate is an antitussive medication that suppresses cough reflex. If the client denies having coughing spells, it indicates that the medication is effectively suppressing the cough. This is the most direct indicator of the medication's effectiveness. A: Reports reduced nasal discharge - This is not directly related to the effectiveness of benzonatate in suppressing cough. C: Able to sleep through the night - While improved sleep may result from reduced coughing, it is not as specific an indicator of antitussive effectiveness as denying coughing spells. D: Expectorating bronchial secretions - This indicates productive coughing, which is not the intended effect of benzonatate.