The client on warfarin has an INR of 4.5. What is the most appropriate action by the nurse?

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Question 1 of 5

The client on warfarin has an INR of 4.5. What is the most appropriate action by the nurse?

Correct Answer: A

Rationale: The correct answer is A: Administer vitamin K. When a client on warfarin has an INR of 4.5, it indicates over-anticoagulation, putting them at risk of bleeding. Vitamin K helps reverse the effects of warfarin by promoting clotting factors. Administering vitamin K will lower the INR back into the therapeutic range. Holding the next dose of warfarin (B) is not enough to rapidly reverse the effects. Increasing the dose of warfarin (C) would worsen the over-anticoagulation. Monitoring the INR closely (D) is important but not the immediate action needed for a high INR.

Question 2 of 5

While completing a nursing admission history, you obtain this information about the patient's cardiovascular risk factors: patient's mother and two siblings have had myocardial infarctions. Patient smokes and has a 20 pack/year history of cigarette use. Her work as a mail carrier involves a lot of walking. She takes metoprolol (Lopressor) for hypertension and her blood pressure has been in the range of 130/60 to 140/85. Which interventions will be most important to include in the discharge plan? (Choose all that apply.)

Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Question 3 of 5

You have just received change-of-shift report about these patients on the coronary step down unit. Which one will you assess first?

Correct Answer: B

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Question 4 of 5

Which of the following veins is the largest and carries back deoxygenated blood from the tissues in the lower extremities and enters the heart proximally?

Correct Answer: B

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Question 5 of 5

Which of the following are the reasons a nurse discourages the consumption of alcohol for a client with mitral valve prolapse?

Correct Answer: D

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

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