a nurse is reviewing the laboratory results of a client who is taking warfarin for atrial fibrillation which of the following findings should the nurs

ATI RN

Proctored Pharmacology ATI

1. A healthcare professional is reviewing the laboratory results of a client taking Warfarin for atrial fibrillation. Which of the following findings should the professional report to the provider immediately?

A. INR of 4.0
B. Potassium level of 4.5 mEq/L
C. Creatinine level of 1.0 mg/dL
D. BUN of 18 mg/dL

Correct answer: A

Rationale: An INR of 4.0 indicates that the client's blood is clotting too slowly, increasing the risk of bleeding. This level is above the therapeutic range for a client on Warfarin therapy. Therefore, the healthcare professional should notify the provider immediately to prevent potential bleeding complications. The other laboratory values are within normal limits and do not pose an immediate risk to the client's health while on Warfarin therapy.

2. A client with angina asks about obtaining a prescription for sildenafil to treat erectile dysfunction. Which of the following medications is contraindicated with Sildenafil?

A. Aspirin
B. Isosorbide
C. Clopidogrel
D. Atorvastatin

Correct answer: B

Rationale: Isosorbide is an organic nitrate used to manage angina. Concurrent use of sildenafil with organic nitrates, like isosorbide, is contraindicated due to the risk of fatal hypotension. It is essential for clients to avoid taking nitrate medications within 24 hours of using isosorbide to prevent serious complications.

3. A healthcare professional is preparing to administer Spironolactone to a client. Which of the following laboratory results should the professional review before administering this medication?

A. Serum potassium.
B. Serum sodium.
C. Serum chloride.
D. Serum calcium.

Correct answer: A

Rationale: When administering Spironolactone, it is essential to monitor the client's serum potassium levels because Spironolactone is a potassium-sparing diuretic. Monitoring potassium levels helps to detect hyperkalemia, a potential adverse effect of the medication.

4. Which of the following is a potassium-sparing diuretic?

A. Furosemide
B. Spironolactone
C. Hydrochlorothiazide
D. Bumetanide

Correct answer: B

Rationale: Spironolactone is classified as a potassium-sparing diuretic. It works by antagonizing the aldosterone receptor, leading to potassium retention and sodium excretion. This mechanism makes it a suitable choice for conditions where potassium retention is desired, such as in patients with heart failure or liver cirrhosis. Choices A, C, and D are not potassium-sparing diuretics. Furosemide, hydrochlorothiazide, and bumetanide are loop diuretics and thiazide diuretics, respectively, which promote the excretion of potassium.

5. Why has an ACE inhibitor been prescribed following an MI?

A. “This medication will lower your potassium level.”
B. “ACE inhibitors have been found to reduce mortality following MI.”
C. “ACE inhibitors are always prescribed with a beta blocker and calcium channel blocker following an MI.”
D. “This medication will treat your hypotension.”

Correct answer: B

Rationale: Following a myocardial infarction (MI), ACE inhibitors are commonly prescribed due to their proven benefit in reducing mortality and improving outcomes post-MI. These medications help by decreasing the workload of the heart, preventing remodeling of the heart chambers, and improving survival rates. While ACE inhibitors may have effects on potassium levels, the primary reason for their prescription post-MI is their mortality-reducing properties.