the client on warfarin has an inr of 12 what is the nurses priority action the client on warfarin has an inr of 12 what is the nurses priority action
Logo

Nursing Elites

ATI RN

Cardiovascular System Exam Questions And Answers

1. The client on warfarin has an INR of 1.2. What is the nurse’s priority action?

Correct answer: A

Rationale: The correct answer is to increase the dose of warfarin. An INR of 1.2 is below the therapeutic range for a client on warfarin, indicating that the dose is subtherapeutic. The priority action in this situation is to adjust the dose to achieve the target therapeutic INR range (usually 2-3) to prevent thromboembolic events. Administering vitamin K is not necessary as the INR is low, and there are no signs of bleeding. Monitoring for signs of bleeding is important but not the priority in this case since the INR is subtherapeutic. Holding the next dose and notifying the healthcare provider would delay the intervention needed to adjust the dose and achieve the therapeutic range.

2. A nurse is providing teaching about food allergies to the parents of a toddler. Which of the following foods should the nurse identify as highest risk for allergies in toddlers?

Correct answer: A

Rationale: Eggs are one of the most common food allergens in toddlers and should be introduced carefully.

3. A nurse is reviewing a client's medication regimen. Which of the following medications places the client at increased risk for digoxin toxicity?

Correct answer: D

Rationale: The correct answer is D, Loop diuretics. Loop diuretics can lead to hypokalemia, which increases the risk for digoxin toxicity. Loop diuretics cause potassium loss, and hypokalemia can potentiate the toxic effects of digoxin. Choices A, B, and C are incorrect because calcium channel blockers, potassium-sparing diuretics, and beta blockers do not directly increase the risk of digoxin toxicity.

4. A nurse is assessing a client who has left-sided heart failure. Which of the following findings should the nurse expect?

Correct answer: C

Rationale: The correct answer is C: Jugular vein distention. In left-sided heart failure, the left ventricle fails to efficiently pump blood to the body, causing increased pressure in the pulmonary circulation. This increased pressure can lead to symptoms like jugular vein distention, as blood backs up in the pulmonary circulation and causes congestion. Choices A, B, and D are incorrect: Peripheral edema is more commonly associated with right-sided heart failure, cough with frothy sputum is a sign of pulmonary edema which can occur in left-sided heart failure but is not as specific as jugular vein distention, and dependent edema is also more indicative of right-sided heart failure due to fluid retention and increased venous pressure in the systemic circulation.

5. What is required for effective hand washing?

Correct answer: A

Rationale: To effectively wash hands, soap or detergent is essential as they help emulsify fats and oils, allowing them to be rinsed away. Hot water alone cannot effectively destroy bacteria, and a disinfectant is not typically required for routine hand washing.

Similar Questions

A nurse is caring for a 30-month-old toddler and is preparing a nutritional snack. Which of the following foods is appropriate for the nurse to offer the toddler?
A healthcare provider is caring for an adolescent who has sickle-cell anemia. Which of the following manifestations indicates acute chest syndrome and should be immediately reported to the provider?
When teaching a client with schizophrenia strategies to cope with anticholinergic effects of Fluphenazine, which of the following should the nurse suggest to minimize anticholinergic effects?
What is the combat health support system in the field designed to do?
What is the common denominator of all forms of heart failure?

Access More Features

ATI Basic

  • 50,000 Questions with answers
  • All ATI courses Coverage
    • 30 days access @ $69.99

ATI Basic

  • 50,000 Questions with answers
  • All ATI courses Coverage
    • 90 days access @ $149.99