the client on warfarin has an inr of 38 what is the most appropriate action by the nurse

ATI RN

Cardiovascular System Practice Exam

1. The client on warfarin has an INR of 3.8. What is the most appropriate action by the nurse?

A. Administer vitamin K.
B. Hold the next dose of warfarin.
C. Increase the dose of warfarin.
D. Notify the healthcare provider immediately.

Correct answer: A

Rationale: An INR of 3.8 is elevated, indicating an increased risk of bleeding. Administering vitamin K can help reverse the effects of warfarin. Holding the next dose of warfarin would be appropriate if the INR was too high, but not as the first-line action. Increasing the dose of warfarin would worsen the situation by further increasing the INR. Notifying the healthcare provider is important, but immediate action to address the elevated INR is necessary.

2. The client on furosemide is at risk for which electrolyte imbalance?

A. Hypokalemia
B. Hypernatremia
C. Hyperkalemia
D. Hyponatremia

Correct answer: A

Rationale: The correct answer is A: Hypokalemia. Furosemide is a loop diuretic that can lead to potassium loss, resulting in hypokalemia. This electrolyte imbalance is a significant risk associated with the use of diuretics. Choice B, Hypernatremia, is incorrect as furosemide is not known to cause high sodium levels. Choice C, Hyperkalemia, is also incorrect as furosemide tends to cause potassium depletion rather than excess. Choice D, Hyponatremia, is not directly related to furosemide use.

3. What type of medication is used to reduce inflammation in the airways and prevent asthma attacks?

A. Corticosteroid
B. Bronchodilator
C. Antihistamine
D. Mucolytic

Correct answer: A

Rationale: The correct answer is A, Corticosteroid. Corticosteroids are medications that work by reducing inflammation in the airways, helping to prevent asthma attacks and manage chronic respiratory conditions. Bronchodilators (choice B) work by relaxing the muscles around the airways to make breathing easier, but they do not primarily target inflammation. Antihistamines (choice C) are used to treat allergic reactions and do not directly target airway inflammation. Mucolytics (choice D) help to break down and thin mucus in the airways but do not reduce inflammation.

4. The client is on dobutamine. Adverse effects of Dobutrex (dobutamine) include the following: Select all that apply.

A. Heart failure
B. Bradycardia
C. Tachycardia
D. Respiratory distress

Correct answer: C

Rationale: The correct answer is C: Tachycardia. Dobutamine is a medication that primarily increases heart rate (tachycardia) and blood pressure. Therefore, the adverse effects of dobutamine include tachycardia. Choices A, B, and D are incorrect. Heart failure is not an adverse effect of dobutamine; in fact, it is used to treat heart failure by increasing heart contractility. Bradycardia (slow heart rate) is not an expected adverse effect of dobutamine, as it usually increases heart rate. Respiratory distress is not a common adverse effect of dobutamine.

5. What is the primary effect of a calcium channel blocker on the heart?

A. Decreases heart rate
B. Increases heart rate
C. Increases blood pressure
D. Decreases blood pressure

Correct answer: D

Rationale: The correct answer is D: Decreases blood pressure. Calcium channel blockers primarily work by relaxing blood vessels, leading to a decrease in blood pressure. While these medications can have secondary effects on the heart, such as reducing the workload of the heart muscle, the primary effect related to blood pressure regulation. Therefore, choices A, B, and C are incorrect as they do not reflect the primary action of calcium channel blockers on the heart.