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Question 1

A patient is prescribed warfarin. Which laboratory value is the PRIMARY indicator used to monitor therapeutic dosing?

Accepted Answer

International Normalized Ratio (INR)

Answer

The INR is the standardized test used to monitor warfarin anticoagulation therapy, with a target range of 2.0–3.0 for most indications.

Question 2

Which statement about enteric-coated medications is correct?

Accepted Answer

They must be swallowed whole to protect the stomach lining

Answer

Enteric-coated medications must be swallowed whole because crushing destroys the coating designed to prevent gastric irritation and ensure intestinal absorption.

Question 3

A nurse is administering IV potassium chloride. Which action is essential for patient safety?

Accepted Answer

Infuse no faster than 10 mEq/hr via peripheral IV

Answer

IV potassium must never be given by IV push; the maximum safe infusion rate via peripheral IV is 10 mEq/hr to prevent fatal cardiac dysrhythmias.

Question 4

Which medication requires the nurse to assess the apical pulse for one full minute BEFORE administration?

Accepted Answer

Digoxin

Answer

Digoxin is withheld and the prescriber notified if the apical pulse is below 60 bpm, as digoxin further slows heart rate and can cause toxicity.

Question 5

A patient taking lithium reports nausea, tremors, and confusion. The nurse should first:

Accepted Answer

Check the serum lithium level and notify the prescriber

Answer

Nausea, tremors, and confusion are signs of lithium toxicity; the serum lithium level must be checked immediately and the prescriber notified because the therapeutic window is very narrow.

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