INR Quiz: Is The Warfarin Dose Right?

1. A patient on warfarin reports increased bleeding from gums and bruising. INR is 6.2 (target 2–3). What is the first intervention?

Hold warfarin and administer vitamin K 2.5–5 mg orally

Continue warfarin and monitor closely

Administer vitamin K 10 mg IV immediately

Perform PT/INR stat and await results

2. Which patient condition may require a lower warfarin dose to achieve therapeutic INR ranges?

Fever

Liver cirrhosis

Hypothyroidism

Hypercalcemia

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4. A patient's INR is 9.0 with major bleeding (GI bleed). What is the most appropriate treatment?

Vitamin K 2.5 mg orally only

Fresh frozen plasma and vitamin K 10 mg IV

Prothrombin complex concentrate and vitamin K 10 mg IV

Vitamin K 50 mg IV stat

5. Which statement about therapeutic INR ranges is correct?

All indications require the same INR target

Atrial fibrillation and DVT both target INR 2–3

Mechanical valves require lower INR than atrial fibrillation

INR targets never change once established

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7. INR measures the effect of warfarin by evaluating which clotting factors?

Factors II, VII, and X

Factors II, V, VII, and X

Factors V, VIII, and IX

Factors VIII, IX, and X

8. A patient stabilized on warfarin with INR 2.3 suddenly has INR 1.8. Which question is most important to ask?

Have you increased vitamin K intake?

Are you taking any new medications?

Have you missed any doses?

Have you been bleeding?

Submit

10. Which herbal supplement is most likely to decrease warfarin effectiveness?

St. John's Wort

Ginkgo biloba

Garlic

Ginger

11. A patient on warfarin for atrial fibrillation has an INR of 2.5. The therapeutic INR range for this condition is 2–3. What is the appropriate nursing action?

Hold the next dose and recheck INR in 24 hours

Continue current dose and monitor INR as scheduled

Increase the dose immediately

Administer vitamin K to lower the INR

12. What does an INR of 1.0 indicate?

Therapeutic anticoagulation

Normal coagulation, no anticoagulation effect

Severe over-anticoagulation

Impending disseminated intravascular coagulation

13. A patient taking warfarin starts antibiotics. Which antibiotic class most likely increases INR?

Penicillins

Fluoroquinolones

Macrolides

Cephalosporins

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15. A patient's INR is 8.0 with minor bleeding. What medication is indicated?

Vitamin K 10 mg IV

Vitamin K 2.5 mg orally

Fresh frozen plasma

Prothrombin complex concentrate

16. Which factor most commonly causes a subtherapeutic INR (below target range)?

Increased dietary vitamin K intake

Concurrent use of NSAIDs

Liver disease

Amiodarone use

17. A patient on warfarin with an INR of 4.5 (target 2–3) is asymptomatic. What is the priority action?

Administer vitamin K and hold warfarin

Skip the next dose, recheck INR in 3–5 days

Administer fresh frozen plasma immediately

Increase warfarin dose to bring INR down faster

18. INR monitoring frequency after warfarin initiation typically follows which schedule?

Every 24 hours until stable, then weekly for 1–2 weeks, then monthly

Once weekly indefinitely

Only when bleeding occurs

Every 6 months after the first month

19. A patient's INR is 1.2 while on warfarin for DVT prophylaxis (target 2–3). What does this indicate?

The patient is over-anticoagulated

The patient is under-anticoagulated

The INR is therapeutic

The patient should stop warfarin immediately

20. Which condition typically requires a higher therapeutic INR range of 2.5–3.5?

Atrial fibrillation

Mechanical heart valve replacement

Deep vein thrombosis (first episode)

Unstable angina

INR Quiz: Is the Warfarin Dose Right?

1. A patient on warfarin reports increased bleeding from gums and bruising. INR is 6.2 (target 2–3). What is the first intervention?

2.

What first name or nickname would you like us to use?

2. Which patient condition may require a lower warfarin dose to achieve therapeutic INR ranges?

3. When a patient starting warfarin reaches therapeutic INR, heparin is typically ____.

4. A patient's INR is 9.0 with major bleeding (GI bleed). What is the most appropriate treatment?

5. Which statement about therapeutic INR ranges is correct?

6. A patient on warfarin with INR 7.5 and no bleeding is at home. The appropriate action is ____.

7. INR measures the effect of warfarin by evaluating which clotting factors?

8. A patient stabilized on warfarin with INR 2.3 suddenly has INR 1.8. Which question is most important to ask?

9. For uncomplicated DVT (first occurrence), the target therapeutic INR range is ____.

10. Which herbal supplement is most likely to decrease warfarin effectiveness?

11. A patient on warfarin for atrial fibrillation has an INR of 2.5. The therapeutic INR range for this condition is 2–3. What is the appropriate nursing action?

12. What does an INR of 1.0 indicate?

13. A patient taking warfarin starts antibiotics. Which antibiotic class most likely increases INR?

14. For mechanical heart valve replacement, the typical therapeutic INR range is ____.

15. A patient's INR is 8.0 with minor bleeding. What medication is indicated?

16. Which factor most commonly causes a subtherapeutic INR (below target range)?

17. A patient on warfarin with an INR of 4.5 (target 2–3) is asymptomatic. What is the priority action?

18. INR monitoring frequency after warfarin initiation typically follows which schedule?

19. A patient's INR is 1.2 while on warfarin for DVT prophylaxis (target 2–3). What does this indicate?

20. Which condition typically requires a higher therapeutic INR range of 2.5–3.5?