Progressive Care Nursing Certification (PCCN) Practice Exam

What action should be taken if a patient's INR is 6.0 while on warfarin?

1. Administer vitamin A

2. Provide additional anticoagulants

3. Administer vitamin K

4. Re-evaluate the anticoagulation therapy

The correct answer is: Administer vitamin K

When a patient's INR (International Normalized Ratio) is 6.0 while on warfarin, it indicates a significantly elevated risk of bleeding due to increased anticoagulation. The normal therapeutic range for most conditions treated with warfarin is usually between 2.0 and 3.0. An INR of 6.0 exceeds this range and requires prompt intervention to reverse the effects of warfarin. Administering vitamin K is the appropriate action in this situation because it serves as an antidote to warfarin. Vitamin K facilitates the synthesis of clotting factors that warfarin interferes with, effectively helping to restore the balance of coagulation in the body and decrease the INR to a safer level. This intervention is critical to mitigate the bleeding risk associated with such an elevated INR. Addressing other alternatives: Administering vitamin A does not have a role in reversing warfarin’s anticoagulant effects. Providing additional anticoagulants would exacerbate the risk of bleeding rather than prevent it. Re-evaluating the anticoagulation therapy is important but should follow the immediate action of reversing the warfarin effect, which is best accomplished through vitamin K administration in this case.