NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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What should be done if a patient's INR is still elevated 1-2 days before surgery?

  1. Proceed with surgery as planned

  2. Cancel the surgery

  3. Administer a high dose of Vitamin K

  4. Give low-dose Vitamin K (1-2 mg)

The correct answer is: Give low-dose Vitamin K (1-2 mg)

It is important to give low-dose Vitamin K (1-2 mg) to the patient if their INR is still elevated 1-2 days before surgery. This is because giving a high dose of Vitamin K (choice C) can lead to a rapid and unpredictable decrease in the patient's INR, putting them at risk for bleeding during surgery. Proceeding with surgery as planned (choice A) may also increase the risk of excessive bleeding, while canceling the surgery (choice B) may not be necessary if the patient's INR can be managed with low-dose Vitamin K. Therefore, option D is the most appropriate course of action in this situation.

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