A client taking warfarin has an INR of 5.8 and reports black… | MyMerci
Adverse Effects/Contraindications/InteractionsPPT
Question
A client taking warfarin has an INR of 5.8 and reports black, tarry stools. Which action should the nurse take first?
1Hold the warfarin and notify the provider immediately.✓ Correct answer
2Give the next dose with a large meal.
3Tell the client that dark stools are expected with warfarin.
4Encourage vigorous tooth brushing to assess gum bleeding.
Explanation
An elevated INR with black, tarry stools suggests possible gastrointestinal bleeding and excessive anticoagulation. The nurse should hold warfarin according to protocol and notify the provider promptly. Continuing the dose or dismissing bleeding cues is unsafe.
In-depth explanation
Clinical Judgment Use the client cues, timing, labs, and safety risks to select the response that best fits Warfarin bleeding concern.
Memory Tip Match the strongest cue cluster to the safest nursing judgment.
KR vs US NCLEX items reward cue-based priority thinking rather than isolated recall.
Clinical scenario
Clinical Practice Guide For Warfarin bleeding concern, compare the complete cue pattern with the client's current stability, ordered data, and expected nursing scope.
Caution Do not choose an action from one isolated cue when the full scenario changes priority or safety.
Key concepts
Warfarin — An oral anticoagulant that requires monitoring of clotting effect.
INR — A laboratory measure used to monitor warfarin anticoagulation.
Melena — Black, tarry stool that can indicate gastrointestinal bleeding.