A client taking warfarin has an INR of 5.8 and reports black… | MyMerci
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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
2Tell the client that dark stools are expected with warfarin.
3Encourage a vitamin K-rich meal and arrange to recheck the INR next week.
4Give the next dose with a large meal.
Explanation
An INR of 5.8 with black, tarry stools suggests excessive anticoagulation and possible gastrointestinal bleeding. The nurse should hold warfarin according to protocol and notify the provider immediately (option 1) so the client can be evaluated and reversal therapy ordered when indicated. Black stools are not an expected effect. Dietary vitamin K is not a substitute for urgent evaluation, and giving another warfarin dose can worsen bleeding.
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.