Level: Clinical
Difficulty: Medium
Subtopic: Anticoagulants
NCLEX: A 45-year-old client in the emergency department is being evaluated for warfarin anticoagulation. Assessment data…
Pharmacology Pharmacological and Parenteral Therapies
Case Study
A 45-year-old client in the emergency department is being evaluated for warfarin anticoagulation. Assessment data include the client reports dizziness, blood pressure 92/58 mm Hg, and heart rate 118/min after the morning dose. Which action is appropriate within the RN scope of practice?
Question
A. Assess, analyze cues, implement nursing interventions per orders, teach, evaluate outcomes, and question unsafe orders.
B. Independently diagnose the medical disease and prescribe treatment.
C. Prescribe new medications without a provider order.
D. Delegate nursing assessment and evaluation on an unstable client.
B. Independently diagnose the medical disease and prescribe treatment.
C. Prescribe new medications without a provider order.
D. Delegate nursing assessment and evaluation on an unstable client.
Rationale
Correct answer: A. Assess, analyze cues, implement nursing interventions per orders, teach, evaluate outcomes, and question unsafe orders.
Rationale: RNs assess, coordinate care, teach, and evaluate. Diagnosis and prescribing are provider responsibilities.
Hint: Apply ABCs, client stability, and NCSBN clinical judgment steps before choosing an intervention.
Rationale: RNs assess, coordinate care, teach, and evaluate. Diagnosis and prescribing are provider responsibilities.
Hint: Apply ABCs, client stability, and NCSBN clinical judgment steps before choosing an intervention.