Certified Hospice and Palliative Assistant (CHPNA) Practice Test

What challenge does warfarin present for debilitated patients?

1. Easy management of dosage

2. Requires frequent venipunctures for monitoring

3. Effective for all types of patients

4. Minimal interaction with other medications

The correct answer is: Requires frequent venipunctures for monitoring

Warfarin is an anticoagulant (blood thinner) that requires careful monitoring to ensure the patient remains within a therapeutic range, which is crucial to prevent either thromboembolism or excessive bleeding. This monitoring is typically done through a blood test that checks the International Normalized Ratio (INR), which assesses how well warfarin is working and how quickly the blood clots. Debilitated patients may struggle with the frequent venipunctures necessary for regular INR monitoring due to factors such as impaired immune response, fragile veins, or overall decreased physical health, making the process challenging and potentially uncomfortable. Regular monitoring can also be logistically difficult for patients who may have mobility issues or need assistance getting to a lab or healthcare facility. In contrast, the other options do not accurately reflect the challenges associated with the management of warfarin in debilitated patients. The management of its dosage is not simple due to the need for individual adjustments based on INR results. Warfarin is not uniformly effective for all types of patients; its efficacy can vary based on multiple factors, including other health conditions and medications. Additionally, warfarin has significant interactions with many other medications and dietary substances, requiring careful consideration in a patient’s treatment plan.