A nurse is teaching a client who has diabetes mellitus about how to prevent hypoglycemia when taking insulin. Which of the following statements by the client indicates an understanding of the teaching?

A) This is correct as the INR level measures how long it takes for blood to clot and is used to monitor the effectiveness and safety of warfarin therapy. A high INR level indicates a higher risk of bleeding.

B) This is correct as some herbal supplements, such as garlic, ginger, ginkgo, and ginseng, can interact with warfarin and increase the risk of bleeding.

C) This is incorrect as vitamin K-rich foods, such as green leafy vegetables, can interfere with warfarin and decrease its effectiveness, leading to a lower risk of bleeding. However, clients taking warfarin should maintain a consistent intake of vitamin K-rich foods and avoid sudden changes in their diet.

D) This is correct as peptic ulcer disease is a condition that causes erosion and inflammation of the lining of the stomach or duodenum and can lead to bleeding complications, especially when taking warfarin.

E) This is incorrect as blood pressure does not directly affect the risk of bleeding from warfarin therapy. However, clients taking warfarin should monitor their blood pressure regularly and report any signs of hypertension or hypotension to their provider.

B) This is correct as mixing medications with food or liquids that are easy to swallow can help to prevent choking and aspiration and improve compliance. However, some medications may interact with certain foods or liquids, so the nurse should check with the pharmacist before mixing them.

C) This is correct as giving one medication at a time and allowing time for swallowing can help to prevent choking and aspiration and ensure that each medication is taken correctly. The nurse should also monitor the client for signs of difficulty swallowing, such as coughing, gagging, drooling, or regurgitation.

E) This is correct as assessing the client's mouth for pocketing of medications can help to prevent medication errors and ensure that each medication is taken correctly. Pocketing of medications occurs when the client holds medications in their cheeks or under their tongue instead of swallowing them. This can lead to ineffective therapy, toxicity, or adverse effects.

A) This is incorrect as crushing or dissolving tablets and capsules before giving them to the client can alter their effectiveness, absorption, or bioavailability and cause medication errors or adverse effects. Some tablets and capsules are designed to be swallowed whole, such as enteric-coated, extended-release, or sublingual formulations. The nurse should check with the pharmacist before crushing or dissolving any tablets or capsules.

D) This is incorrect as encouraging the client to drink water before and after taking medications can help to prevent choking and aspiration and ensure adequate hydration, but it may not be appropriate for some clients who have dysphagia or who are on fluid restrictions. The nurse should assess the client's ability to drink water safely and follow their individualized plan of care.