Anticoagulants prevent thrombus formation by interrupting the coagulation cascade, but their therapeutic window is narrow — the same mechanism that prevents clotting can cause life-threatening haemorrhage. Anticoagulant-related bleeding is one of the most common preventable drug errors in Canadian hospitals. Missed early bleeding signs (rising heart rate, falling urine output, subtle CNS changes) convert a minor bleed into an irreversible event. Top 3 nursing priorities: (1) Identify high-risk patients before administration — weight extremes, renal/hepatic impairment, recent surgery, concurrent NSAIDs/antiplatelets; (2) Monitor coagulation labs at appropriate intervals and hold/notify if supratherapeutic; (3) Know the specific reversal agent for each drug class before the first dose is given. Common NCLEX trap: A patient on warfarin with an INR of 3.8 (target 2–3) has no visible bleeding — the nurse gives the next dose because there are "no symptoms." The correct action is to hold the dose and notify the prescriber. Supratherapeutic anticoagulation requires intervention before hemorrhage occurs, not after. On the exam, writers often pair stable-sounding options with unstable data—notice the mismatch before you commit. If the stem names a **license...