A nurse is interviewing a preoperative patient scheduled for a total hip replacement. Which of the following failings would require the nurse to collaborate with the surgeon immediately before sending the patient to the operating room?

The client took warfarin 2.5 mg with a sip of water at 6 a.m.

The client took metoprolol 25 mg with a sip of water at 6 a.m.

The client took phenytoin 100 mg with a sip of water at 6 a.m.

The client took half their morning dose of insulin at 6 a.m.