A nurse is reviewing the medication list of a client who is prescribed dabigatran and has a history of peptic ulcer disease. The nurse should recognize that which of the following medications can increase the risk of bleeding in this client?
Omeprazole
Ranitidine
Sucralfate
Misoprostol.
The Correct Answer is A
Omeprazole is a proton pump inhibitor (PPI) that reduces the production of stomach acid.
Dabigatran is an anticoagulant that prevents blood clots from forming.
Both drugs can increase the risk of bleeding in the gastrointestinal tract, especially in clients with peptic ulcer disease. Therefore, they should not be used together unless absolutely necessary.
Choice B. Ranitidine is wrong because ranitidine is a histamine-2 receptor antagonist (H2RA) that also reduces the production of stomach acid, but to a lesser extent than PPIs. Ranitidine does not interact significantly with dabigatran and does not increase the risk of bleeding.
Choice C. Sucralfate is wrong because sucralfate is a mucosal protectant that forms a barrier over ulcers and protects them from acid and enzymes. Sucralfate does not affect the coagulation system and does not increase the risk of bleeding.
Choice D. Misoprostol is wrong because misoprostol is a synthetic prostaglandin that inhibits gastric acid secretion and increases bicarbonate and mucus production.
Misoprostol is used to prevent ulcers in clients who take NSAIDs, which can cause ulcers and bleeding.
Misoprostol does not interact with dabigatran and does not increase the risk of bleeding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
This statement indicates that the patient understands that rivaroxaban (Xarelto) is an anticoagulant that can increase the risk of bleeding and bruising.The patient should avoid activities that may cause injury, such as contact sports, sharp objects, or falls.
Choice A is wrong because aspirin is also an antiplatelet drug that can further increase the risk of bleeding when taken with rivaroxaban.The patient should not take aspirin or any other nonsteroidal anti-inflammatory drugs (NSAIDs) without consulting the prescriber.
Choice C is wrong because rivaroxaban can be taken with or without food.The patient does not need to take the medication with food to prevent stomach upset or absorption problems.
Choice D is wrong because rivaroxaban should be taken as prescribed and not stopped abruptly without consulting the prescriber.Stopping the medication can increase the risk of blood clots and stroke.The patient should not stop taking the medication even if they feel better or have no symptoms.
Correct Answer is ["B"]
Explanation
Alteplase is a fibrinolytic agent that dissolves blood clots and restores blood flow.However, it also increases the risk of bleeding from any site, such as the nose, gums, injection sites, or internal organs.Therefore, the nurse should monitor the client for signs of bleeding, such as bruising, hematuria, hematemesis, melena, or decreased hemoglobin and hematocrit levels.
Choice A is wrong because hypotension is not a common adverse effect of alteplase.Hypotension may occur due to blood loss from bleeding or other causes, such as dehydration, sepsis, or cardiac dysfunction.
Choice C is wrong because dysrhythmias are not a common adverse effect of alteplase.Dysrhythmias may occur due to pulmonary embolism itself, which can cause hypoxia, acidosis, and increased pulmonary artery pressure.
Choice D is wrong because nausea is not a common adverse effect of alteplase.Nausea may occur due to other factors, such as anxiety, pain, or medications.
Choice E is wrong because fever is not a common adverse effect of alteplase.Fever may occur due to infection, inflammation, or other causes.
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