The healthcare provider prescribes clopidogrel (Plavix) for a patient at risk for a myocardial infarction. While instructing the patient about the adverse effects and precautions associated with this drug, the nurse tells him that the following drugs should not be used while on clopidogrel unless the doctor is consulted. (Select all that apply.)

alteplase (Activase)

Diltiazem

Ibuprofen

Aspirin

Coumadin

Answer and Explanation

Correct Answer : A,B,C,D,E

A. Alteplase (Activase): Alteplase is a thrombolytic agent used to dissolve blood clots. Concurrent use with clopidogrel, an antiplatelet medication, can increase the risk of bleeding due to additive effects on clotting. Therefore, it's important to consult the doctor before using these medications together.

B. Diltiazem: Diltiazem is a calcium channel blocker used to treat hypertension and certain heart rhythm disorders. Diltiazem will decrease the level or effect of clopidogrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Therefore, it's advisable to consult the doctor before using these medications together.

C. Ibuprofen: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain and inflammation. Like other NSAIDs, it can increase the risk of bleeding when taken with clopidogrel. Therefore, it's important to consult the doctor before using these medications together.

D. Aspirin: Aspirin is another antiplatelet medication commonly used to prevent heart attacks and strokes. Combining clopidogrel with aspirin can increase the risk of bleeding without significantly improving outcomes in most cases. However, in some situations, such as after certain cardiac procedures, dual antiplatelet therapy (clopidogrel plus aspirin) may be prescribed under close medical supervision. Therefore, it's crucial to consult the doctor before using these medications together.

E. Coumadin (warfarin): Coumadin is an anticoagulant medication used to prevent blood clots. Concurrent use with clopidogrel can increase the risk of bleeding. Therefore, it's essential to consult the doctor before using these medications together.

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Correct Answer is C

Explanation

A. Ferrous sulfate: This is an iron supplement and wouldn't be used to reverse warfarin's anticoagulant effect.

B. Prednisone: This is a steroid medication used for various inflammatory conditions and wouldn't be used to address excessive blood thinning.

C. Vitamin K: Vitamin K is the antidote for warfarin poisoning or excessive anticoagulation. By providing vitamin K, the body can resume producing clotting factors, counteracting warfarin's effect.

D. Heparin: This is another blood thinner medication. While it can be used in specific situations, it wouldn't be the first choice to reverse warfarin's effect because it adds another layer of anticoagulation, which could be risky.

A. Reduced cardiac output B. Abnormal coagulation C. Electrolyte imbalance D. Respiratory issues

Correct Answer is B

Explanation

A. Reduced cardiac output: While liver disease can affect circulation in later stages, abnormal coagulation is a more immediate concern.

B. Abnormal coagulation: The liver plays a vital role in producing proteins essential for blood clotting. Liver damage can impair this function, leading to increased bleeding risk.

C. Electrolyte imbalance: The liver plays a role in some aspects of electrolyte balance, but abnormal coagulation is a more specific and critical complication in early liver damage.

D. Respiratory issues: While liver disease can progress to respiratory complications in severe cases, abnormal coagulation is a more immediate threat.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has been taking warfarin and has a prothrombin time of 30 seconds and an INR of 7. Which of the following medications should the nurse anticipate the provider to prescribe?

Correct Answer is C

Explanation

A nurse is reviewing the laboratory report of a client and realizes the liver function tests are elevated, indicating liver damage. The client should be monitored for which potential complication?

Correct Answer is B

Explanation

is the stopping of blood flow, an essential mechanism protecting the body from both external and internal injury.

A nurse is preparing to administer amoxicillin 350 mg PO. Available is amoxicillin 250 mg/5 mL. How many mL should the nurse administer? (Round to the nearest whole number.)

Which of the following statements would most likely NOT be allowed on the label of a dietary supplement?

A nurse is reviewing laboratory data from a client who has pulmonary embolism and is receiving IV heparin. Which of the following findings should the nurse report to the provider?

A nurse is caring for a client who has thrombophlebitis and is receiving a continuous heparin infusion. Which of the following medications should the nurse have available to reverse heparin's effects?

A nurse is reinforcing teaching for a client who has a new prescription for warfarin. Which of the following information should the nurse include?

When asked if there are any regulatory controls on herbal or dietary supplements, the nurse responds to the client by informing him that herbal and dietary supplements are regulated by the: