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 D

Explanation

A. May improve cardiac function: This statement avoids claiming to diagnose, treat, cure, or prevent disease. It uses general language about supporting heart health, which is permissible.

B. May reduce pain and inflammation: Similar to option A, this statement avoids disease claims and uses general terms about pain and inflammation, which is allowed.

C. Helps promote a healthy immune system: This follows the same principle. It avoids disease claims and uses general language regarding the immune system.

D. Reduces blood pressure and the risk for stroke: This statement specifically mentions a disease (stroke) and claims to reduce its risk. Dietary supplement labels are not allowed to make disease claims. They can only make general claims about supporting bodily functions.

A. Hypothermia B. Hypotension C. Black stools D. Constipation

Correct Answer is C

Explanation

A. Hypothermia: Clopidogrel is not typically associated with temperature regulation and wouldn't cause hypothermia.

B. Hypotension: While some medications can cause low blood pressure (hypotension), clopidogrel is not a common culprit.

C. Black stools: This can be a sign of upper gastrointestinal bleeding, which is a potential side effect of clopidogrel. Clopidogrel inhibits platelet aggregation, which can increase bleeding risk.

D. Constipation: Constipation is not a common side effect of clopidogrel.

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Naxlex Comprehensive Predictor Exams

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

Correct Answer is D

Explanation

A nurse is collecting data from a client who is receiving clopidogrel following the placement of a cardiac stent. Which of the following findings should the nurse identify as an adverse effect of this medication?

Correct Answer is C

Explanation

A nurse is preparing to administer amoxicillin 300 mg PO. The amount available is amoxicillin oral solution 250 mg/5 mL. How many mL should the nurse administer? (Round the answer to the nearest tenth/whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Why is it important for the nurse to collect information from the patient about the use of complementary and alternative medicine (CAM)?

A patient has been taking heparin for three days and has developed hematuria. The most appropriate action for the nurse is to:

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.)

A client taking warfarin (Coumadin) should be instructed to avoid herbal supplements such as green tea, ginkgo, feverfew, garlic, and ginger because these could:

The healthcare provider has ordered that a patient be placed on a hemostatic drug to control postoperative bleeding. Which of the following medications will most likely be given in this situation?

The nurse responds to the client's questions about CAM therapies and explains that some have been popular for centuries in treating conditions of the body and mind including which of the following? (Select All that Apply.)