A 65-year-old female client with a long history of acute coronary syndrome (ACS) had two cardiac stents placed via percutaneous coronary intervention. After this procedure, she was started on aspirin 325 mg orally once daily and clopidogrel 75 mg orally once daily. The nurse is preparing to provide education about each of these drugs.

For each health teaching statement below, click a box to indicate whether it is Essential (necessary or appropriate drug information) or Unrelated (not relevant or appropriate drug information) for the client.

"Drink a glass of water after each dose of your new drug."

"Avoid taking other medications that can cause bleeding, such as NSAIDS like ibuprofen."

"Follow up with the prescribed laboratory testing needed to monitor your clotting values."

"Eat foods high in Vitamin K and calcium to help prevent clotting."

"Continue to take your newly prescribed medications until your prescriber tells you not to do so."

“Report any unexpected bleeding to your primary health provider."

Answer and Explanation

The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"A"},"F":{"answers":"A"}}

Essential

1. "Avoid taking other medications that can cause bleeding, such as NSAIDs like ibuprofen." Both aspirin and clopidogrel increase the risk of bleeding. NSAIDs like ibuprofen can further increase this risk, so it is crucial to avoid them unless advised otherwise by a healthcare provider.

2. "Continue to take your newly prescribed medications until your prescriber tells you not to do so." Discontinuing aspirin and clopidogrel without medical advice can increase the risk of stent thrombosis and other complications. It is essential to follow the prescribed regimen strictly.

3. “Report any unexpected bleeding to your primary health provider." Monitoring for signs of bleeding (such as bruising, blood in the stool or urine, or unusual bleeding) is important due to the increased bleeding risk associated with these medications. Prompt reporting can help manage and mitigate serious complications.

Unrelated

1. "Drink a glass of water after each dose of your new drug." While staying hydrated is generally good advice, it is not specifically relevant to the efficacy or safety of aspirin and clopidogrel.

2. "Follow up with the prescribed laboratory testing needed to monitor your clotting values." Routine clotting tests (such as INR, PT, or aPTT) are not typically required for monitoring the effects of aspirin and clopidogrel, as these medications do not usually require lab monitoring like warfarin does.

3. "Eat foods high in Vitamin K and calcium to help prevent clotting." This advice is unrelated because Vitamin K can counteract the effects of anticoagulants like warfarin but does not affect the action of antiplatelet drugs like aspirin and clopidogrel. Calcium intake is also unrelated to the management of these medications.

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Correct Answer is ["B","C"]

Explanation

A. Constipation: Constipation is not a commonly reported adverse effect of clopidogrel (Plavix). Clopidogrel is an antiplatelet medication that works by inhibiting platelet aggregation, and gastrointestinal effects such as constipation are not typically associated with its use.

B. Bruising: This is a correct answer. Bruising is a known adverse effect of clopidogrel. As an antiplatelet medication, clopidogrel inhibits platelet aggregation, which can increase the risk of bleeding and bruising.

C. Rash: Rash is a potential adverse effect of clopidogrel, although it is not as common as other side effects such as bruising or gastrointestinal symptoms. Patients taking clopidogrel should be monitored for signs of allergic reactions, including rash, which may indicate the need for further evaluation or discontinuation of the medication.

D. Headache: Headache is not a commonly reported adverse effect of clopidogrel. While some patients may experience headache while taking clopidogrel, it is not considered a frequent or significant side effect of the medication.

E. Diarrhea: Diarrhea is not a commonly reported adverse effect of clopidogrel. Gastrointestinal symptoms such as diarrhea are not typically associated with clopidogrel use, although some patients may experience gastrointestinal upset as a side effect of antiplatelet therapy.

A. Most CAM therapies are totally ineffective B. Patient must be warned the most CAM therapies for dangerous C. Additional treatment may not be needed D. CAM therapies could interact with prescription and OTC medications

Correct Answer is D

Explanation

A. Most CAM therapies are not totally ineffective: While some CAM therapies may lack strong scientific evidence, it's not accurate to say they are all ineffective. Some CAM therapies may have benefits, but it's important to be aware of them to avoid interactions.

B. Not all CAM therapies are dangerous: Many CAM therapies are generally safe. However, some can interact with medications or have unforeseen side effects, so assessing use is crucial.

C. Additional treatment may still be needed: Even if a patient uses CAM, they might still require conventional medical treatment. Assessing CAM use helps ensure a complete picture of the patient's healthcare regimen.

D. CAM therapies could interact with prescription and OTC medications. Correct. The primary reason to assess CAM use is to identify potential interactions with medications, potentially improving patient safety and treatment effectiveness.

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Naxlex Comprehensive Predictor Exams

A patient has started taking clopidogrel (Plavix) after experiencing a transient ischemic attack. What adverse effects are associated with this drug? (Select all that apply)

Correct Answer is ["B","C"]

Explanation

It is important for the nurse to assess for the use of complementary and alternative medicine (CAM) because:

Correct Answer is D

Explanation

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 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 patient is receiving alteplase (Activase), a thrombolytic drug. The nurse monitors the patient for which of the following possible adverse effects?

A nurse is preparing to administer heparin subcutaneously to a client. Which of the following is an appropriate action by the nurse?

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 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.)

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?

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