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 C

Explanation

White Blood Cell Count (WBC): WBCs are part of the immune system and play a role in fighting infections. However, they are not directly involved in hemostasis or clot formation. WBCs do not adhere to the vessel wall during hemostasis.
Activated Partial Thromboplastin Time (aPTT): aPTT measures the time it takes for blood to clot. It is primarily used to monitor heparin therapy, not warfarin. aPTT is not specific for warfarin monitoring.
Prothrombin Time (PT): PT measures how quickly blood clots. It is used to monitor warfarin therapy and assess clotting factors. PT is essential for monitoring warfarin effectiveness.
Platelet Count: Platelets are crucial for clot formation. Platelet count helps assess platelet function. Platelets play a direct role in hemostasis.

Correct Answer is ["23"]

Explanation

To determine how many milliliters (mL) of potassium chloride the nurse should administer to provide 30 mEq, we can set up a proportion:

20 mEq is contained in 15 mL. So, to find out how many mL contain 30 mEq, we can set up the proportion:

20 mEq:15 mL=30 mEq:𝑥 mL20mEq:15mL=30mEq:xmL

Cross multiply:

20×𝑥=15×3020×x=15×30

20𝑥=45020x=450

Now, solve for 𝑥x:

𝑥=45020x=20450

𝑥=22.5x=22.5

So, the nurse should administer approximately 22.5 mL of potassium chloride.

Rounded to the nearest whole number, this would be 23 mL.

Therefore, the nurse should administer 23 mL of potassium chloride.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a new prescription for warfarin. The nurse should use the results of which of the following diagnostic tests to monitor the effect of this therapy?

Correct Answer is C

Explanation

A nurse is preparing to administer potassium chloride 30 mEq PO daily. The amount available is potassium chloride 20 mEq/15mL. 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.)

Correct Answer is ["23"]

Explanation

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