A client has a prescription for clopidogrel bisulfate 75 mg by mouth daily at 0900. In which situation should the nurse hold this medication?

Elective surgery is scheduled in two hours.

An abdominal sonogram is scheduled.

Breakfast has not been eaten.

The client's platelet level is high.

Answer and Explanation

The Correct Answer is A

A. Elective surgery is scheduled in two hours: Clopidogrel is an antiplatelet agent that significantly increases the risk of bleeding. It should be held prior to surgery to minimize intraoperative and postoperative bleeding risks. Surgeons often require clopidogrel to be discontinued several days in advance, making it critical to withhold the drug if surgery is imminent.

B. An abdominal sonogram is scheduled: An abdominal ultrasound is a noninvasive imaging test that does not carry bleeding risks. There is no need to hold clopidogrel prior to sonogram procedures because it does not impact the safety or accuracy of the imaging study.

C. Breakfast has not been eaten: Clopidogrel can be taken with or without food. Skipping a meal does not contraindicate administering the medication, although taking it with food can sometimes help reduce gastrointestinal discomfort.

D. The client's platelet level is high: Clopidogrel works by inhibiting platelet aggregation, not by lowering platelet count. A high platelet count alone is not a reason to withhold the medication unless there is a specific bleeding risk or another contraindication identified by the healthcare provider.

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Correct Answer is A

Explanation

A. Take the medication during pregnancy: Methotrexate is highly teratogenic and absolutely contraindicated during pregnancy because it can cause severe fetal malformations or death. Clients must be instructed to avoid pregnancy while on methotrexate and for some time after discontinuing the drug, making this a critical point requiring immediate correction.

B. Use folic acid to protect the liver: Methotrexate interferes with folate metabolism, and folic acid supplementation is recommended to reduce some side effects such as liver toxicity, mucositis, and bone marrow suppression. This statement reflects appropriate understanding of supportive care during methotrexate therapy.

C. Store the medication at room temperature: Methotrexate should be stored at room temperature away from light and moisture, consistent with safe medication handling practices. This information is accurate and does not require additional instruction.

D. Obtain a platelet count weekly: Methotrexate can cause bone marrow suppression, increasing the risk of thrombocytopenia. Regular monitoring of blood counts, including platelets, is standard practice to detect toxicity early, so this action is appropriate and understood correctly.

A. Use a stool softener as needed. B. Discontinue when spasms cease. C. Avoid the ingestion of alcohol. D. Take medication with meals.

Correct Answer is B

Explanation

A. Use a stool softener as needed: Baclofen can cause constipation as a side effect due to its muscle-relaxant properties. Using a stool softener as needed is an appropriate and safe strategy to manage this potential issue without needing additional instruction.

B. Discontinue when spasms cease: Baclofen should not be abruptly discontinued because sudden withdrawal can lead to serious complications such as seizures, hallucinations, or rebound spasticity. Clients must be taught to taper the medication gradually under healthcare provider supervision.

C. Avoid the ingestion of alcohol: Alcohol can potentiate the central nervous system depressant effects of baclofen, increasing the risk of sedation, dizziness, and respiratory depression. Clients should be advised to avoid alcohol while on this medication.

D. Take medication with meals: Taking baclofen with meals helps reduce gastrointestinal upset, such as nausea, which can occur with muscle relaxants. This practice is appropriate and does not require additional instruction.

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A client has a prescription for clopidogrel bisulfate 75 mg by mouth daily at 0900. In which situation should the nurse hold this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client receives a prescription for methotrexate. Which information provided by the client requires additional instruction by the nurse?

Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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