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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Free Nursing Study Resources

Correct Answer is A

Explanation

A. Hold the dose and notify the healthcare provider (HCP) of the changes in the laboratory studies: Fluconazole is hepatotoxic and can cause elevations in liver enzymes, including AST. A rising trend in liver enzymes suggests possible liver injury, and administering another dose without medical clearance could worsen hepatic damage. Immediate communication with the HCP is the safest and most appropriate action.

B. Hold the dose and notify the pharmacy to stop dispersing the next premixed doses: Although stopping further dispensing may eventually be needed if the drug is discontinued, the pharmacy cannot make this clinical decision. Notifying the HCP for evaluation and new orders must take priority.

C. Begin the infusion and submit a drug reaction report to the nursing supervisor: Initiating the infusion despite abnormal liver function tests can endanger the client. Reporting an adverse reaction to the supervisor is important after ensuring the client’s safety, but the infusion should be held first pending provider instructions.

D. Begin the infusion and monitor the client's blood urea nitrogen (BUN), serum creatinine, and liver function tests: While monitoring labs is critical during fluconazole therapy, starting the infusion in the presence of worsening liver enzyme trends without provider approval can increase the risk of serious hepatic complications.

A. Advise the client that once symptoms occur it is too late to receive an influenza vaccination. B. Explain to the client that antibiotics are not useful in treating viral infections such as influenza. C. Refer the client to the healthcare provider at the clinic to obtain a medication prescription. D. Instruct the client that over-the-counter medications are sufficient to manage influenza symptoms.

Correct Answer is C

Explanation

A. Advise the client that once symptoms occur it is too late to receive an influenza vaccination: While it is true that vaccination is preventive and not therapeutic, the client's question concerns treatment, not vaccination. Discussing vaccination at this point does not directly address the immediate need for antiviral therapy.

B. Explain to the client that antibiotics are not useful in treating viral infections such as influenza: Although educating about antibiotic misuse is important, this response does not answer the client’s question about oseltamivir, which is an antiviral medication specifically intended for early influenza treatment.

C. Refer the client to the healthcare provider at the clinic to obtain a medication prescription: Oseltamivir must be prescribed and is most effective when started within 48 hours of symptom onset. Prompt referral ensures the client can receive the medication in time to potentially shorten the illness and reduce complications.

D. Instruct the client that over-the-counter medications are sufficient to manage influenza symptoms: Over-the-counter remedies may relieve symptoms, but they do not treat the viral infection. Early antiviral treatment with oseltamivir can decrease the severity and duration of influenza, particularly in high-risk individuals.

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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?

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Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is C

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