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 ["6.0"]

Explanation

To find the volume of amoxicillin solution the nurse needs to administer, we can divide the desired dose (300 mg) by the concentration of the solution (250 mg/5 mL).

Here's the calculation:

Amoxicillin volume (mL) = Desired dose (mg) / Concentration (mg/mL) Amoxicillin volume (mL) = 300 mg / 250 mg/5 mL

Since we're dividing by a fraction, it's mathematically equivalent to multiply by the reciprocal of the fraction. The reciprocal of 250 mg/5 mL is 5 mL/250 mg.

Amoxicillin volume (mL) = 300 mg * (5 mL / 250 mg)

Cancel out the milligrams (mg) units:

Amoxicillin volume (mL) = 300 mg / 250 mg * 5 mL

Amoxicillin volume (mL) = 1.2 mL (rounded to one decimal place)

However, since we are dealing with medication, it's best to round to the nearest whole number for accuracy in administering the dose.

Therefore, the nurse should administer 6.0 mL of amoxicillin oral solution.

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

Correct Answer is D

Explanation

A. Most CAM therapies are totally ineffective: Incorrect. Dismissing all CAM therapies as ineffective without considering individual cases could lead to overlooking potentially helpful treatments for patients.

B. Additional treatment may not be needed: Incorrect. Collecting information about CAM use allows healthcare providers to assess the overall treatment regimen comprehensively.

C. Patients must be warned that most CAM therapies are dangerous: Incorrect. While some CAM therapies may carry risks, it's not accurate to generalize that most CAM therapies are dangerous.

D. CAM therapies could interact with prescription and OTC medications: Correct. Understanding potential interactions between CAM therapies and conventional medications is essential for patient safety and optimal treatment outcomes.

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Naxlex Comprehensive Predictor Exams

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.)

Correct Answer is ["6.0"]

Explanation

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

Correct Answer is D

Explanation

When beginning herbal products, the nurse understands that the best way to identify allergic or other adverse reactions is to have the client:

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

Which of the following clump and adhere to the wall of the injured blood vessel to begin the process of hemostasis?

A nurse is collecting data from a client who has a prosthetic aortic valve and takes warfarin daily at bedtime. Which of the following data is the priority finding for the nurse to report to the provider?

A nurse is caring for a client who has a prescription for clopidogrel. Which of the following actions should the nurse plan to take?

Complementary and alternative medicine focuses on treating the person using natural products and mind-body therapies.

A nurse is caring for a client who has been taking warfarin and has a prothrombin time of 30 seconds and an INR of 7. Which of the following medications should the nurse anticipate the provider to prescribe?