An 83-year-old client with nonvalvular atrial fibrillation weighs 58 kg and has a serum creatinine of 1.3 mg/dL. Which apixaban dose should the nurse expect?

1 2.5 mg orally 2 times per 1 day because the client meets 2 dose-reduction criteria. ✓ Correct answer
2 5 mg orally 2 times per 1 day because serum creatinine is below 1.5 mg/dL.
3 10 mg orally 2 times per 1 day for 7 days because every atrial-fibrillation client uses the acute VTE regimen.
4 No anticoagulant can be used after age 80 years.

Explanation

For nonvalvular atrial fibrillation, age 80 years or older and weight 60 kg or less are 2 qualifying criteria, so the labeled dose is 2.5 mg 2 times per 1 day.

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In-depth explanation

Quick answer
Expect apixaban 2.5 mg 2 times per 1 day.

Why this is correct
The nonvalvular atrial-fibrillation label reduces the dose when at least 2 of 3 characteristics are present: age at least 80, weight at most 60 kg, or serum creatinine at least 1.5 mg/dL. This client meets age and weight.

Easy analogy or mental picture
2 checked boxes open the reduced-dose pathway; the remaining box does not have to be checked.

Memory hook
Apixaban AF: any 2 of age 80, weight 60, creatinine 1.5.

NCLEX decision rule
Confirm the indication, then count the exact criteria; do not borrow a regimen from a different indication.

Why the other choices are wrong
The VTE loading regimen does not apply to routine AF stroke prevention, and age alone is not a blanket contraindication.

References

1DailyMed: Apixaban TabletsTwo-of-three reduction rule for nonvalvular atrial fibrillation

Clinical scenario

Indication-specific anticoagulant dosing
Confirm indication, age, weight, serum creatinine, bleeding risk, interacting drugs, and the exact labeled regimen.

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An 83-year-old client with nonvalvular atrial fibrillation weighs 58 kg and has a serum creatinine of 1.3 mg/dL. Which apixaban dose should the nurse expect?

In-depth explanation

Clinical scenario

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