# 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? > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=514131&lang=en > language: en > subject: Adverse Effects/Contraindications/Interactions > category: PPT ## Question 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? ## Option 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. **Correct answer: 1** ## 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. ## 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. ## Related questions - [A nurse is reviewing the morning lab results for an adult client receiving warfarin for at…](https://mymerci.kr/pages/nclex_q.php?qn_id=360515&lang=en) - [A client is admitted to the emergency department after ingesting an unknown amount of acet…](https://mymerci.kr/pages/nclex_q.php?qn_id=362720&lang=en) - [A client with chronic heart failure is prescribed metoprolol 25 mg orally twice daily. Bef…](https://mymerci.kr/pages/nclex_q.php?qn_id=362756&lang=en) - [A 28-year-old client with type 1 diabetes receives regular insulin 6 units and NPH insulin…](https://mymerci.kr/pages/nclex_q.php?qn_id=362792&lang=en) - [A client receives IV vancomycin 1 g every 12 hours for MRSA bacteremia. Before the next do…](https://mymerci.kr/pages/nclex_q.php?qn_id=362833&lang=en) - [A client with bipolar disorder has been taking lithium carbonate 600 mg orally three times…](https://mymerci.kr/pages/nclex_q.php?qn_id=362894&lang=en) - [An 80-year-old male with heart failure is prescribed digoxin 0.125 mg daily. During mornin…](https://mymerci.kr/pages/nclex_q.php?qn_id=372686&lang=en) - [A 38-year-old female with rheumatoid arthritis is being discharged with a new prescription…](https://mymerci.kr/pages/nclex_q.php?qn_id=372687&lang=en) ## Read in another language - [en](https://mymerci.kr/pages/nclex_q.php?qn_id=514131&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=514131&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=514131&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=514131&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=514131&lang=vi) --- More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en) _For study reference only. Always follow current clinical guidelines and your institution’s protocols._