# A client is 2 weeks post-drug-eluting stent placement and says, “I stopped ticagrelor yesterday because I have bruises.” Which response is the priority?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522062&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client is 2 weeks post-drug-eluting stent placement and says, “I stopped ticagrelor yesterday because I have bruises.” Which response is the priority?

## Option

1. “Restart ticagrelor only after all bruises have completely disappeared.”
2. “Replace ticagrelor and aspirin with ibuprofen until the bruises improve.”
3. “Continue withholding ticagrelor until the next routine cardiology visit.”
4. “Contact cardiology now to assess bleeding and authorize the antiplatelet plan.” **✔ Correct answer**

**Correct answer: 4**

## Explanation

Early unplanned interruption of a prescribed P2Y12 inhibitor after ACS PCI can threaten stent patency; bruising and bleeding must be assessed promptly without an unsupervised stop.

## In-depth explanation

Quick answer
Escalate for a same-day bleeding and stent-protection plan.

Why this is correct
DAPT balances ischemic protection against bleeding. The nurse should assess the bruising, identify dangerous bleeding, and obtain an authorized plan rather than endorse unilateral interruption.

Easy analogy or mental picture
Do not remove a bridge support without checking whether the bridge is still carrying its highest load.

Memory hook
New stent plus stopped P2Y12 inhibitor means call now.

NCLEX decision rule
Treat adherence interruption as a time-sensitive medication-safety issue after recent PCI.

Why the other choices are wrong
Waiting, substituting an NSAID, or using bruise resolution alone ignores both stent and bleeding risk.References
1AHA/ACC 2025 Acute Coronary Syndromes GuidelineDAPT after ACS, individualized bleeding strategies, and coordinated secondary prevention

## Clinical scenario

DAPT interruption review
Assess last dose, stent timing, bleeding site and severity, hemoglobin, other antithrombotics, NSAIDs, adherence barrier, and cardiology instructions.

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