A nurse in an emergency department is reviewing the medical record of a client who is having an acute myocardial infarction. Which of the following findings places the client at risk if he receives alteplase?

A. A recent hip arthroplasty puts the client at risk for bleeding if alteplase is administered, as there is a potential for hemorrhage at the surgical site. B. Acute renal failure may affect medication clearance but is not a contraindication for alteplase. C. Chronic obstructive pulmonary disease (COPD) does not place the client at risk for alteplase therapy. D. A family history of malignant hypertension does not directly affect the safety of alteplase therapy.