A client who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. While taking the client’s history, the nurse determines that the client has been self-administering St. John's Wort, an herbal preparation on the advice of a friend.

Which information is most significant about this finding?

The client probably used this herb to treat depression.

Wort can decrease plasma concentrations of the cyclosporine.

Ingestion of wort can reduce the client’s intake of sodium.

Adding the herb can decrease the need for corticosteroids.

Answer and Explanation

The Correct Answer is B

Cyclosporine is an immunosuppressive medication commonly used to prevent graft rejection after organ transplantation. St. John's Wort is known to induce cytochrome P450 enzymes, which can increase the metabolism and decrease the eﬀectiveness of many medications, including cyclosporine. This interaction can lead to decreased plasma concentrations of cyclosporine, which can increase the risk of graft rejection. Therefore, it is important to advise the client to discontinue the use of St. John's Wort and inform their healthcare provider about any herbal or supplement use to prevent potential interactions with prescribed medications. Options a, c, and d are not directly related to the client's current condition and are not as significant as option b.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

Lovastatin is an antilipemic medication used to lower cholesterol levels in the blood1. It is important for clients taking lovastatin to avoid drinking alcohol as it can increase the risk of liver problems. If the client remarks that they will avoid taking alcoholic beverages while taking this medication, it indicates that they understand the drug’s treatment protocol.

A. Salmeterol B. Tiotropium C. Prednisone D. Guaifenesin

Correct Answer is D

Explanation

Guaifenesin is an expectorant that helps to loosen and thin mucus in the airways, making it easier to cough up. It is commonly used to manage symptoms of a chronic productive cough in conditions such as COPD.

Salmeterol and Tiotropium are both bronchodilators that help to open up the airways and improve breathing in COPD, but they are not specifically indicated for managing a chronic productive cough.

Prednisone is a corticosteroid that can help reduce inﬂammation in the airways and improve breathing in COPD exacerbations, but it is not typically used for managing a chronic productive cough.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

The nurse is preparing a client with Chronic Obstructive Pulmonary Disease (COPD) and a chronic productive cough for discharged home. Which prescribed medication should the nurse review with the client to manage this symptom?

Correct Answer is D

Explanation

The home health nurse observes a client self-administering an epinephrine injection using an auto-injector pen. Which client action requires intervention by the nurse?

A client receives a new prescription for levothyroxine. Which statement made by client indicates to the nurse that the education was eﬀective?

An elderly client with heart failure comet to the emergency room because of nausea, vomiting, and anorexia. Based on the client’s signs and symptoms, which data from the medical history has the most significance when planning this client’s care?

Before administering a newly prescribed dose of terbinafine HCL to a client with a fungal toenail infection, which assessment finding is most important for the nurse to address?

A client with hepatic encephalopathy is receiving lactulose. Which assessment provides the nurse with the nest information to evaluate the client’s therapeutic response to the drug?

A client with anemia secondary to chronic kidney disease started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is eﬀective?

The nurse administers risedronate to a client with osteoporosis at 07:00. The client asks for a glass of milk to drink with the medication. Which action should the nurse take?

The nurse is planning to discharge teaching for a client with diabetes mellitus who has a new prescription for insulin glargine. Which action should the nurse include in the discharge teaching?