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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Correct Answer is B

Explanation

Orlistat works by inhibiting the absorption of dietary fat in the intestines. The side eﬀects of faty stools and ﬂatus can be managed by reducing the intake of dietary fat. The nurse should ask the client to describe her dietary intake history for the last several days to determine if she has been consuming a diet high in fat.

Based on this information, the nurse can provide appropriate dietary advice to help manage these side eﬀects.

A. Take medication on an empty stomach. B. Avoid the use of iron supplements. C. Administer levothyroxine at bedtime. D. Consume foods that are high in iodine.

Correct Answer is A

Explanation

Levothyroxine is a thyroid hormone replacement medication used to treat hypothyroidism. To ensure proper absorption and eﬀectiveness of the medication, it should be taken on an empty stomach, preferably in the morning, and at least 30 minutes before eating. Therefore, when the client indicates that they understand the need to take the medication on an empty stomach, it indicates that the education was eﬀective.

Option b, "Avoid the use of iron supplements," is also important education for clients taking levothyroxine because iron supplements can interfere with the absorption of the medication. However, it is not the best indicator of eﬀective education because the question asks for the statement that indicates education was eﬀective, and option a is a more direct and specific response to the medication.

Option c, "Administer levothyroxine at bedtime," is not accurate information because the medication should be taken in the morning on an empty stomach.

Option d, "Consume foods that are high in iodine," is not recommended for clients taking levothyroxine because high amounts of iodine can interfere with thyroid function. Therefore, this statement indicates a need for further education.

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Naxlex Comprehensive Predictor Exams

After taking orlistat for one week, a female client tells the home health nurse that she is experiencing increasingly frequent faty stools and ﬂatus. Which action should the nurse take?

Correct Answer is B

Explanation

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

Correct Answer is A

Explanation

A client with open-angle glaucoma asks the nurse how long the prescribed eye drops will need to be used. Which response made by the nurse is accurate?

Before administering initial dose of sumatriptan succinate to a client with a migraine headache, it is most to determine if the client’s history includes which problem?

A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this patient’s plan of care?

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?

A client with psychosis who is receiving an antipsychotic medication is continuously rubbing the back of the neck. Which nursing intervention is best for the nurse to implement?

A male client has been receiving the antibiotic gentamicin sulfate IV piggyback every 12 hours for several days. Which observations by the nurse indicate that the client may be experiencing an adverse eﬀect of gentamicin?

Prior to administering the evening dose of carbamazepine, the nurse noted that the client’s morning carbamazepine level was 8.4 mg/L. Which action should the nurse take?

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?