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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Free Nursing Study Resources

Correct Answer is ["A","D"]

Explanation

The correct answer is:

a. Report any tendon pain or swelling to the healthcare provider immediately.

d. Limit exposure to sunlight and avoid tanning beds.

Choice A: Report any tendon pain or swelling to the healthcare provider immediately.

Ciprofloxacin, like other fluoroquinolones, can cause tendinitis and tendon rupture. This risk is higher in older adults, those on corticosteroid therapy, and those with kidney, heart, or lung transplants. Reporting any tendon pain or swelling immediately is crucial to prevent severe complications.

Choice B: Use NSAIDS to relieve mid joint aches and pains caused by the medication.

This is not recommended. Using NSAIDs with ciprofloxacin can increase the risk of central nervous system effects, including seizures. Therefore, it is not advised to use NSAIDs to relieve joint aches and pains caused by ciprofloxacin.

Choice C: Crush and mix the tablets with pudding if you have trouble swallowing the tablets.

Ciprofloxacin tablets should not be crushed. Crushing the tablets can affect the drug’s effectiveness and increase the risk of side effects. If swallowing is an issue, the healthcare provider should be consulted for alternative forms of the medication.

Choice D: Limit exposure to sunlight and avoid tanning beds.

Ciprofloxacin can increase the skin’s sensitivity to sunlight, leading to severe sunburns. Patients are advised to limit their exposure to sunlight and avoid tanning beds while taking this medication.

A. Teach the client self-injection skills for daily subcutaneous administration. B. Demonstrate how to select dose based on before meal blood sugar readings. C. Explain to the family how to inject this medication for severe hypoglycemia. D. Provide information on increasing medication dosage if ketoacidosis occurs.

Correct Answer is A

Explanation

Insulin glargine is a long-acting insulin that is given once daily at the same time every day via subcutaneous injection. Therefore, it is essential to teach the client self-injection skills for daily subcutaneous administration to ensure proper administration of insulin.

Option b is incorrect because insulin glargine is typically given at the same dose every day, not based on before meal blood sugar readings.

Option c is incorrect because insulin glargine is not used for the treatment of severe hypoglycemia, and it should not be administered by someone who is not trained to do so.

Option d is incorrect because ketoacidosis is a serious complication of diabetes mellitus that requires urgent medical atention, and increasing medication dosage is not appropriate for this condition.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is preparing a discharge teaching plan for a clientwho is taking ciproﬂoxacin hydrochloride tablets which were prescribed because of a suspected anthrax exposure. Which instructions should be included in the teaching plan? (Select all that apply.)

Correct Answer is ["A","D"]

Explanation

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?

Correct Answer is A

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?

Which assessment data indicated to the nurse that a client is having an anaphylactic reaction to a medication?

A client with chemotherapy induced nausea receives a prescription for metoclopramide. Which adverse eﬀect is most important for the nurse to report?

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?

On admission, the healthcare provider describes a broad spectrum of antibiotic, ticarcillin for a client with a gram-negative infection. Before administering the first dose, it is most important for the nurse to implement which prescription?

After receiving five doses of filgrastim, the nurse notes that the clients white blood cell count has increased from 2,500/mm3 to 5,000/mm3. Which action would the nurse take?