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.
Adding the herb can decrease the need for corticosteroids.
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.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Probenecid is a uricosuric drug that works by inhibiting the reabsorption of uric acid in the kidneys and promotes its excretion in the urine. This drug is used to treat gout and hyperuricemia (high levels of uric acid in the blood). Therefore, the nurse should explain to the client that the purpose of probenecid is to promote the excretion of uric acid in the urine and lower the levels of uric acid in the blood, which can help prevent gout attacks and kidney stones.
Options a, b, and d are incorrect as they do not accurately describe the mechanism of action or purpose of probenecid.

Correct Answer is B
Explanation
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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