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 D

Explanation

The client is experiencing syncope (fainting) due to a drop in blood pressure to 70/40 mm Hg, which is too low. This suggests that the client's blood pressure medications are reducing their blood pressure too much, resulting in hypotension. The rationale for the nurse's decision to hold the client's scheduled antihypertensive medications is to prevent further hypotension and allow the client's blood pressure to stabilize at a safer level.

Option a is incorrect because diuresis (increased urine output) is not a likely cause of the client's hypotension.

Option b is incorrect because the client's symptoms suggest hypotension due to reduced blood pressure, rather than drug toxicity.

Option c is incorrect because the antagonistic interaction among blood pressure medications would result in reduced eﬀectiveness but would not necessarily cause hypotension.

A. Begin therapy 1 week before the next normal menstrual cycle. B. Use condoms and a backup method of birth control. C. Call the healthcare provider immediately if there is a chance of conception. D. Ensure a negative pregnancy test two weeks before therapy.

Correct Answer is A

Explanation

Misoprostol should not be used during pregnancy as it can cause harm to the fetus. Women of childbearing potential should use eﬀective contraception while taking misoprostol. If there is a chance of conception, the healthcare provider should be contacted immediately. A negative pregnancy test is required before starting therapy with misoprostol .

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Naxlex Comprehensive Predictor Exams

A client who receives multiple antihypertensive multiple medications experiences syncope due to a drop in blood pressure to 70/40 mm Hg. Which is the rationale for the nurse’s decision to hold the client’s scheduled antihypertensive medications?

Correct Answer is D

Explanation

A female client with a history of peptic ulcer disease receives a prescription for misoprostol. Which information provided by the client indicates to the nurse a need for further teaching?

Correct Answer is A

Explanation

A client who is taking albendazole reports experiencing fatigue, nausea, and dark urine. The nurse observes a yellowing of the client’s skin and sclera. Which lab results should the nurse review?

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.)

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?

The nurse is planning care for a patient with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain?

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

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?

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?