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

A carbamazepine level of 8.4 mg/L is within the therapeutic range of 4-12 mg/L. The nurse should administer the evening dose of carbamazepine as prescribed. The nurse should continue to monitor the client’s carbamazepine levels and assess for any side eﬀects of the medication.

A. Explain that the drug should be used early in the course of the disease process. B. Affirm the decision to use the drug when the symptoms start to worsen. C. Assess the client’s current mental health status before deciding to support the decision. D. Confirm that the daughter is aware of the progressive nature of the disease.

Correct Answer is A

Explanation

The nurse should explain to the client's daughter that Rivastigmine is most eﬀective when used early during Alzheimer's disease. Delaying the use of the medication until the symptoms are no longer manageable may result in the drug being less eﬀective.

The nurse should emphasize the importance of following the healthcare provider's instructions for administering the medication to maximize its therapeutic eﬀect. It is important to educate the client's daughter about the progressive nature of Alzheimer's disease and the need for ongoing monitoring and care.

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is D

Explanation

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 caring for a client who is taking diclofenac, an NSAID drug for rheumatoid arthritis. During a clinic visit, the client appears pale and reports increasing fatigue. Which of the client’s serum laboratory values is most important for the nurse to review?

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?

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?

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?

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?

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