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A client with depression has been taking citalopram, an SSRI, for several months and has presented for a follow-up assessment. The client tells the nurse, "I've been reading a lot online about the benefits of St. John's wort for depression, so I've started taking it once per day." In addition to referring the client to the provider, what is the nurse's best response?

"There can be an unsafe reaction between your antidepressant and St. John's wort, which is why taking them both is discouraged."

"Herbal remedies often contain unknown doses of the desired ingredient, which can be dangerous."

"It's very important that you not take the St. John's wort at the same time of day as your antidepressant."

"It's very important that you comply with your prescribed treatment."

Answer and Explanation

The Correct Answer is A

A. "There can be an unsafe reaction between your antidepressant and St. John's wort, which is why taking them both is discouraged." is correct; St. John's wort can reduce the effectiveness of SSRIs and may increase the risk of serotonin syndrome, making it vital for the nurse to address this safety concern.

B. "Herbal remedies often contain unknown doses of the desired ingredient, which can be dangerous." is a valid point, but it does not specifically address the interaction with the client’s current medication.

C. "It's very important that you not take the St. John's wort at the same time of day as your antidepressant." is misleading; the concern is not just about timing but about taking both together at all.

D. "It's very important that you comply with your prescribed treatment." while true, this response does not directly address the specific risks associated with combining St. John's wort and citalopram.

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Correct Answer is A

Explanation

A. An antipsychotic agent, particularly first-generation antipsychotics, can cause extrapyramidal symptoms such as tremors, drooling, gait changes, and spasms due to their dopamine-blocking effects in the brain.

B. An antidiabetic agent does not typically cause these neurological symptoms; its primary effects are related to glucose metabolism.

C. A general anesthetic is used to induce unconsciousness and does not generally result in muscular tremors or drooling.

D. An anticholinergic agent can cause side effects like dry mouth and constipation but does not typically lead to the muscular symptoms described; in fact, it may reduce drooling.

A. "Acetaminophen has no effect on inflammation." B. "It takes some people a few weeks to feel a difference." C. "Acetaminophen's only clinical use is for pain treatment." D. "Keep taking it as ordered, and watch for any signs of bleeding."

Correct Answer is A

Explanation

A. Acetaminophen is primarily an analgesic and antipyretic; it does not have anti-inflammatory properties, so it will not reduce swelling or inflammation.

B. While some medications may take time to show effects, this is not applicable to acetaminophen regarding inflammation, as it does not address that symptom.

C. Although acetaminophen is used for pain relief, saying it has only clinical use for pain is misleading; it is not effective for inflammation.

D. Monitoring for bleeding is important for medications that can affect coagulation, such as NSAIDs, but acetaminophen does not typically cause this risk.

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Naxlex Comprehensive Predictor Exams

A client exhibits muscular tremors, drooling, gait changes, and spasms. When reviewing the client's medication history, which would the nurse most likely find?

Correct Answer is A

Explanation

A client with acute joint inflammation tells the nurse, "I've been taking acetaminophen as it's ordered on the bottle, but my swelling and inflammation doesn't seem to be getting better." What should the nurse teach the client?

Correct Answer is A

Explanation

A patient receiving heparin therapy develops bruising and bleeding gums. What should the nurse suspect and what is the appropriate action?

A client diagnosed with hyperlipidemia has been taking atorvastatin for several months. How can the therapeutic effect of the medication be determined?

A patient is prescribed long-acting insulin (glargine) for basal control of blood glucose. Which statement by the nurse is correct when educating the patient?

A nurse is caring for a patient who is receiving both short-acting and intermediate-acting insulin. The nurse should understand that:

When caring for a patient with angina, the nurse instructs the patient to place the nitroglycerin tablet between the cheek and the gums. Which route of administration is the nurse referring to?

The nurse is teaching a client how to use nasal spray. What will the nurse include in the teaching plan? (Select all that apply.)

The nurse is caring for a client who is taking a bronchodilator. In what disease process should bronchodilators be used cautiously?

The nurse is caring for a client taking fluoxetine for depression. Which assessment findings indicate that the medication is effective? (Select all that apply.)