A female client with mild depression reports to the nurse that she recently started taking St. John’s wort. Which information provided by the client requires further instruction?

Insomnia may occur while taking the medication.

Another form of contraception is not needed.

Sensitivity to the sun can develop.

Hard candy can be used for a dry mouth.

Answer and Explanation

The Correct Answer is B

Choice A reason:

Insomnia is a known side effect of St. John’s wort. While it can be bothersome, it does not typically require further instruction beyond standard advice on managing insomnia. Patients should be advised to take the medication earlier in the day to minimize sleep disturbances.

Choice B reason:

St. John’s wort can interact with hormonal contraceptives, reducing their effectiveness and increasing the risk of unintended pregnancy. This interaction occurs because St. John’s wort induces the enzymes that metabolize contraceptive hormones, leading to lower levels of these hormones in the body. Therefore, it is crucial to instruct the client to use an additional form of contraception to prevent pregnancy.

Choice C reason:

Sensitivity to the sun, or photosensitivity, is a documented side effect of St. John’s wort. Patients should be advised to use sunscreen and wear protective clothing when exposed to sunlight. While this side effect requires caution, it does not necessitate further instruction beyond these preventive measures.

Choice D reason:

Using hard candy to alleviate dry mouth is a common and effective strategy. St. John’s wort can cause dry mouth, and sucking on sugar-free hard candy can help stimulate saliva production. This advice is appropriate and does not require further instruction.

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Correct Answer is D

Explanation

Choice A reason:

Phenazopyridine does not eliminate urinary bacteria. It is not an antibiotic and does not have antibacterial properties. Instead, it is used to relieve symptoms such as pain, burning, and discomfort caused by irritation of the urinary tract. Therefore, this choice is incorrect.

Choice B reason:

Using phenazopyridine after voiding or after sexual intercourse is not a standard recommendation. This medication is typically taken after meals to reduce stomach upset. It is not specifically indicated for use after sexual intercourse, and this choice does not align with the typical usage instructions for phenazopyridine.

Choice C reason:

Phenazopyridine does not calm spasms in the urinary tract. Its primary function is to provide symptomatic relief from pain, burning, and discomfort in the urinary tract. It does not have antispasmodic properties, so this choice is also incorrect.

Choice D reason:

Phenazopyridine provides an analgesic effect for irritated bladder mucosa. It works by numbing the lining of the urinary tract, which helps to alleviate pain and discomfort associated with conditions like cystitis. This is the correct therapeutic effect of the medication.

A. Give the next scheduled dose. B. Obtain another blood sample. C. Monitor for signs of bleeding. D. Notify the healthcare provider.

Correct Answer is D

Explanation

Choice A reason: Giving the next scheduled dose without further assessment is not advisable. An INR of 2.8 is within the therapeutic range for many conditions treated with warfarin, but it is important to ensure that the INR is stable and not trending higher, which could increase the risk of bleeding.

Choice B reason: Obtaining another blood sample might be necessary if there is suspicion of an error or if the INR is unexpectedly high or low. However, in this scenario, the INR is within the therapeutic range, so this action is not immediately necessary.

Choice C reason: Monitoring for signs of bleeding is always important for clients on warfarin, but it does not address the immediate need to communicate with the healthcare provider about the current INR level and any potential adjustments to the medication.

Choice D reason: Notifying the healthcare provider is the most appropriate action. The healthcare provider needs to be aware of the current INR level to make any necessary adjustments to the warfarin dosage and to provide further instructions on monitoring and follow-up.

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A female client with mild depression reports to the nurse that she recently started taking St. John’s wort. Which information provided by the client requires further instruction?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with cystitis receives a prescription for phenazopyridine. Which information should the nurse explain to the client about its therapeutic effect?

Correct Answer is D

Explanation

The nurse is caring for a client with atrial fibrillation who receives a prescription for warfarin. The international normalized ratio (INR) is 2.8. Which action should the nurse take?

Correct Answer is D

Explanation

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