A nurse is teaching a client who has heart failure about the use of digoxin as a conventional drug to improve his cardiac function. Which of the following statements by the client indicates a need for further teaching?

"I should avoid taking licorice as an herb because it may cause irregular heart rhythms."

"I should monitor my pulse rate and report any changes to my health care provider."

"I should take digoxin with food or milk to prevent stomach upset."

"I should check my weight daily and report any sudden increase to my health care provider."

Answer and Explanation

The Correct Answer is C

The correct answer is

C. "I should take digoxin with food or milk to prevent stomach upset."

Choice A reason: This statement is correct and does not indicate a need for further teaching. The client should avoid taking licorice as an herb because it may cause irregular heart rhythms. Licorice contains glycyrrhizin, which can lower the potassium level in the blood and increase the risk of digoxin toxicity. Licorice may also increase blood pressure and interfere with the effects of some blood pressure medications.

Choice B reason: This statement is also correct and does not indicate a need for further teaching. The client should monitor his pulse rate and report any changes to his healthcare provider. Digoxin can affect the heart rate and rhythm, and cause bradycardia (slow heart rate) or arrhythmias (irregular heartbeats)¹². The client should check his pulse before taking digoxin, and if it is below 60 beats per minute, he should skip the dose and call his healthcare provider. The client should also report any signs of digoxin toxicity, such as nausea, vomiting, loss of appetite, blurred vision, yellow or green halos around objects, confusion, or weakness.

Choice C reason: This statement is incorrect and indicates a need for further teaching. The client should not take digoxin with food or milk to prevent stomach upset. Food or milk may decrease the absorption of digoxin and reduce its effectiveness. Digoxin should be taken on an empty stomach, at least one hour before or two hours after a meal. If the client experiences stomach upset from digoxin, he should consult his healthcare provider for advice.

Choice D reason: This statement is also correct and does not indicate a need for further teaching. The client should check his weight daily and report any sudden increase to his healthcare provider. Digoxin is used to treat heart failure, a condition in which the heart cannot pump enough blood to meet the body's needs¹². One of the symptoms of heart failure is fluid retention, which can cause weight gain, swelling of the legs or ankles, shortness of breath, or difficulty breathing. A sudden increase in weight may indicate worsening of heart failure and require adjustment of the treatment plan.

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Correct Answer is ["C","E"]

Explanation

The correct answer is

C. Prednisone, a corticosteroid for inflammation

E. Fluoxetine, an SSRI for depression

Choice A reason: This statement is incorrect and inappropriate for identifying the interaction between echinacea and lisinopril. Echinacea does not interact with lisinopril, an ACE inhibitor for blood pressure. There is no evidence that echinacea affects the blood pressure or the pharmacokinetics of lisinopril.

Choice B reason: This statement is incorrect and inappropriate for identifying the interaction between echinacea and amoxicillin. Echinacea does not interact with amoxicillin, a penicillin antibiotic for infection. There is no evidence that echinacea affects the antibacterial activity or the pharmacokinetics of amoxicillin.

Choice C reason: This statement is correct and appropriate for identifying the interaction between echinacea and prednisone. Echinacea may interact with prednisone, a corticosteroid for inflammation, by reducing its effectiveness or increasing its side effects. Echinacea has immunostimulatory properties that may counteract the immunosuppressive effects of prednisone. Echinacea may also induce the enzyme cytochrome P450 3A4, which is involved in the metabolism of prednisone, and decrease its blood level. Furthermore, echinacea may increase the risk of infection or bleeding in people who take prednisone.

Choice D reason: This statement is incorrect and inappropriate for identifying the interaction between echinacea and metformin. Echinacea does not interact with metformin, a biguanide for diabetes mellitus. There is no evidence that echinacea affects the blood glucose or the pharmacokinetics of metformin.

Choice E reason: This statement is correct and appropriate for identifying the interaction between echinacea and fluoxetine. Echinacea may interact with fluoxetine, an SSRI for depression, by increasing its side effects or toxicity. Echinacea may inhibit the enzyme cytochrome P450 2D6, which is involved in the metabolism of fluoxetine, and increase its blood level¹². Echinacea may also increase the risk of serotonin syndrome, a potentially life-threatening condition caused by excessive serotonin in the brain, in people who take fluoxetine.

Correct Answer is ["C","E"]

Explanation

Choice C reason: This statement is correct and appropriate for identifying the interaction between echinacea and prednisone. Echinacea may interact with prednisone, a corticosteroid for inflammation, by reducing its effectiveness or increasing its side effects. Echinacea has immunostimulatory properties that may counteract the immunosuppressive effects of prednisone¹². Echinacea may also induce the enzyme cytochrome P450 3A4, which is involved in the metabolism of prednisone, and decrease its blood level¹². Furthermore, echinacea may increase the risk of infection or bleeding in people who take prednisone¹².

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A nurse is teaching a client who has heart failure about the use of digoxin as a conventional drug to improve his cardiac function. Which of the following statements by the client indicates a need for further teaching?

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medication list of a client who uses echinacea as a CAM product to boost his immune system function. The nurse should identify that echinacea may interact with which of the following conventional drugs? (Select all that apply.)

Correct Answer is ["C","E"]

Explanation

A nurse is reviewing the medication list of a client who uses echinacea as a CAM product to boost his immune system function. The nurse should identify that echinacea may interact with which of the following conventional drugs? (Select all that apply.)

Correct Answer is ["C","E"]

Explanation

A nurse is evaluating a client who has been using biologically based therapies such as herbs and supplements to treat his health conditions. The nurse should assess the client for which of the following adverse effects or interactions that may occur with biologically based therapies?

A nurse is counseling a client who has undergone a kidney transplant and is taking cyclosporine as an immunosuppressant to prevent organ rejection. Which of the following statements by the nurse is appropriate?

A nurse is caring for a client who takes warfarin for atrial fibrillation and wants to use ginkgo biloba as a CAM product to improve his memory. The nurse should inform the client that ginkgo biloba may interact with warfarin in which of the following ways?

A nurse is evaluating a client who has been using biologically based therapies such as herbs and supplements to treat his health conditions. The nurse should assess the client for which of the following adverse effects or interactions that may occur with biologically based therapies?

A nurse is counseling a client who has undergone a kidney transplant and is taking cyclosporine as an immunosuppressant to prevent organ rejection. Which of the following statements by the nurse is appropriate?

A nurse is caring for a client who takes warfarin for atrial fibrillation and wants to use ginkgo biloba as a CAM product to improve his memory. The nurse should inform the client that ginkgo biloba may interact with warfarin in which of the following ways?

A nurse is teaching a client who has heart failure about the use of digoxin as a conventional drug to improve his cardiac function. Which of the following statements by the client indicates a need for further teaching?

A nurse is teaching a client who has heart failure about the use of digoxin as a conventional drug to improve his cardiac function. Which of the following statements by the client indicates a need for further teaching?