A patient who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection.
During the patient’s history taking, the nurse finds out that the patient has been self-administering St. John’s Wort, an herbal preparation, on a friend’s advice.
What information is most significant about this finding?
St. John’s Wort can decrease plasma concentrations of cyclosporine.
Consumption of St. John’s Wort can reduce the patient’s sodium intake.
Adding the herb can decrease the need for corticosteroids.
The patient probably used this herb to treat depression.
The Correct Answer is A
Choice A rationale
St. John’s Wort is known to interact with many prescription drugs, including cyclosporine, a medication often given to transplant patients to prevent organ rejection. St. John’s Wort can decrease plasma concentrations of cyclosporine, thus endangering the success of organ transplantations.
Choice B rationale
There is no evidence to suggest that consumption of St. John’s Wort can reduce the patient’s sodium intake.
Choice C rationale
Adding the herb does not decrease the need for corticosteroids. In fact, it can interact with many medications and cause serious complications.
Choice D rationale
While St. John’s Wort is often used to treat depression, in the context of a patient who has undergone a renal transplant, the most significant information is its potential to interact with cyclosporine and endanger the success of the transplant.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Eliminating spinach and other green vegetables from the diet is not necessary for a client taking dabigatran. Unlike warfarin, another anticoagulant that interacts with vitamin K found
in green leafy vegetables, dabigatran does not have this interaction. Therefore, clients taking dabigatran do not need to modify their intake of green vegetables.
Choice B rationale
The nurse should instruct the client to avoid the use of nonsteroidal anti-inflammatory drugs (NSAIDs) while taking dabigatran. NSAIDs can increase the risk of bleeding, which is already elevated in clients taking anticoagulants like dabigatran.
Choice C rationale
Continuing to obtain scheduled laboratory bleeding tests is not necessary for a client taking dabigatran. Unlike some other anticoagulants, dabigatran does not require regular blood tests to monitor its effectiveness or adjust its dosage.
Choice D rationale
Keeping an antidote available in case of hemorrhage is not typically part of the teaching plan for a client taking dabigatran. While an antidote for dabigatran does exist, it is usually administered in a hospital setting in the event of life-threatening bleeding or emergency surgery.
Correct Answer is A
Explanation
Choice A rationale
Ipratropium is a bronchodilator used to prevent bronchospasm in people with chronic obstructive pulmonary disease (COPD)3. The inhaler needs to be primed before use to ensure the right amount of medicine is delivered. However, priming the inhaler with 7 pumps is not recommended. Therefore, if the client primes the inhaler with 7 pumps, it indicates that additional teaching is needed.
Choice B rationale
Storing the medication at room temperature is the correct way to store ipratropium. Therefore, this action does not indicate that additional teaching is needed.
Choice C rationale
Rinsing the mouth after each use of the inhaler is a recommended practice. This helps to prevent dry mouth and throat irritation caused by the medication. Therefore, this action does not indicate that additional teaching is needed.
Choice D rationale
Attaching a spacer device to the inhaler can help improve the delivery of the medication. Therefore, this action does not indicate that additional teaching is needed.
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