The nurse is assigned a 49-year-old female client in the primary care office for a wellness visit. The nurse assesses the client, documents nurses notes, and reviews the medication administration record for potential interactions. The nurse should be most concern with the potential interaction between __________and _________.
Complete the sentence by choosing one answer from each option in the drop-down list below:
Medication Reconciliation:
St. John's wort 450 mg by mouth twice daily
Gabapentin 400 mg by mouth twice daily
Aspirin 81 mg by mouth daily
Atorvastatin 80 mg by mouth daily
Lisinopril 5 mg by mouth daily
Warfarin 5 mg by mouth daily
Ginger 5mg by mouth daily
Valerian 10mg by mouth daily
Correct Answer : A,F
A. St. John's wort 450 mg by mouth twice daily: St. John's wort is known to be a potent inducer of cytochrome P450 enzymes and can significantly reduce the effectiveness of warfarin by increasing its metabolism. This interaction can lead to subtherapeutic levels of warfarin and an increased risk of thromboembolic events.
B. Gabapentin 400 mg by mouth twice daily: While gabapentin can interact with other medications, its interactions with warfarin or St. John's wort are generally not as significant as those between warfarin and St. John's wort.
C. Aspirin 81 mg by mouth daily: Aspirin has anticoagulant properties and can have interactions with warfarin. However, the interaction with St. John's wort is less pronounced compared to the interaction between warfarin and St. John's wort.
D. Atorvastatin 80 mg by mouth daily: Atorvastatin primarily affects lipid levels and has different metabolic pathways compared to warfarin. It does not have a strong interaction with St. John's wort.
E. Lisinopril 5 mg by mouth daily: Lisinopril is an ACE inhibitor and does not have significant interactions with St. John's wort or warfarin.
F. Warfarin 5 mg by mouth daily. Warfarin is an anticoagulant that requires careful monitoring due to its interactions with various substances that can either increase the risk of bleeding or decrease its effectiveness.
G. Ginger 5 mg by mouth daily: Ginger can affect platelet function but is not as significant in interaction with warfarin as St. John's wort.
H. Valerian 10 mg by mouth daily: Valerian may have mild interactions with central nervous system depressants but does not have significant interactions with warfarin or St. John's wort.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Palliative therapy: Palliative therapy is aimed at providing relief from symptoms and improving the quality of life in patients with serious or terminal illnesses. It does not pertain to the use of antibiotics before culture results are available.
B) Prophylactic therapy: Prophylactic therapy is used to prevent the occurrence of an illness or infection before it happens. For example, antibiotics given before surgery to prevent infections would be considered prophylactic therapy, but this is not the case here.
C) Maintenance therapy: Maintenance therapy is used to sustain a desired level of therapeutic effect after an initial treatment phase. It focuses on keeping a condition under control rather than addressing an acute or uncertain condition.
D) Empiric therapy: Empiric therapy refers to the use of antibiotics or other medications based on clinical judgment and initial symptoms before the results of diagnostic tests, such as wound cultures, are available. This approach is used to start treatment promptly and manage the infection while awaiting precise identification of the pathogen.
Correct Answer is ["A","B","C","D"]
Explanation
A. Category A:
Medications classified as Category A are considered the safest during pregnancy. They have been well-studied in pregnant humans, and no risk to the fetus has been demonstrated. This classification means that adequate and well-controlled studies have shown no evidence of harm to the fetus in the first trimester and no risk in later trimesters.
B. Category C:
Category C medications have shown potential risks to the fetus in animal studies, and there are no well-controlled studies in humans. The benefits of the medication may outweigh the potential risks, but caution is advised. These medications are used when the potential benefits justify the potential risks to the fetus.
C. Category X:
Category X medications are contraindicated in pregnancy due to evidence of fetal abnormalities or risks that outweigh any potential benefits. These medications have demonstrated clear evidence of harm to the fetus in both human and animal studies, and their use is not recommended during pregnancy.
D. Category B:
Category B medications have shown no risk to animal fetuses, but there is a lack of adequate and well-controlled studies in pregnant humans. The absence of evidence of harm in animal studies suggests that these drugs are generally considered safe, though their effects on human fetuses are not well-documented.
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