A client who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. While taking the client’s history, the nurse determines that the client has been self-administering St. John's Wort, an herbal preparation on the advice of a friend.

Which information is most significant about this finding?

The client probably used this herb to treat depression.

Wort can decrease plasma concentrations of the cyclosporine.

Ingestion of wort can reduce the client’s intake of sodium.

Adding the herb can decrease the need for corticosteroids.

Answer and Explanation

The Correct Answer is B

Cyclosporine is an immunosuppressive medication commonly used to prevent graft rejection after organ transplantation. St. John's Wort is known to induce cytochrome P450 enzymes, which can increase the metabolism and decrease the eﬀectiveness of many medications, including cyclosporine. This interaction can lead to decreased plasma concentrations of cyclosporine, which can increase the risk of graft rejection. Therefore, it is important to advise the client to discontinue the use of St. John's Wort and inform their healthcare provider about any herbal or supplement use to prevent potential interactions with prescribed medications. Options a, c, and d are not directly related to the client's current condition and are not as significant as option b.

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Correct Answer is D

Explanation

The client's symptoms suggest liver dysfunction, which is a known adverse eﬀect of albendazole. Albendazole is primarily metabolized in the liver, and its use can cause liver damage in some cases. Therefore, it is essential to review liver function test results to assess the severity of liver damage and to determine if the medication should be discontinued or the dosage should be adjusted.

The renal function panel (a) measures the levels of various substances, such as creatinine and blood urea nitrogen, in the blood to assess kidney function.

The thyroid function test (b) evaluates the levels of thyroid hormones in the blood to diagnose thyroid disorders.

The basic metabolic panel (c) includes several tests that assess the levels of electrolytes, glucose, and other substances in the blood to evaluate metabolic function. However, these lab tests are not directly related to the symptoms and adverse eﬀects associated with albendazole use

A. Administer sucralfate once a day, preferably at bedtime. B. Asses for secondary candida infection. C. Monitor for electrolyte imbalance. D. Give sucralfate on an empty stomach.

Correct Answer is D

Explanation

Sucralfate is a medication used to treat and prevent the return of duodenal ulcers. It is important to take sucralfate on an empty stomach, either 1 hour before meals or 2 hours after meals. This allows the medication to work eﬀectively by sticking to damaged ulcer tissue and protecting against acid and enzymes so healing can occur.

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Naxlex Comprehensive Predictor Exams

A client who is taking albendazole reports experiencing fatigue, nausea, and dark urine. The nurse observes a yellowing of the client’s skin and sclera. Which lab results should the nurse review?

Correct Answer is D

Explanation

The nurse is planning to administer the antiulcer GI agent sucralfate to a client with a peptic ulcer disease. Which action should the nurse include in this client’s plan of care?

Correct Answer is D

Explanation

A client who receives multiple antihypertensive multiple medications experiences syncope due to a drop in blood pressure to 70/40 mm Hg. Which is the rationale for the nurse’s decision to hold the client’s scheduled antihypertensive medications?

A client receives a new prescription for levothyroxine. Which statement made by client indicates to the nurse that the education was eﬀective?

Prior to administering the evening dose of carbamazepine, the nurse noted that the client’s morning carbamazepine level was 8.4 mg/L. Which action should the nurse take?

Two months after taking nitrofurantoin for a bacterial infection, a client reports the onset of severe, watery diarrhea to the home care nurse. How should the nurse respond?

A client with psychosis who is receiving an antipsychotic medication is continuously rubbing the back of the neck. Which nursing intervention is best for the nurse to implement?

The home health nurse observes a client self-administering an epinephrine injection using an auto-injector pen. Which client action requires intervention by the nurse?

A client with bipolar disorder admitted with severe depression and suicidal ideation receives a prescription for lithium carbonate, which instruction should the nurse provide to the client?