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

Intermittent claudication is a condition in which there is pain in the legs due to reduced blood ﬂow. Pentoxifylline is a medication that can improve blood ﬂow by reducing the viscosity of the blood. Therefore, to determine the eﬀectiveness of the medication in managing intermittent claudication, the nurse should monitor the client's pain level using a numeric pain scale. This will help to assess if the medication provides pain relief and improving the client's ability to walk without discomfort.

Options a, b, and c are not relevant to the assessment of the eﬀectiveness of pentoxifylline in managing intermittent claudication.

A. Advise the client to stop taking the drug and contact the healthcare provider. B. Ask the client to describe her dietary intake history for the last several days. C. Instruct the to increase her intake of saturated fats over the next week. D. Obtain a stool to evaluate occult blood and fat content. E. Obtain a stool to evaluate occult blood and fat content.

Correct Answer is B

Explanation

Orlistat works by inhibiting the absorption of dietary fat in the intestines. The side eﬀects of faty stools and ﬂatus can be managed by reducing the intake of dietary fat. The nurse should ask the client to describe her dietary intake history for the last several days to determine if she has been consuming a diet high in fat.

Based on this information, the nurse can provide appropriate dietary advice to help manage these side eﬀects.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse assesses a client with intermittent claudication who is receiving pentoxifylline. Which assessment should the nurse perform to determine the eﬀectiveness of the medication?

Correct Answer is D

Explanation

After taking orlistat for one week, a female client tells the home health nurse that she is experiencing increasingly frequent faty stools and ﬂatus. Which action should the nurse take?

Correct Answer is B

Explanation

A female client with a history of peptic ulcer disease receives a prescription for misoprostol. Which information provided by the client indicates to the nurse a need for further teaching?

A client with benign prostatic receives a new prescription of tamsulosin. Which intervention should the nurse use to monitor an adverse reaction?

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 a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?

When caring for a client with diabetes insipidus who is receiving antidiuretic hormone intranasally, which serum lab test is most important for the nurse to monitor?

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?

Which nursing action had the highest priority when administering a dose of codeine with acetaminophen to a client?

A client with hepatic encephalopathy is receiving lactulose. Which assessment provides the nurse with the nest information to evaluate the client’s therapeutic response to the drug?