A female client with mild depression reports to the nurse that she recently started taking St. John’s wort. Which information provided by the client requires further instruction?

Insomnia may occur while taking the medication.

Another form of contraception is not needed.

Sensitivity to the sun can develop.

Hard candy can be used for a dry mouth.

Answer and Explanation

The Correct Answer is B

Choice A reason:

Insomnia is a known side effect of St. John’s wort. While it can be bothersome, it does not typically require further instruction beyond standard advice on managing insomnia. Patients should be advised to take the medication earlier in the day to minimize sleep disturbances.

Choice B reason:

St. John’s wort can interact with hormonal contraceptives, reducing their effectiveness and increasing the risk of unintended pregnancy. This interaction occurs because St. John’s wort induces the enzymes that metabolize contraceptive hormones, leading to lower levels of these hormones in the body. Therefore, it is crucial to instruct the client to use an additional form of contraception to prevent pregnancy.

Choice C reason:

Sensitivity to the sun, or photosensitivity, is a documented side effect of St. John’s wort. Patients should be advised to use sunscreen and wear protective clothing when exposed to sunlight. While this side effect requires caution, it does not necessitate further instruction beyond these preventive measures.

Choice D reason:

Using hard candy to alleviate dry mouth is a common and effective strategy. St. John’s wort can cause dry mouth, and sucking on sugar-free hard candy can help stimulate saliva production. This advice is appropriate and does not require further instruction.

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Correct Answer is B

Explanation

Choice A reason: Hypercholesterolemia, or high cholesterol, is not a primary concern when prescribing methylphenidate. While managing cholesterol levels is important for overall cardiovascular health, it does not directly interact with the administration of methylphenidate.

Choice B reason: Hypertension, or high blood pressure, is a critical condition to review before administering methylphenidate. Methylphenidate can increase blood pressure and heart rate, potentially exacerbating pre-existing hypertension. Monitoring and managing blood pressure is essential to prevent complications such as stroke or heart attack.

Choice C reason: Diabetes mellitus is important to manage, but it is not directly affected by methylphenidate. While some medications can influence blood sugar levels, methylphenidate primarily affects the central nervous system and cardiovascular system.

Choice D reason: Bronchitis, an inflammation of the bronchial tubes, is not a primary concern with methylphenidate use. Although respiratory conditions should be managed appropriately, they do not typically interact with the effects of methylphenidate.

A. Administer a PRN dose of an antianxiety drug. B. Obtain orthostatic blood pressure readings. C. Notify the healthcare provider. D. Collect a capillary glucose level.

Correct Answer is C

Explanation

Choice A reason:

Administering a PRN dose of an antianxiety drug might seem like a reasonable action if the tremors are related to anxiety. However, without a clear indication that anxiety is the cause of the tremors, this action could mask the underlying issue and delay appropriate treatment. It is essential to identify the root cause of the tremors before administering any medication.

Choice B reason:

Obtaining orthostatic blood pressure readings is a useful assessment for determining if the client has orthostatic hypotension, which can cause dizziness and fainting. However, this action is not directly related to the complaint of hand tremors. While it is a good practice to monitor vital signs, it does not address the immediate concern of tremors caused by pregabalin.

Choice C reason:

Notifying the healthcare provider is the most appropriate action. Tremors can be a side effect of pregabalin12. The healthcare provider needs to be informed to evaluate the severity of the side effect and decide whether to adjust the medication dosage or switch to an alternative treatment. This ensures that the client receives the most appropriate care and avoids potential complications.

Choice D reason:

Collecting a capillary glucose level is important for clients with diabetes or those at risk of hypoglycemia or hyperglycemia. However, there is no indication in the scenario that the client has diabetes or that blood glucose levels are related to the tremors. Therefore, this action is not directly relevant to the client’s current complaint.

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A female client with mild depression reports to the nurse that she recently started taking St. John’s wort. Which information provided by the client requires further instruction?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with narcolepsy receives a new prescription for methylphenidate. Prior to administration of the medication, the nurse should review the medical record for which condition?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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