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 C

Explanation

Choice A reason: Suggesting the use of an antacid two hours after taking risedronate is not the best initial response. While antacids can help with heartburn, they can also interfere with the absorption of risedronate if taken too close to the medication. It is more important to first understand how the client is taking the medication to ensure proper administration.

Choice B reason: Reminding the client to take the medication with plenty of water is good advice, as risedronate should be taken with a full glass of water to prevent esophageal irritation. However, this response does not address the immediate concern of increasing heartburn. Understanding the client’s current administration method is crucial.

Choice C reason: Asking the client to describe how she takes the medication is the most appropriate response. This allows the nurse to identify any potential issues with the administration technique, such as not taking the medication with enough water or not remaining upright for at least 30 minutes after taking it. Correcting these issues can help reduce heartburn and improve the medication’s effectiveness.

Choice D reason: Advising the client to go to the nearest emergency department is not necessary unless the heartburn is severe or accompanied by other symptoms such as chest pain or difficulty swallowing. Initially, it is more appropriate to assess the client’s administration technique and provide guidance on proper medication use.

A. Use a straw to ingest. B. Swallow undiluted. C. Mix with an antacid. D. Take with a glass of milk.

Correct Answer is A

Explanation

Choice A Reason:

Use a straw to ingest: Ferrous sulfate elixir can cause staining of the teeth. Using a straw helps to minimize contact with the teeth, thereby reducing the risk of staining. This method ensures that the medication is ingested directly into the throat, bypassing the teeth.

Choice B Reason:

Swallow undiluted: Swallowing ferrous sulfate elixir undiluted is not recommended because it can cause gastrointestinal irritation. Diluting the elixir in water or juice can help to minimize this irritation and improve absorption.

Choice C Reason:

Mix with an antacid: Mixing ferrous sulfate with an antacid is not advisable because antacids can interfere with the absorption of iron. Iron is best absorbed in an acidic environment, and antacids neutralize stomach acid, thereby reducing iron absorption.

Choice D Reason:

Take with a glass of milk: Taking ferrous sulfate with milk is not recommended because calcium in milk can inhibit the absorption of iron. It is best to take iron supplements on an empty stomach or with a source of vitamin C, such as orange juice, to enhance absorption

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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 female client with osteoporosis has been taking a weekly dose of oral risedronate for several weeks. The client calls the clinic nurse to report increasing heartburn. How should the nurse respond?

Correct Answer is C

Explanation

Ferrous sulfate elixir is prescribed for a client with iron deficiency anemia. Which instruction should the nurse provide this client about taking the liquid medication?

Correct Answer is A

Explanation

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