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: Omeprazole is a proton pump inhibitor used to treat gastroesophageal reflux disease (GERD). While it is generally safe, it is not commonly associated with causing jaundice. Omeprazole can cause liver enzyme elevations in rare cases, but it is not a primary concern for drug-induced jaundice.

Choice B reason: Acetaminophen is known to cause hepatotoxicity, especially in high doses or with prolonged use. It is one of the most common causes of drug-induced liver injury, which can lead to jaundice. The nurse should notify the healthcare provider about the use of acetaminophen, as it is a likely culprit for the client’s jaundice.

Choice C reason: Captopril is an ACE inhibitor used to treat hypertension. While it can cause various side effects, it is not typically associated with causing jaundice. The primary concerns with captopril are related to renal function and electrolyte imbalances.

Choice D reason: Prednisone is a corticosteroid used to reduce inflammation in conditions like osteoarthritis. Although long-term use of corticosteroids can affect liver function, it is not commonly associated with causing jaundice. The nurse should still monitor liver function but focus on more likely causes.

A. I should take this medication only when I am having an asthma attack. B. I will not need to use my inhalers twice a day when I start this medicine. C. I will take the tablet every evening to control my asthma. D. This medication will stop an asthma attack immediately.

Correct Answer is C

Explanation

Choice A Reason:

I should take this medication only when I am having an asthma attack: This statement is incorrect because montelukast is not a rescue medication. It is a maintenance medication designed to be taken regularly to prevent asthma symptoms and attacks. Using it only during an asthma attack would not provide the intended preventive benefits.

Choice B Reason:

I will not need to use my inhalers twice a day when I start this medicine: This statement is also incorrect. Montelukast is often used as an adjunct therapy and does not replace the need for inhalers, especially for those with moderate to severe asthma. Inhalers, particularly corticosteroids, remain a critical part of asthma management.

Choice C Reason:

I will take the tablet every evening to control my asthma: This statement is correct. Montelukast is typically prescribed to be taken once daily in the evening. This helps to control asthma symptoms and prevent attacks by reducing inflammation and constriction in the airways.

Choice D Reason:

This medication will stop an asthma attack immediately: This statement is incorrect. Montelukast is not a fast-acting medication and will not provide immediate relief during an asthma attack. Fast-acting bronchodilators, such as albuterol, are used for immediate relief.

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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?

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A client with chronic asthma receives a prescription for montelukast, a leukotriene modifier. Which statement by the client indicates to the nurse that medication teaching was effective?

Correct Answer is C

Explanation

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