A nurse is teaching a client who is about to start taking fluoxetine. The nurse should instruct the client that which of the following supplements interacts adversely with fluoxetine?
St. John's wort
Soy protein
Echinacea
Ginkgo biloba
The Correct Answer is A
Choice A reason:
St. John's wort is known to interact adversely with fluoxetine. Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) used to treat depression and other conditions. St. John's wort also has effects on serotonin, and when taken with fluoxetine, it can increase the risk of serotonin syndrome, a potentially life-threatening condition. Symptoms of serotonin syndrome include confusion, rapid heart rate, dilated pupils, loss of muscle coordination, heavy sweating, and muscle rigidity³. Therefore, it is crucial for patients on fluoxetine to avoid taking St. John's wort to prevent any serious complications.
Choice B reason:
Soy protein is not known to have a significant interaction with fluoxetine. Soy products are commonly consumed foods and are generally considered safe. However, patients should always consult with their healthcare provider before starting any new supplement to ensure it does not interfere with their medication regimen.
Choice C reason:
Echinacea is commonly used to support the immune system, especially for colds and other respiratory infections. There is no well-documented interaction between echinacea and fluoxetine, but as with any supplement, it is advisable to consult with a healthcare provider before combining it with prescription medications.
Choice D reason:
Ginkgo biloba is often used for memory enhancement or to improve circulation. While there are some concerns about ginkgo's potential to affect bleeding due to its blood-thinning properties, there is no direct adverse interaction with fluoxetine. However, patients taking fluoxetine should be cautious with any supplements that can affect bleeding, especially if they are also taking other medications with similar effects.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}
Explanation
The nurse should identify that the client’s diagnostic results and abdominal examination are consistent with sexual assault.
Choice A: The diagnostic results show a positive test for GHB (gamma-hydroxybutyric acid). GHB is a central nervous system depressant that is commonly referred to as a “club drug” or “date rape” drug. It is often used in cases of drugging and sexual assault due to its euphoric and calming effects at low doses. Larger doses can cause loss of consciousness and a type of short-term memory loss known as anterograde amnesia4. These effects have led sexual predators to use GHB as a date-rape drug.
Choice B: The client’s blood pressure is 128/88 mm Hg, which falls within the normal range of 90/60 mmHg to 120/80 mmHg. Therefore, the blood pressure does not provide any specific indication of sexual assault.
Choice C: the abdominal examination reveals tenderness, which could be a result of the assault. This, along with the client’s statement and physical signs such as bruising and broken fingernails, supports the client’s claim of sexual assault.
Choice D: The client’s temperature is 37°C (98.6°F), which is within the normal body temperature range of 97.8°F to 99.1°F (36.5°C to 37.3°C). Therefore, the temperature does not provide any specific indication of sexual assault.
Choice E: While the presence of GHB in the client’s system is a significant finding, it is part of the diagnostic results rather than a separate drug assessment. Therefore, this choice is not as accurate as Choice A (Diagnostic results).
Correct Answer is C
Explanation
Choice A reason:
Telling the client that they will eventually get used to people talking at night is not a supportive or effective response. It dismisses the client's current discomfort and does not address the immediate issue of noise disrupting their sleep. Clients in inpatient treatment for eating disorders often have heightened sensitivity to their environment, and dismissing their concerns can increase stress and anxiety.
Choice B reason:
Recommending that the client try to sleep during the day when it is quieter is not practical. It disrupts the client's natural circadian rhythm and can lead to further sleep disturbances. Encouraging a regular sleep schedule at night is more beneficial for overall health and recovery.
Choice C reason:
Keeping conversations and activities to a minimum during the nighttime is the most appropriate action. This approach directly addresses the client's concern about noise and helps create a quieter, more restful environment. Reducing noise levels at night can significantly improve sleep quality for clients in inpatient settings.
Choice D reason:
Turning on the client's television at night to cover up environmental noises is not advisable. While it might mask some noise, it can also introduce new disturbances and prevent the client from achieving deep, restorative sleep. The light and sound from the television can interfere with the body's natural sleep processes.
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