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

Answer and Explanation

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.

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Correct Answer is ["A","C","D","F","G"]

Explanation

Choice A: Gastrointestinal assessment
The client reports weight loss and minimal appetite over the past 3 months. This is significant because chronic alcohol use can lead to malnutrition, gastrointestinal issues, and liver damage. Weight loss and poor appetite may indicate underlying conditions such as gastritis, pancreatitis, or liver disease, which require further evaluation and intervention.
Choice B: Smoking history
The client quit smoking over 20 years ago and has no current respiratory issues. While smoking history is important for a comprehensive health assessment, it does not require immediate follow-up in this context as it is not directly related to the current acute issues of alcohol intoxication and potential withdrawal.
Choice C: Blood alcohol level
The client’s blood alcohol level (BAC) is 310 mg/dL, which is significantly elevated (normal range: 0 to 50 mg/dL). This level of intoxication can lead to severe complications such as respiratory depression, aspiration, and even death. Immediate medical intervention is necessary to manage the acute effects of alcohol intoxication and to monitor for withdrawal symptoms.
Choice D: Client’s recent loss
The recent death of the client’s parents is a significant emotional stressor that has contributed to the relapse of alcohol use disorder. Addressing this loss is crucial for the client’s mental health and recovery process. The nurse should ensure that the client receives appropriate psychological support and counseling to cope with this loss1.
Choice E: Genitourinary assessment
The client reports no known genitourinary problems. Therefore, this area does not require immediate follow-up in the context of the current admission for alcohol use disorder.
Choice F: Client’s recent consumption of alcohol
The client had their last drink 2 hours ago. This information is critical for monitoring potential alcohol withdrawal symptoms, which can begin within a few hours after the last drink and can be life-threatening if not properly managed. Close monitoring and timely intervention are essential
Choice G: Neurological assessment
The client is intoxicated, has slurred speech, and is unable to coherently respond to questions. These neurological symptoms indicate significant alcohol intoxication and the potential for withdrawal symptoms. Continuous neurological assessment is necessary to monitor for any changes in mental status and to prevent complications.
Choice H: Cardiac assessment
The client has a normal sinus rhythm and palpable pulses with no history of heart disease. While cardiac assessment is always important, there are no immediate concerns in this context that require follow-up.
Choice I: Respiratory assessment
The client’s respiratory rate is 10/min, which is on the lower end of normal (normal range: 12-20/min). However, the client has clear lungs and no shortness of breath. While respiratory status should be monitored, it is not an immediate concern requiring follow-up in this context.

Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A"}

Explanation

The nurse should first address the client’s heart rate followed by the client’s skin turgor.

Target 1: Heart Rate

Reason: The client’s heart rate is 44/min, which is significantly below the normal range of 60-100 beats per minute for adults. This condition, known as bradycardia, can be life-threatening and requires immediate medical attention. Bradycardia in anorexia nervosa patients is often due to malnutrition and electrolyte imbalances, which can lead to cardiac complications. Addressing the heart rate is crucial to stabilize the client’s cardiovascular system and prevent potential cardiac arrest.

Target 2: Skin Turgor

Reason: Skin turgor is an important indicator of hydration status. The client has decreased skin turgor, suggesting dehydration. Dehydration can exacerbate other medical conditions and lead to severe complications if not treated promptly. By addressing skin turgor, the nurse can help restore the client’s fluid balance, which is essential for overall health and recovery.

Choice A: Body Image

Reason: While body image is a significant psychological aspect of anorexia nervosa, it is not the immediate priority in this scenario. Addressing body image issues is crucial for long-term recovery and preventing relapse, but it does not pose an immediate threat to the client’s physical health. Psychological interventions can be initiated once the client’s critical physical health issues are stabilized.

Choice B: Lanugo

Reason: Lanugo, the fine hair that develops on the body, is a sign of severe malnutrition and the body’s attempt to conserve heat. While it indicates the chronic nature of the client’s condition, it is not an immediate threat to life. Addressing lanugo involves improving the client’s nutritional status over time, which will naturally resolve as the client’s health improves.

Choice C: Heart Rate

Reason: As previously mentioned, the client’s heart rate is critically low and poses an immediate risk to their life. Bradycardia must be addressed first to stabilize the client’s cardiovascular function and prevent life-threatening complications.

Choice D: Skin Turgor

Reason: Decreased skin turgor indicates dehydration, which can lead to severe complications if not corrected. Rehydration is essential for the client’s recovery and overall health, making it a priority after stabilizing the heart rate.

Choice E: Russell’s Sign

Reason: Russell’s sign, characterized by calluses on the knuckles from self-induced vomiting, is a physical indicator of the client’s purging behavior. While it is important to address the underlying behaviors associated with Russell’s sign, it is not an immediate threat to the client’s physical health. Behavioral interventions can be implemented once the client’s critical physical health issues are managed.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a mental health facility is admitting a client. Exhibits A nurse is caring for a client who was admitted for alcohol use disorder. Which of the following findings require follow-up by the nurse? Select all that apply.

Correct Answer is ["A","C","D","F","G"]

Explanation

A nurse is initiating the plan of care for a client who has anorexia nervosa. Exhibits Complete the following sentence by using the lists of options. The nurse should first address the client’s dropdown followed by the client’s dropdown

Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A"}

Explanation

Target 1: Heart Rate

Target 2: Skin Turgor

Choice A: Body Image

Choice B: Lanugo

Choice C: Heart Rate

Choice D: Skin Turgor

Choice E: Russell’s Sign

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