A nurse is teaching a client who plans to take St. John's wort to treat her depression. Which of the following information should the nurse include in the teaching?

"St. John's wort may increase your risk of developing oxalate kidney stones."

"You may experience vivid dreams while taking St. John's wort

"You should avoid driving when taking St. John's wort because it can cause doziness."

"St. John's wort may cause gastrointestinal irritation."

Answer and Explanation

The Correct Answer is D

A. "St. John's wort may increase your risk of developing oxalate kidney stones." There is no strong evidence to support that St. John's wort increases the risk of kidney stones. This is not a known or common side effect of the herb, making this statement incorrect.

B. "You may experience vivid dreams while taking St. John's wort." While vivid dreams are not a common side effect of St. John's wort, there is no significant evidence supporting this as a typical reaction. The herb is more commonly associated with other side effects, such as gastrointestinal discomfort, photosensitivity, or potential interactions with medications.

C. "You should avoid driving when taking St. John's wort because it can cause drowsiness." Drowsiness is not a typical side effect of St. John's wort. In fact, St. John's wort is often used for its potential antidepressant effects, which may actually improve mood and energy levels. Therefore, advising avoidance of driving due to drowsiness is not accurate for this herb.

D. "St. John's wort may cause gastrointestinal irritation."St. John's wort can cause gastrointestinal issues such as nausea, upset stomach, or other forms of GI irritation, especially when taken in higher doses. This is one of the common side effects, so it’s important for clients to be aware of it.

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Correct Answer is C

Explanation

A. Weight gain is not typically associated with acute mania. Instead, individuals in acute mania may have increased energy and may not focus on eating or maintaining regular eating habits.

B. While auditory hallucinations (hearing voices) may occur in a manic episode, the specific symptom of "voices telling him to write a novel" could indicate a more complex thought process and may not directly link to acute mania. This could also suggest psychotic features, which may or may not be part of the manic episode.

C. Disorganized speech, often referred to as "flight of ideas" or "pressured speech," is a hallmark symptom of acute mania. It involves rapid, incoherent speech that jumps from topic to topic, indicating impaired thought processes. This directly supports the diagnosis of acute mania.

D. Dressing in all black is more likely associated with personal style or emotional expression and is not a specific symptom of acute mania. The client’s choice of clothing does not necessarily reflect manic behavior.

A. "You will need to leave the dining room right now and go somewhere else to exercise." B. "We need you to decide what activities you will do today." C. "You are already too thin and exercise is not good for you. Go sit down somewhere and eat something." D. "Come with me. Here is a milkshake to drink."

Correct Answer is D

Explanation

A. This directive is overly confrontational and lacks redirection; clients with mania may respond better to calm, supportive redirection rather than commands.

B. Giving the client control over all activity choices can be overwhelming and may worsen manic behavior. Structured guidance is more appropriate.

C. This statement is judgmental and may be perceived as critical or shaming, which can escalate agitation or reduce cooperation.

D. Offering a high-calorie, easy-to-consume item like a milkshake helps address nutritional needs without requiring the client to sit and eat a full meal. It also provides gentle redirection in a non-confrontational way, which is effective during acute mania.

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A nurse is teaching a client who plans to take St. John's wort to treat her depression. Which of the following information should the nurse include in the teaching?

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Naxlex Comprehensive Predictor Exams

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