A patient is being discharged on anticoagulant therapy. The nurse will include in the patient-education conversation that it is important to avoid herbal products that contain which substance?
Valerian
St. John’s wort
Saw palmetto
Soy
The Correct Answer is B
Choice A reason: Valerian, used for sleep disorders, has no significant interaction with anticoagulants like warfarin. It may cause sedation but does not affect hepatic CYP450 enzymes or vitamin K-dependent clotting factors, making it safe for patients on anticoagulant therapy, with no impact on bleeding risk or drug metabolism.
Choice B reason: St. John’s wort induces hepatic CYP450 enzymes, particularly CYP3A4, accelerating warfarin metabolism. This reduces warfarin’s anticoagulant effect, decreasing INR and increasing thrombosis risk. Patients must avoid it to maintain therapeutic anticoagulation, making this a critical herbal interaction to report.
Choice C reason: Saw palmetto, used for prostate health, has minimal interaction with anticoagulants. It does not significantly affect CYP450 enzymes or clotting factor synthesis. While it may have mild antiplatelet effects, it is not a primary concern for warfarin therapy compared to St. John’s wort’s enzyme induction.
Choice D reason: Soy has no significant interaction with anticoagulants like warfarin. It does not affect hepatic metabolism or vitamin K-dependent clotting factors. While dietary vitamin K can influence warfarin, soy’s impact is minimal, making it less critical to avoid compared to enzyme inducers like St. John’s wort.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Definitive therapy targets a confirmed infection with antibiotics chosen based on culture results. Prescribing antibiotics before a dental procedure for a heart condition aims to prevent infection, not treat an existing one, making this incorrect for endocarditis prophylaxis.
Choice B reason: Empiric therapy involves antibiotics for suspected infections without confirmed pathogens. Antibiotics before dental procedures in heart patients prevent endocarditis, not treat suspected infections. This is a preventive measure based on risk, not empiric treatment, making this incorrect.
Choice C reason: Supportive therapy addresses symptoms or supports other treatments, not infection prevention. Antibiotics before dental procedures in patients with heart conditions (e.g., valvular disease) prevent bacterial endocarditis, a specific prophylactic measure, not supportive care, making this an incorrect classification.
Choice D reason: Prophylactic antibiotic therapy prevents infections in high-risk patients, such as those with heart conditions (e.g., mitral valve prolapse) before dental procedures. It reduces the risk of bacterial endocarditis from transient bacteremia, aligning with guidelines for prophylaxis in susceptible individuals, making this correct.
Correct Answer is D
Explanation
Choice A reason: Temporary swelling and rash are not common adverse effects of topical acyclovir. This antiviral inhibits viral DNA replication with minimal local irritation. Allergic reactions are rare, and swelling or rash would suggest hypersensitivity, not a typical response to topical application for genital herpes.
Choice B reason: Numbness and tingling are not associated with topical acyclovir. These symptoms may occur with systemic antivirals or nerve-related conditions, but topical acyclovir acts locally on herpes lesions with minimal systemic absorption, causing primarily mild irritation rather than neurological symptoms like paresthesia.
Choice C reason: Insomnia is not a side effect of topical acyclovir, which has negligible systemic absorption. Systemic antivirals like oral acyclovir may rarely cause CNS effects, but topical application is confined to the skin, primarily causing local irritation, not systemic effects like sleep disturbances.
Choice D reason: A burning sensation is a common adverse effect of topical acyclovir when applied to genital herpes lesions. The drug’s vehicle or local tissue irritation during application can cause transient burning or stinging, which is expected and typically resolves, requiring patient education to ensure adherence.
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