The nurse is assigned a 49-year-old female client in the primary care office for a wellness visit. The nurse assesses the client, documents nurses notes, and reviews the medication administration record for potential interactions. The nurse should be most concern with the potential interaction between __________and _________.
Complete the sentence by choosing one answer from each option in the drop-down list below:
Medication Reconciliation:
St. John's wort 450 mg by mouth twice daily
Gabapentin 400 mg by mouth twice daily
Aspirin 81 mg by mouth daily
Atorvastatin 80 mg by mouth daily
Lisinopril 5 mg by mouth daily
Warfarin 5 mg by mouth daily
Ginger 5mg by mouth daily
Valerian 10mg by mouth daily
Correct Answer : A,F
A. St. John's wort 450 mg by mouth twice daily: St. John's wort is known to be a potent inducer of cytochrome P450 enzymes and can significantly reduce the effectiveness of warfarin by increasing its metabolism. This interaction can lead to subtherapeutic levels of warfarin and an increased risk of thromboembolic events.
B. Gabapentin 400 mg by mouth twice daily: While gabapentin can interact with other medications, its interactions with warfarin or St. John's wort are generally not as significant as those between warfarin and St. John's wort.
C. Aspirin 81 mg by mouth daily: Aspirin has anticoagulant properties and can have interactions with warfarin. However, the interaction with St. John's wort is less pronounced compared to the interaction between warfarin and St. John's wort.
D. Atorvastatin 80 mg by mouth daily: Atorvastatin primarily affects lipid levels and has different metabolic pathways compared to warfarin. It does not have a strong interaction with St. John's wort.
E. Lisinopril 5 mg by mouth daily: Lisinopril is an ACE inhibitor and does not have significant interactions with St. John's wort or warfarin.
F. Warfarin 5 mg by mouth daily. Warfarin is an anticoagulant that requires careful monitoring due to its interactions with various substances that can either increase the risk of bleeding or decrease its effectiveness.
G. Ginger 5 mg by mouth daily: Ginger can affect platelet function but is not as significant in interaction with warfarin as St. John's wort.
H. Valerian 10 mg by mouth daily: Valerian may have mild interactions with central nervous system depressants but does not have significant interactions with warfarin or St. John's wort.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) Inject a volume of less than 2 mL: While it is generally recommended to inject a volume of less than 2 mL into the deltoid muscle to avoid discomfort and ensure proper absorption, this is not the primary action to focus on when planning the injection.
B) Inject the medication at a 90 degree angle: This is the correct action. Administering an intramuscular (IM) injection at a 90-degree angle ensures that the medication is delivered deep into the muscle tissue, which is necessary for proper absorption and effectiveness.
C) Inject the medication 12.7 cm (5 in) below the client’s acromion process: The correct injection site for the deltoid muscle is typically 2-3 finger widths (approximately 2.5-5 cm) below the acromion process, not 12.7 cm. Injecting too far below the acromion process could result in an incorrect injection site.
D) Use a 21-gauge needle for the injection: While a 21-gauge needle can be used for IM injections, the gauge of the needle is not the primary focus in this context. The angle of injection is more critical to ensure proper delivery of the medication.
Correct Answer is ["D","E"]
Explanation
A) Affinity: Affinity refers to the strength of the interaction between a drug and its receptor. It does not describe the body's overall handling of the drug or the drug's effects on the body.
B) Efficacy: Efficacy describes the ability of a drug to produce a desired therapeutic effect. It pertains to the drug’s effectiveness once it interacts with its target but does not encompass the body's handling of the drug.
C) Biotransformation: Biotransformation is the process of drug metabolism, specifically how the body chemically alters a drug. While it is a part of pharmacokinetics, it does not cover the entire concept.
D) Pharmacokinetics: Pharmacokinetics is the term used to describe what the body does with the drug, including absorption, distribution, metabolism, and excretion. It encompasses the processes that determine the drug's concentration in the body over time.
E) Pharmacodynamics: Pharmacodynamics refers to what the drug does to the body, including the relationship between drug concentration and effect. It encompasses the mechanisms of action, including receptor interactions and therapeutic effects.
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