Question

A female client with mild depression reports to the nurse recently starting St. John's wort. Which information provided by the client requires further instruction?

Answer 1

Correct Answers:

Another form of contraception is not needed.

Rationale :

🩺St. John's wort is known to interact with hormonal contraceptives, potentially reducing their effectiveness due to enzyme induction in the liver.

🌿Clients using oral contraceptives should be advised to use an additional method of contraception while taking this herb.

⚠️Failure to do so may result in unintended pregnancy, which is especially important to prevent in clients being treated for mental health conditions.

💊While dry mouth, insomnia, and photosensitivity are known expected side effects, the belief that additional contraception is not needed reflects a misunderstanding that must be corrected.

📌Core Message

St. John’s wort can reduce contraceptive effectiveness, so clients should use backup birth control.

Answer 2

Correct Answers:

Toasted wheat bread and jelly.

Rationale :

🍞Tetracyclines should be taken with non-dairy, non-calcium-rich foods if needed to reduce GI upset.

🥛Dairy products like milk, cheese, and yogurt can bind to tetracycline and impair absorption, reducing the drug’s effectiveness.

🔬Toasted bread with jelly provides a low-calcium, mild option that won't interfere with medication absorption.

🚫Taking it with calcium-rich snacks like cereal with milk or yogurt can lead to subtherapeutic levels of the drug.

📌Core Message

Tetracycline should be taken without dairy to avoid reduced drug absorption and maintain effectiveness.

Answer 3

Correct Answers:

Platelet count of 100,000/mm³ (100 x 10^9/L).

Rationale :

🩸Enoxaparin is an anticoagulant that can cause heparin-induced thrombocytopenia (HIT), a potentially life-threatening complication.

📉A platelet count of 100,000 is below the normal range, indicating a significant drop that may warrant stopping the medication.

🧪Other lab values like hematocrit, BUN, and creatinine are within normal limits and do not indicate urgent concern.

⚠️Immediate action is needed to prevent bleeding or thrombotic events associated with HIT.

📌Core Message

Thrombocytopenia is a serious complication of enoxaparin and requires immediate nursing intervention.

Answer 4

Correct Answers:

Feverfew may interact with aspirin or non-steroidal anti- inflammatory drugs.

Rationale :

🔍Feverfew has antiplatelet properties, which can potentiate the effects of other medications that affect bleeding, such as NSAIDs or aspirin.

🩹This interaction can increase the risk of bleeding, particularly in clients who are also taking anticoagulants or antiplatelet drugs.

🌿Clients using feverfew should be cautioned against concurrent use of medications with similar effects unless directed by a healthcare provider.

🧠Although side effects like nausea and sensitivity in allergic individuals are important, the interaction with common medications poses a more significant clinical risk.

📌Core Message

Feverfew can increase bleeding risk when taken with NSAIDs or aspirin and requires patient education.

Answer 5

Correct Answers:

Body mass index.

Rationale :

📏Orlistat works by blocking fat absorption in the gastrointestinal tract, which over time contributes to weight loss.

⚖️Body mass index (BMI) is a key, standardized measurement to evaluate progress in weight reduction therapies.

📅Monitoring BMI at regular intervals gives a reliable indicator of the medication’s effectiveness in the context of a structured weight management plan.

🩺While other parameters may reflect overall health, they do not specifically measure the direct therapeutic outcome of orlistat.

📌Core Message

BMI is the most appropriate measure to assess orlistat’s effectiveness in managing obesity.

Answer 6

Correct Answers:

Pepperoni pizza.

Rationale :

🧀Phenelzine is a monoamine oxidase inhibitor (MAOI), and clients taking it must avoid foods high in tyramine.

🍕Pepperoni pizza contains aged meats and cheese, both of which are high in tyramine and can trigger a hypertensive crisis when combined with MAOIs.

📛This dangerous reaction includes elevated blood pressure, headaches, and potential stroke, requiring emergency care.

🚫Foods like beef tips or fried shrimp may be high in fat but do not contain the tyramine risk associated with pepperoni and similar processed meats.

📌Core Message

Tyramine-rich foods like pepperoni must be avoided with MAOIs to prevent hypertensive crises.

Answer 7

Correct Answers:

Apical pulse rate of 50 beats/minute.

Rationale :

❤️Digoxin slows the heart rate and increases contractility, but it can cause bradycardia, especially in older adults or those with renal impairment.

📉An apical pulse less than 60 bpm is a contraindication for administration and should prompt withholding the dose and notifying the provider.

🩺An irregular rhythm may require further evaluation, but rate takes precedence for immediate medication decisions.

💁‍♂️Murmurs and auscultation sites are less relevant than the pulse rate threshold that dictates safe administration.

📌Core Message

Digoxin should be withheld if the apical pulse is below 60 bpm due to the risk of severe bradycardia.

Answer 8

Correct Answers:

Avoid hazardous activities until symptoms subside.

Rationale :

💤Fatigue and dizziness are expected early side effects of baclofen, a muscle relaxant used for spasticity.

🚫These effects can impair alertness and coordination, making it unsafe to drive, operate machinery, or perform tasks requiring focus.

🔁Symptoms often resolve after a few days as the body adjusts to the medication.

🗣Instructing the client to avoid hazardous activities rather than stopping the drug helps maintain therapeutic benefit while reducing injury risk.

📌Core Message

Early baclofen side effects like dizziness require temporary activity precautions, not abrupt discontinuation.

Answer 9

Correct Answers:

Denies having coughing spells.

Rationale :

😷Benzonatate is a peripherally acting antitussive that numbs the stretch receptors in the respiratory tract, thereby reducing the cough reflex.

💤The intended effect is to relieve nonproductive, persistent cough, especially to improve sleep and comfort.

🔇The best evidence that the medication is working is when the client reports a reduction or absence of coughing spells.

💬Other symptoms like nasal discharge or sleep quality may be secondary benefits but do not directly reflect cough suppression.

📌Core Message

Effectiveness of benzonatate is confirmed by reduced or absent coughing episodes.

Answer 10

Correct Answers:

Eliminate use of nonsteroidal anti-inflammatory drugs (NSAIDs).

Rationale :

🧪Lithium levels can become toxic with reduced kidney function, and NSAIDs reduce renal clearance, increasing the risk of lithium toxicity.

⚠️Clients should be counseled to avoid NSAIDs, such as ibuprofen, unless approved by the healthcare provider.

💊Lithium has a narrow therapeutic index, and small changes in excretion can lead to serious side effects like tremors, confusion, or renal failure.

🔎Other options like iodine or blood glucose monitoring are not directly affected by lithium, making NSAID avoidance the priority.

📌Core Message

NSAIDs must be avoided with lithium due to the risk of decreased clearance and toxicity.

1 :
A female client with mild depression reports to the nurse recently starting St. John's wort. Which information provided by the client requires further instruction?

2 :
A client who is taking an oral dose of a tetracycline reports gastrointestinal (GI) upset. Which snack should the nurse instruct the client to take with the tetracycline?

4 :
A client who experiences migraine headaches reports having fewer headaches since using the herbal remedy feverfew. Which information is most important for the nurse to include in a teaching plan for this client?

5 :
A client is receiving orlistat as part of a weight management program. Which ongoing assessment should be included in the plan of care to determine the effectiveness of the medication?

6 :
A client with bulimia and depression who is taking phenelzine 90 mg daily is admitted to an acute care hospital for uncontrolled hypertension. Which dietary choices should the nurse instruct the client to avoid?

7 :
Which assessment finding requires nursing intervention prior to the administration of a prescribed dose of digoxin to an adult?

8 :
A client with multiple sclerosis starts a new prescription, baclofen, to control muscle spasticity. Three days later, the client calls the clinic nurse and reports feeling fatigued and dizzy. Which instruction should the nurse provide?

9 :
A client with a cold is taking the antitussive medication benzonatate. Which assessment information indicates to the nurse that the medication is effective?

10 :
A client with bipolar disorder admitted with severe depression and suicidal ideation receives a prescription for lithium carbonate. Which instruction should the nurse provide to the client?

1 : A female client with mild depression reports to the nurse recently starting St. John's wort. Which information provided by the client requires further instruction?

2 : A client who is taking an oral dose of a tetracycline reports gastrointestinal (GI) upset. Which snack should the nurse instruct the client to take with the tetracycline?

4 : A client who experiences migraine headaches reports having fewer headaches since using the herbal remedy feverfew. Which information is most important for the nurse to include in a teaching plan for this client?

5 : A client is receiving orlistat as part of a weight management program. Which ongoing assessment should be included in the plan of care to determine the effectiveness of the medication?

6 : A client with bulimia and depression who is taking phenelzine 90 mg daily is admitted to an acute care hospital for uncontrolled hypertension. Which dietary choices should the nurse instruct the client to avoid?

7 : Which assessment finding requires nursing intervention prior to the administration of a prescribed dose of digoxin to an adult?

8 : A client with multiple sclerosis starts a new prescription, baclofen, to control muscle spasticity. Three days later, the client calls the clinic nurse and reports feeling fatigued and dizzy. Which instruction should the nurse provide?

9 : A client with a cold is taking the antitussive medication benzonatate. Which assessment information indicates to the nurse that the medication is effective?

10 : A client with bipolar disorder admitted with severe depression and suicidal ideation receives a prescription for lithium carbonate. Which instruction should the nurse provide to the client?

1 :
A female client with mild depression reports to the nurse recently starting St. John's wort. Which information provided by the client requires further instruction?

2 :
A client who is taking an oral dose of a tetracycline reports gastrointestinal (GI) upset. Which snack should the nurse instruct the client to take with the tetracycline?

4 :
A client who experiences migraine headaches reports having fewer headaches since using the herbal remedy feverfew. Which information is most important for the nurse to include in a teaching plan for this client?

5 :
A client is receiving orlistat as part of a weight management program. Which ongoing assessment should be included in the plan of care to determine the effectiveness of the medication?

6 :
A client with bulimia and depression who is taking phenelzine 90 mg daily is admitted to an acute care hospital for uncontrolled hypertension. Which dietary choices should the nurse instruct the client to avoid?

7 :
Which assessment finding requires nursing intervention prior to the administration of a prescribed dose of digoxin to an adult?

8 :
A client with multiple sclerosis starts a new prescription, baclofen, to control muscle spasticity. Three days later, the client calls the clinic nurse and reports feeling fatigued and dizzy. Which instruction should the nurse provide?

9 :
A client with a cold is taking the antitussive medication benzonatate. Which assessment information indicates to the nurse that the medication is effective?

10 :
A client with bipolar disorder admitted with severe depression and suicidal ideation receives a prescription for lithium carbonate. Which instruction should the nurse provide to the client?