Nokea
A client who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. While taking the client's history, the nurse determines the client has been self-administering St. John's wort, an herbal preparation, on the advice of a friend. What information is most significant about this finding?
- A. Wort can decrease plasma concentration of Cyclospora
- B. Wort can decrease plasma concentration of Tacrolimus
- C. Wort can decrease plasma concentration of Cyclosporine
- D. Wort can decrease plasma concentration of Mycophenolate
Correct Answer: C
Rationale: The most significant information about the client self-administering St. John's wort, an herbal preparation, is that it can decrease the plasma concentration of Cyclosporine. St. John's wort is known to reduce the efficacy of Cyclosporine, which is a common immunosuppressant drug used to prevent transplant rejection. Choices A, B, and D are incorrect because St. John's wort does not affect the plasma concentration of Cyclospora, Tacrolimus, or Mycophenolate.
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A client with a diagnosis of schizophrenia is prescribed clozapine. The nurse should monitor the client for which potential side effect?
- A. Agranulocytosis
- B. Dry mouth
- C. Weight gain
- D. Hypersalivation
Correct Answer: A
Rationale: The correct answer is Agranulocytosis. Clozapine is known to potentially cause agranulocytosis, a serious condition characterized by a dangerously low white blood cell count. Monitoring white blood cell counts is crucial to detect this side effect early and prevent complications. Choices B, C, and D are incorrect because dry mouth, weight gain, and hypersalivation are not typically associated with clozapine use. While dry mouth can be a common side effect of some antipsychotic medications, it is not specifically linked to clozapine. Weight gain can occur with certain antipsychotics, but clozapine is more commonly associated with metabolic side effects. Hypersalivation is not a common side effect of clozapine.
A client is prescribed amitriptyline for depression. The practical nurse (PN) should monitor for which potential side effect?
- A. Insomnia
- B. Weight loss
- C. Dry mouth
- D. Increased appetite
Correct Answer: D
Rationale: The correct answer is 'D: Increased appetite.' Amitriptyline, a tricyclic antidepressant, is known to commonly cause increased appetite, leading to weight gain. Monitoring for increased appetite is crucial as it can impact the client's overall health and well-being. Choice A, 'Insomnia,' is less likely as amitriptyline is more associated with sedative effects. Choice B, 'Weight loss,' is incorrect as weight gain is a more common side effect. Choice C, 'Dry mouth,' is a potential side effect of amitriptyline, but it is not directly related to increased appetite, which is the primary concern in this case.
A client with a diagnosis of schizophrenia is prescribed risperidone. The nurse should monitor for which potential side effect?
- A. Weight gain
- B. Tremors
- C. Insomnia
- D. Hyperglycemia
Correct Answer: A
Rationale: The correct answer is A: Weight gain. When a client is prescribed risperidone, monitoring weight is crucial due to the potential side effect of weight gain associated with this medication. This side effect can be significant as it may lead to other health issues. Choice B, Tremors, is not typically associated with risperidone use. Choice C, Insomnia, is less likely to be a direct side effect of risperidone compared to weight gain. Choice D, Hyperglycemia, is a possible side effect of some antipsychotic medications, but it is not commonly associated with risperidone.
A client with a diagnosis of generalized anxiety disorder is prescribed venlafaxine. The nurse should instruct the client that this medication may have which potential side effect?
- A. Nausea
- B. Dry mouth
- C. Insomnia
- D. Headache
Correct Answer: A
Rationale: The correct answer is A: Nausea. Venlafaxine, a medication used for generalized anxiety disorder, can commonly cause nausea as a side effect. It is essential for clients to be aware of this potential side effect and advised to take the medication with food if nausea occurs. Choices B, C, and D are incorrect because dry mouth, insomnia, and headache are less commonly associated side effects of venlafaxine compared to nausea.
A client with angina pectoris has been prescribed nitroglycerin tablets prn for chest pain. Which statement by the client causes the practical nurse (PN) to clarify instructions for this client?
- A. I will take one tablet every 5 minutes, up to three tablets.
- B. I should take one tablet at the onset of angina and stop activity.
- C. I need to replace nitroglycerin tablets every 3 to 6 months to maintain freshness.
- D. I should ensure that I chew the pill completely before swallowing it.
Correct Answer: D
Rationale: Nitroglycerin tablets should be taken at the onset of angina, and the client should stop activity and rest. One tablet should be placed under the tongue (sublingually), not chewed or swallowed. One tablet can be taken every 5 minutes, up to three doses. If pain relief not achieved after taking three pills, seek medical attention immediately. Nitroglycerin should be replaced every 3 to 6 months. Nitroglycerin pain relief should occur in 5 minutes and duration should last 30 minutes.