Nokea
An LPN is reviewing medication lists for several clients recently admitted to the hospital. Which of the following scenarios would be least concerning?
- A. A client taking allopurinol for gout states they have been taking black cohosh to help with post-menopausal symptoms.
- B. A client has an order for warfarin and states they have been taking Ginkgo biloba to improve their memory.
- C. A client taking Lipitor states they have been taking ginseng for an energy boost.
- D. A client has a prescription for an SSRI and states they have been taking St. John's wort to also help with their depression.
Correct Answer: C
Rationale: Ginseng may cause an increased risk of bleeding but should not interact with Lipitor. St. John's wort should not be taken with an SSRI as it may cause serotonin syndrome. Black cohosh should not be taken with allopurinol as they can both cause hepatotoxicity, especially in combination. Ginkgo biloba should not be taken with warfarin as it causes an increased risk of bleeding.
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Ciprofloxacin is prescribed for the client to treat a UTI. Which information should the nurse stress when teaching the client about the medication?
- A. Avoid taking ciprofloxacin with dairy products such as milk or yogurt.
- B. Treat diarrhea, a side effect of ciprofloxacin, with bismuth subsalicylate.
- C. Avoid fennel because it will increase the absorption of the ciprofloxacin.
- D. Take dietary calcium tablets one hour before or two hours after ciprofloxacin.
Correct Answer: A
Rationale: A: Ciprofloxacin (Cipro) is a fluoroquinolone antibiotic. Milk or yogurt decreases its absorption and should be avoided. B: Bismuth subsalicylate decreases the absorption of ciprofloxacin and should be avoided. C: Fennel will decrease, not increase, the absorption of the ciprofloxacin. D: Dietary calcium can be taken at any time; it is unaffected by ciprofloxacin.
Which of the following should not be included in the teaching for clients who take oral iron preparations?
- A. Mix the liquid iron preparation with antacids to reduce GI distress
- B. Take the iron with meals if GI distress occurs
- C. Liquid forms should be taken with a straw to avoid discoloration of tooth enamel
- D. Oral forms should be taken with juice, not milk
Correct Answer: A
Rationale: Iron should not be mixed with antacids, as antacids can reduce iron absorption. The other options are appropriate: taking with meals can reduce GI distress, using a straw prevents tooth discoloration, and juice enhances absorption while milk can inhibit it.
The nurse is reviewing client information for adverse effects of trazodone. Which finding should the nurse identify as an adverse effect unique to trazodone?
- A. Priapism
- B. Weight gain
- C. Hepatic failure
- D. Cardiac dysrhythmias
Correct Answer: A
Rationale: Prolonged or inappropriate erections (priapism) are a rare but problematic side effect of treatment with trazodone (Oleptro).
The client with GERD is taking cimetidine. Which serum laboratory finding should the nurse determine is most concerning?
- A. Increased liver enzymes
- B. Increased platelet count
- C. Decreased creatinine
- D. Decreased prolactin
Correct Answer: A
Rationale: A: Elevation of liver enzymes should be most concerning because drug-induced hepatitis is an adverse effect of cimetidine (Tagamet HB) therapy. B: Histamine-2 receptor blockers can cause myelosuppression including thrombocytopenia. A decreased (not increased) platelet count would be concerning. C: Renal adverse effects of the drug include elevated (not decreased) creatinine and BUN. D: Cimetidine can increase (not decrease) secretion of prolactin from the anterior pituitary, inducing gynecomastia.
Around what age do children start to develop "stranger anxiety"?
- A. 9 months
- B. 6 months
- C. 3 months
- D. 12 months
Correct Answer: B
Rationale: By 6 months, children should be able to recognize familiar faces, and thus they are aware of strangers. Strangers may illicit anxiety.