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A nurse is completing an admission assessment for a client who has been taking St. John’s wort. The nurse should identify that which of the following medications can interact with St. John’s wort?

A.

Rifampin.

B.

Furosemide.

C.

Citalopram.

D.

Allopurinol.

Answer and Explanation

The Correct Answer is C

Choice A rationale

 

Rifampin is an antibiotic used to treat tuberculosis and other bacterial infections. It does not have a known interaction with St. John’s wort.

 

Choice B rationale

 

Furosemide is a diuretic used to treat fluid retention and high blood pressure. It does not have a known interaction with St. John’s wort.

 

Choice C rationale

 

Citalopram is a selective serotonin reuptake inhibitor (SSRI) used to treat depression. St. John’s wort can interact with SSRIs like citalopram, potentially leading to serotonin syndrome, a serious condition caused by excessive levels of serotonin in the brain.

 

Choice D rationale

 

Allopurinol is used to treat gout and kidney stones. It does not have a known interaction with St. John’s wort.


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Correct Answer is D

Explanation

Choice A rationale

Asthma is not a contraindication for sumatriptan. Sumatriptan is a selective serotonin receptor agonist used to treat migraines by constricting blood vessels in the brain. It does not have a significant impact on respiratory conditions like asthma.

Choice B rationale

Kidney disease is not a contraindication for sumatriptan. However, caution is advised when using sumatriptan in patients with severe renal impairment due to potential accumulation of the drug and its metabolites.

Choice C rationale

Rheumatoid arthritis is not a contraindication for sumatriptan. Sumatriptan’s mechanism of action does not interfere with the inflammatory processes involved in rheumatoid arthritis.

Choice D rationale

Coronary artery disease (CAD) is a contraindication for sumatriptan. Sumatriptan can cause vasoconstriction of coronary arteries, which can exacerbate CAD and increase the risk of myocardial infarction or other cardiac events.

Correct Answer is C

Explanation

Choice A rationale

Mannitol is an osmotic diuretic used primarily to reduce intracranial pressure (ICP) and treat cerebral edema. It does not affect thyroxine levels, which are related to thyroid function. Thyroxine levels are regulated by the thyroid gland and are not influenced by mannitol administration.

Choice B rationale

Mannitol is not used to correct atrial flutter. Atrial flutter is a type of arrhythmia that requires specific antiarrhythmic medications or procedures such as cardioversion. Mannitol’s primary action is to increase osmotic pressure in the kidneys, leading to diuresis and reduction of fluid in tissues, including the brain.

Choice C rationale

Mannitol is effective in reducing intracranial pressure by creating an osmotic gradient that draws fluid from the brain tissue into the bloodstream, which is then excreted by the kidneys. This reduction in intracranial pressure is a desired therapeutic outcome when treating conditions like cerebral edema.

Choice D rationale

Mannitol does not increase hemoglobin levels. Hemoglobin levels are influenced by factors such as red blood cell production and destruction, iron levels, and overall health status. Mannitol’s mechanism of action is related to fluid balance and diuresis, not hematopoiesis.

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