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?
Rifampin.
Furosemide.
Citalopram.
Allopurinol.
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 B
Explanation
Choice A rationale
Monitoring for weight gain is not a primary concern with pramlintide. Pramlintide is an amylin analog used to control postprandial blood glucose levels. Weight gain is not a typical side effect of pramlintide; instead, it may cause weight loss due to its effects on appetite suppression and delayed gastric emptying.
Choice B rationale
Monitoring for hypoglycemia for 3 hours after pramlintide administration is crucial. Pramlintide can increase the risk of insulin-induced hypoglycemia, especially in patients with type 1 diabetes. This is because pramlintide slows gastric emptying and suppresses glucagon secretion, which can lead to lower blood glucose levels.
Choice C rationale
Injecting pramlintide in the upper arm is not recommended. Pramlintide should be administered subcutaneously in the abdomen or thigh, not the upper arm, to ensure proper absorption and effectiveness.
Choice D rationale
Administering pramlintide 30 minutes prior to a meal is incorrect. Pramlintide should be administered immediately before meals to help control postprandial blood glucose levels effectively.
Correct Answer is C
Explanation
Choice A rationale
Crushing hydroxychloroquine tablets can alter the drug’s release and absorption, potentially leading to suboptimal therapeutic effects or increased side effects.
Choice B rationale
Discontinuing hydroxychloroquine when symptoms subside can lead to a flare-up of rheumatoid arthritis symptoms. It is important to continue the medication as prescribed to maintain disease control.
Choice C rationale
Regular eye exams are necessary while taking hydroxychloroquine because the medication can cause retinal toxicity, which can lead to vision changes or loss if not monitored and managed appropriately.
Choice D rationale
Taking a double dose of hydroxychloroquine can increase the risk of side effects and toxicity. It is important to take the medication as prescribed and not to double up on doses.