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 D
Explanation
Choice A rationale
Immediate-release exenatide pens should be discarded 30 days after the first use, not two months. This ensures the medication remains effective and free from contamination.
Choice B rationale
Exenatide is administered subcutaneously, not intramuscularly. The preferred injection sites are the abdomen, thigh, or upper arm.
Choice C rationale
Open exenatide pens should be stored at room temperature, but this is not the most critical aspect of patient education. Proper storage ensures the medication’s stability and effectiveness.
Choice D rationale
Immediate-release exenatide should be taken one hour before morning and evening meals to optimize its glucose-lowering effects by enhancing insulin secretion in response to meals.
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.