Practice Question
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 that the client has been self-administering St. John's Wort, an herbal preparation, on the advice of a friend. Which information is most significant about this finding?
Answer Choices:
Correct Answer:
St. John's Wort can decrease plasma concentrations of cyclosporine.
Rationale:
🟣 St. John’s Wort induces CYP3A4 enzymes, which increase the metabolism of cyclosporine and lower its plasma levels.
🟣 This decreases immunosuppressive protection and significantly raises the risk of organ transplant rejection.
🟣 The most serious consequence of this interaction is graft loss, not minor adverse effects.
🟣 Clients must be educated to avoid herbal supplements without provider consultation post-transplant.
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This question is from RN-HESI Pharmacology Exam 3 which contains 40 questions.
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A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective? Reference Range: Hemoglobin (Hgb) [14 to 18 g/dL (8.7 to 11.2 mmol/L)].
Answer Choices:
A. Takes concurrent iron therapy without adverse effects.
B. Reports of increased energy levels and decreased fatigue.
C. Hemoglobin level increased to 12 g/dl. (7.45 mmol/L).
D. Food diary shows increased consumption of iron-rich foods.
To control asthma, a client in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system, which provides an inhaled powdered form of these combined medications. Which instruction should the nurse provide to this client's caregivers?
Answer Choices:
A. When using the discus, have the client breathe out rapidly into the mouthpiece
B. Offer the discus to the client for use during an acute asthma attack.
C. Clients using the discus may experience decreased blood pressure.
D. Explain that the client should not use the discus more than twice daily.
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Answer Choices:
A. Initiate cardiopulmonary resuscitation (CPR).
B. Prepare to assist with chest tube insertion.
C. Determine Glasgow Coma Scale score.
D. Administer a second dose of naloxone.
The nurse is caring for a client receiving a prescription for sucralfate to treat a peptic ulcer. Which instruction should the nurse provide during discharge education?
Answer Choices:
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B. Administer an additional dose if a dose is missed.
C. Take on an empty stomach at least 1 hour before meals.
D. Schedule doses with each meal and at bedtime.
The nurse administers risedronate to a client with osteoporosis at 0700. The client asks for a glass of milk to drink with the medication. Which action should the nurse take?
Answer Choices:
A. Consult with a pharmacist about scheduling the dose one hour after the client eats.
B. Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low-fat milk.
C. Withhold the medication until the client's breakfast tray is available on the unit.
D. Instruct the client that it is necessary to take nothing but water with the medication.
Question Details
- Category: RN Nursing Exam(s)
- Subcategory: HESI Exam(s)
- Domain: Hesi Pharmacology
- Answer Choices: 4
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