A client has a new prescription for Warfarin. Which of the following herbal supplements should the client be instructed to avoid?

Correct Answer: A

Rationale: In the context of pharmacology, the correct answer is A) St. John's wort. St. John's wort is known to interact with Warfarin, a blood thinner, by decreasing its effectiveness. This herb can lead to an increased risk of blood clots due to its impact on Warfarin metabolism. Therefore, clients on Warfarin should avoid St. John's wort to prevent dangerous interactions. Regarding the other options: - B) Echinacea: Echinacea is not known to interact significantly with Warfarin, so it is not the best answer in this case. - C) Garlic: While garlic may also interact with certain medications, there is no specific evidence to suggest a significant interaction with Warfarin compared to St. John's wort. - D) Ginseng: Ginseng is not typically associated with interactions with Warfarin that are as clinically significant as those with St. John's wort. Educationally, this question highlights the importance of understanding potential herb-drug interactions, especially with commonly used medications like Warfarin. Healthcare providers need to be knowledgeable about these interactions to provide safe and effective care to their patients. Patients should always inform their healthcare providers about any herbal supplements they are taking to prevent adverse effects and optimize treatment outcomes.

Correct Answer: A

Rationale: To determine the flow rate in drops per minute (gtt/min), you can use the formula: (Volume in mL x Drop factor) / Time in minutes = Flow rate in gtt/min. In this case, it would be (100 mL x 10 gtt/mL) / 45 min = 22 gtt/min. Therefore, the healthcare professional should adjust the manual IV infusion to deliver 22 gtt/min.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) 0.8 mL. To determine this, we first need to calculate the amount of heparin needed for each dose. The prescribed dose is 15,000 units, and the concentration of the available heparin injection is 20,000 units/mL. Therefore, we can set up a proportion: 15,000 units = x mL 20,000 units Cross multiplying gives us: 20,000x = 15,000 x = 15,000 / 20,000 x = 0.75 mL However, since the available injection is in 20,000 units/mL, we need to round up to the nearest practical measurement, which is 0.8 mL. Option B) 0.75 mL is incorrect because it is the exact calculated dose but not rounded up for practical administration. Option C) 0.5 mL is too low and would result in underdosing the patient. Option D) 1 mL is too high and would result in overdosing the patient. This question not only tests medication calculation skills but also emphasizes the importance of accurately measuring doses to ensure patient safety and effective treatment. It highlights the need for healthcare professionals to be precise in their calculations and administration of medications to prevent adverse effects.

Correct Answer: B

Rationale: The healthcare professional should withhold the medication and notify the provider of the client's previous reaction to penicillin. This information is crucial for the provider to prescribe an alternative antibiotic. Allergic reactions to penicillin can range from mild to severe anaphylaxis, so prior sensitization should be reported to the provider to avoid potential adverse reactions.

Correct Answer: C

Rationale: In older adults, reduced hepatic function can lead to prolonged effects of medications metabolized by the liver. This situation can result in increased drug levels in the body, causing drowsiness and other side effects. Adjusting the dosage of the hypnotic medication may be necessary to prevent such adverse effects in older adult clients.