A patient who has been diagnosed with social anxiety disorder will begin taking venlafaxine(Effexor). The nurse who performs a medication and dietary history will be concerned about ingestion of which substance or drug?

Correct Answer: D

Rationale: St. John's wort is an herbal supplement that can interact with many medications, including venlafaxine (Effexor). When taken together, it can decrease the effectiveness of venlafaxine by increasing its metabolism, potentially leading to reduced therapeutic effects. This interaction can also increase the risk of side effects or adverse reactions. Therefore, the nurse should be concerned about the ingestion of St. John's wort when a patient is taking venlafaxine to ensure proper medication management and effectiveness. It is important for patients to inform healthcare providers about all supplements they are taking to prevent harmful interactions.

Correct Answer: C

Rationale: The most helpful test in determining the response to highly active antiretroviral therapy (HAART) in an HIV-positive client is the viral load test. This test measures the amount of HIV in a person's blood, indicating how well the medication is working to suppress the virus. A decrease in the viral load over time signifies a positive response to the treatment, while an increase may indicate treatment failure or drug resistance development. Monitoring the viral load is crucial in managing HIV and making informed decisions about the continuation or modification of the antiretroviral therapy regimen. Rapid HIV antigen tests, Western Blot analysis, and white blood cell count do not directly assess the response to HAART in the same way that viral load testing does.

Correct Answer: D

Rationale: When administering a loop diuretic to a patient, it is crucial to determine if the patient is also taking theophylline. Loop diuretics may interact with theophylline, leading to an increase in theophylline levels in the blood. This interaction can result in elevated theophylline concentrations, potentially causing toxicity symptoms such as nausea, vomiting, headache, and arrhythmias. Therefore, monitoring the patient's theophylline levels and adjusting the dosage accordingly is essential to prevent adverse effects. It is important for healthcare providers to be aware of potential drug interactions and consider them when prescribing medications to avoid harmful complications for the patient.

Correct Answer: C

Rationale: Antacids or antidiarrheals should be avoided for at least 4 hours after taking digoxin. These medications can interfere with the absorption of digoxin in the body, thereby reducing its effectiveness. By spacing out the administration of these medications, the risk of decreased digoxin absorption and potential impact on its therapeutic effects can be minimized. It is important for patients to follow this guidance to ensure optimal effectiveness of digoxin therapy.

Correct Answer: D

Rationale: Clozapine, a second-generation antipsychotic, is highly effective for treatment-resistant schizophrenia but carries a 1-2% risk of agranulocytosis, a severe drop in neutrophils, necessitating regular blood monitoring. Chlorpromazine causes rare leukopenia, not agranulocytosis prominence. Buspirone, an anxiolytic, lacks hematological risks. Lithium may increase leukocytes, not decrease them. Asenapine has minimal blood dyscrasia association. Clozapine's unique efficacy comes with this rare but serious side effect, distinguishing it and requiring strict oversight, per FDA guidelines.