An older adult is having difficulty sleeping and asks a nurse, My neighbor told me that I should take melatonin to help me sleep. What do you think about this? The nurse responds to the indi-vidual's question using the knowledge that:
(Select all that apply.)
a. in the natural state melatonin is produced by the pineal gland and regulates the sleep-wake cycle.
b. melatonin is available in both immediate and extended release forms; however, on-ly the immediate form is effective.
c. there are no significant adverse effects to melatonin.
d. it must be used with caution in a patient that is taking other medications that have central nervous system depressant effects.
e. evidence shows that it is effective at de-creasing sleep onset latency, improving quality of sleep, and improving morning wakefulness.
Question 2The nurse is confident that the client who takes glucosamine sulfate daily is conscientious of the safety issues involved when hearing the client state: (Select all that apply.)
a. I'm always careful to buy the same brand of glucosamine sulfate.
b. If glucosamine sulfate wasn't safe the drug store wouldn't sell it.
c. My pharmacist is so helpful when I have questions about the herbals I take.
d. The liquid form of glucosamine sulfate is what I consistently take.
e. I made sure my physician knew that I was allergic to strawberries.
Question 3The major focus regarding nursing education for the older adult regarding the use of herbal sup-plements is the:
a. high risk of herbal overdose since the manufacturing process lacks effective controls.
b. likelihood that the client will substitute herbals for more expensive prescribed medications.
c. expense of the herbal supplements since they are seldom covered by insurance.
d. possibility of dangerous interactions be-tween herbals and the client's prescription medications.
Question 4The nurse is confident that the client who chooses to take red rice yeast daily for dyslipidemia has an understanding of its possible side effects when the client:
a. has regular laboratory work to monitor cholesterol levels.
b. shows caution by slowly rising from the chair.
c. states, If I start noticing muscle pain, I'll stop taking the pills.
d. schedules regular, yearly glaucoma screenings.
Question 5The nurse is conducting a presurgical interview when it is noted that the older adult patient's medication list includes Tylenol 650 mg four times a day for arthritic pain, gingko 80 mg twice a day, and glucosamine chondroitin 500 mg three times per day.
The nurse proceeds to share with the client that in order to minimize the risk for postsurgical complications, there is the need to refrain from taking:
a. glucosamine chondroitin for 1-2 weeks due to a potential for excess anesthetic sedation.
b. ginkgo for 2 weeks due to the potential for increased bleeding.
c. Tylenol for 24-48 hours due to the poten-tial for increased bleeding.
d. gingko for 1 week due to the potential for an allergic reaction during surgery.
Question 6When a nursing interview identifies that a client is daily taking doses of herbal supplements, the nurse's priority is to:
a. evaluate the effectiveness of the herbal supplement self-treatment.
b. determine why the client feels the need to take the herbal supplements.
c. identify when the herbal supplementation began.
d. discuss the client's knowledge regarding the herbal supplements' side effects.
Question 7When a client who routinely takes the herb St. John's Wort (SJW) shares that his or her hay fe-ver is really bad right now, the nurse initially:
a. notifies the primary care provider that the client has been self-medicating for hay fever.
b. compares the client's current blood pres-sure to his/her baseline blood pressure.
c. stresses the need to avoid over-the-counter (OTC) medications containing monoam-ines.
d. suggests that the client stop taking the herb until the hay fever has improved.
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