Nursing Elites

1. A client who is in the rehabilitation facility with newly diagnosed Parkinson's disease (PD) has levodopa-carbidopa prescribed. During the care planning session for this client, the nurse discusses which aspects with the other members of the health care team? (Select all that apply.)

• A. Ask the dietician to avoid increasing the amounts of foods high in Vitamin B6.
• B. Lessening of tremors
• C. Remind others on the team that this medication will not relieve all symptoms of PD.
• D. Ask the evening shift nurses to give the last dose earlier in the day if the client has insomnia.

Correct answer: D

Rationale: Levodopa-carbidopa is a medication commonly used in the treatment of Parkinson's disease (PD). It can cause side effects such as hypotension with sudden position changes. To assist the client in managing this side effect, the physical therapy assistant can help avoid sudden position changes. Additionally, if insomnia occurs, adjusting the timing of the last dose earlier in the day can be beneficial. It is important to note that drowsiness can also be a side effect of the medication and should be reported to the nurse. Foods high in Vitamin B6 can interfere with the absorption of levodopa-carbidopa; hence, it is advisable to avoid increasing the consumption of such foods. Lastly, it is crucial to remind the team that while this medication helps alleviate symptoms like tremors, it may not relieve all symptoms of PD comprehensively.

2. A client with diabetes mellitus type 2 is prescribed liraglutide. The nurse should include which instruction in the client's teaching plan?

• A. Administer this medication once a week.
• B. Administer this medication once a month.
• C. Administer this medication twice a day.
• D. Administer this medication once a day.

Correct answer: D

Rationale: The correct answer is to administer liraglutide once a day. Liraglutide is typically prescribed to be taken once daily, as directed by the healthcare provider. This dosing schedule helps maintain consistent levels of the medication in the body to effectively manage blood sugar levels in clients with diabetes mellitus type 2. Option A, administering once a week, is incorrect as it would not provide consistent control of blood sugar levels. Option B, administering once a month, is also incorrect as it is not the recommended dosing frequency for liraglutide. Option C, administering twice a day, is inaccurate as liraglutide is not typically dosed in this manner. It is important for the nurse to emphasize the importance of adherence to the prescribed dosing regimen to achieve optimal therapeutic outcomes.

3. What should be obtained prior to starting olanzapine for a male client with bipolar disorder?

• A. Complete blood count
• B. Family history of hypertension
• C. History of erectile dysfunction
• D. Baseline weight

Correct answer: D

Rationale: Baseline weight should be obtained prior to starting olanzapine in a male client with bipolar disorder to monitor for potential weight gain associated with the medication. Olanzapine is known to cause weight gain and monitoring the baseline weight can help in assessing any changes during treatment.

4. A client diagnosed with a sinus infection is prescribed ampicillin sodium. The practical nurse (PN) should instruct the client to notify the healthcare provider immediately if which symptom occurs?

• A. Rash
• B. Nausea
• C. Headache
• D. Dizziness

Correct answer: A

Rationale: The correct answer is A - Rash. Rash is the most common adverse side effect of all generations of penicillin, indicating an allergy to the medication. An allergic reaction could lead to anaphylactic shock, a severe and potentially life-threatening emergency. It is crucial for the client to inform the healthcare provider promptly if a rash develops after taking ampicillin sodium.

5. A client is prescribed lisinopril for hypertension. What potential adverse effect should the practical nurse (PN) instruct the client to monitor for?

• A. Persistent cough
• B. Constipation
• C. Increased appetite
• D. Dry skin

Correct answer: A

Rationale: Corrected Rationale: Lisinopril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. This cough is distinctive and different from other causes of cough. It is essential for the client to be aware of this potential side effect as it can indicate a serious issue. Instructing the client to monitor for a persistent cough and report it to the healthcare provider promptly is crucial to ensure timely intervention and management. Choices B, C, and D are incorrect as constipation, increased appetite, and dry skin are not commonly associated with lisinopril use for hypertension. Therefore, the practical nurse should focus on educating the client about monitoring and reporting a persistent cough.

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