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 a diagnosis of bipolar disorder is prescribed lithium. The nurse should monitor for which potential side effect?

• A. Dry mouth
• B. Hair loss
• C. Weight gain
• D. Tremors

Correct answer: D

Rationale: The correct answer is D: Tremors. When a client is prescribed lithium for bipolar disorder, one common side effect to monitor for is tremors. Tremors are a known adverse effect of lithium therapy and should be monitored closely by healthcare providers. Choice A, dry mouth, is not typically associated with lithium use. Hair loss, as in choice B, is not a common side effect of lithium. Weight gain, as mentioned in choice C, can occur with some medications used to treat bipolar disorder, but it is not a prominent side effect of lithium specifically.

3. What instruction should the nurse include in the teaching plan for a client with diabetes mellitus type 2 prescribed alogliptin?

• A. Report any signs of pancreatitis to the healthcare provider.
• B. Take this medication with meals.
• C. Avoid alcohol while taking this medication.
• D. Report any signs of heart failure to the healthcare provider.

Correct answer: A

Rationale: The correct answer is A: Report any signs of pancreatitis to the healthcare provider. Alogliptin is associated with an increased risk of pancreatitis. Therefore, clients should be instructed to report any signs of pancreatitis, such as severe abdominal pain, to their healthcare provider promptly. This is essential for early detection and management of this serious adverse effect. Choices B, C, and D are incorrect because they do not address the specific side effect associated with alogliptin.

4. When should a glucagon emergency kit be used for a client with Type 1 diabetes?

• A. During episodes of hypoglycemia
• B. At the onset of signs of diabetic ketoacidosis
• C. Before meals to prevent hyperglycemia
• D. When signs of severe hypoglycemia occur

Correct answer: D

Rationale: A glucagon emergency kit is used when signs of severe hypoglycemia occur in a client with Type 1 diabetes. Glucagon helps raise blood glucose levels in cases of severe hypoglycemia when the individual is unable to take oral glucose. It is crucial to administer glucagon promptly to prevent serious complications associated with low blood sugar levels. Choices A, B, and C are incorrect because a glucagon emergency kit is specifically indicated for severe hypoglycemia, not for general episodes of hypoglycemia, diabetic ketoacidosis, or prevention of hyperglycemia.

5. A client with bipolar disorder is taking lithium. Which client assessment data would indicate a potential adverse effect of lithium therapy?

• A. Increased appetite
• B. Dry mouth and increased thirst
• C. Tremors and polyuria
• D. Constipation

Correct answer: B

Rationale: When assessing a client taking lithium, dry mouth and increased thirst are indicators of potential adverse effects. Lithium can lead to nephrogenic diabetes insipidus, causing polyuria and subsequent increased thirst due to impaired water reabsorption in the kidneys. Tremors can also be a sign of lithium toxicity. Monitoring and recognizing these symptoms are crucial in managing lithium therapy and preventing further complications.

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