Nursing Elites

1. A home health care nurse observes that a client with Parkinson's syndrome is experiencing increased tremors and difficulty in movement. What should the nurse do in response to this finding?

• A. Report the observed finding to the healthcare provider right away
• B. Arrange a medical evaluation so the medication dose can be adjusted
• C. Schedule a return home visit in 2 weeks to monitor
• D. Explain that this is an expected progression of Parkinson's

Correct answer: B

Rationale: In a client with Parkinson's syndrome experiencing increased tremors and movement difficulty, arranging a medical evaluation is crucial to adjust the medication dose. This proactive approach helps in managing the symptoms effectively. Reporting the finding to the healthcare provider may delay necessary adjustments in treatment. Scheduling a return home visit in 2 weeks may not address the immediate need for medication adjustment. Explaining that the progression is expected without taking action does not address the client's worsening symptoms.

2. A client with rheumatoid arthritis is prescribed sulfasalazine. Which instruction should the nurse include in the client's teaching plan?

• A. Take this medication with meals.
• B. Avoid sunlight while taking this medication.
• C. Report any signs of infection to the healthcare provider.
• D. Take this medication on an empty stomach.

Correct answer: A

Rationale: The correct instruction to include in the client's teaching plan regarding sulfasalazine is to take the medication with meals. Taking sulfasalazine with food helps to minimize gastrointestinal upset, which is a common side effect of the medication. Choice B is incorrect because avoiding sunlight is not specifically related to sulfasalazine. Choice C is important but not directly related to the administration of sulfasalazine. Choice D is incorrect because sulfasalazine should be taken with meals to reduce gastrointestinal side effects.

3. A client with a history of heart failure is prescribed carvedilol. The nurse should monitor for which potential side effect?

• A. Bradycardia
• B. Tachycardia
• C. Hypertension
• D. Hyperglycemia

Correct answer: A

Rationale: When a client is prescribed carvedilol, the nurse should monitor for bradycardia, a potential side effect of this medication. Carvedilol is a beta-blocker that can slow down the heart rate, so monitoring for signs of bradycardia is essential to prevent any adverse effects on the client's cardiovascular system. Tachycardia (Choice B) is less likely to occur with carvedilol since it primarily works to reduce heart rate. Hypertension (Choice C) and hyperglycemia (Choice D) are not common side effects associated with carvedilol.

4. Phenazopyridine is commonly prescribed for clients with urinary tract infections (UTI). Which statement by the practical nurse describes the purpose for the administration of phenazopyridine?

• A. To alter the pH level of the urine
• B. To reduce the frequency of bladder spasms
• C. To alleviate the painful symptoms caused by the UTI
• D. To prevent bacterial replication and resistance development

Correct answer: C

Rationale: The correct answer is C. Phenazopyridine, a urinary analgesic, is utilized to alleviate the pain associated with urinary tract infections (UTIs) like burning, pain, urgency, and frequent voiding. The administration of phenazopyridine can cause the urine to turn a bright red-orange color. It is recommended to take this medication with food to reduce gastric irritation. Phenazopyridine should only be used for a maximum of 2 days when taken alongside an antibacterial agent, which is typically prescribed for about 2 weeks to treat the underlying infection.

5. A client who takes metformin for diabetes mellitus type 2 is nothing by mouth (NPO) for surgery. What pre-op prescription should the practical nurse (PN) anticipate for this client's glucose management?

• A. NPO except for metformin and regular snacks
• B. NPO except for oral antidiabetic agent
• C. Novolin-N insulin subcutaneously twice daily
• D. Regular insulin subcutaneously per sliding scale

Correct answer: D

Rationale: When a client taking metformin for diabetes mellitus type 2 is NPO for surgery, it is crucial to manage their glucose levels effectively. The best approach in this situation is to prescribe regular insulin subcutaneously according to a sliding scale based on the client's blood glucose levels. This method allows for precise adjustment of insulin doses to maintain blood glucose within the target range while the client is unable to take oral medications. Choices A and B are incorrect because metformin is typically held when a client is NPO, and oral antidiabetic agents may not provide sufficient glucose control. Choice C is incorrect as Novolin-N insulin given twice daily may not offer the flexibility needed for glucose management in a surgical setting where the client's intake is restricted.

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