Nursing Elites

1. A client has a new prescription for Levodopa/Carbidopa for Parkinson's disease. Which of the following instructions should the nurse include?

• A. Increase intake of protein-rich foods.
• B. Expect muscle twitching to occur.
• C. Take this medication with food.
• D. Anticipate relief of manifestations in 24 hours.

Correct answer: C

Rationale: The correct instruction for the nurse to include is to advise the client to take Levodopa/Carbidopa with food. This recommendation helps reduce gastrointestinal side effects commonly associated with this medication. Food can help minimize nausea and other stomach-related issues that may occur when taking Levodopa/Carbidopa. Options A, B, and D are incorrect. Increasing intake of protein-rich foods is not necessary with this medication. Muscle twitching is not an expected side effect of Levodopa/Carbidopa. Anticipating relief of manifestations in 24 hours is unrealistic as it may take days to weeks for the full therapeutic effect of the medication to be achieved.

2. The client makes which statement about lifestyle changes to reduce the development and progression of coronary artery disease that indicates the need for further teaching?

• A. “I will check my weight regularly for any gain or loss.”
• B. “I’ll make sure to take my high blood pressure medications.”
• C. “I am attending a smoking cessation class.”
• D. “As long as I exercise, stress at my job will not bother me.”

Correct answer: D

Rationale: The client stating, 'As long as I exercise, stress at my job will not bother me,' indicates a misunderstanding of the relationship between exercise and stress management. It is important to clarify that while exercise can help reduce stress, it may not eliminate all stressors, especially those related to work. Further teaching is needed to ensure the client understands the multifactorial approach required to address stress and its impact on coronary artery disease.

3. A client has a new prescription for Prednisone. Which of the following instructions should be included in the discharge teaching?

• A. Increase your intake of potassium-rich foods.
• B. Avoid consuming grapefruit juice.
• C. Take this medication with food.
• D. Decrease your intake of sodium-rich foods.

Correct answer: A

Rationale: The correct answer is A: 'Increase your intake of potassium-rich foods.' Prednisone can lead to potassium depletion, making it important for clients to increase their intake of potassium-rich foods like bananas, oranges, and spinach to prevent potential complications. Choice B is incorrect because grapefruit juice can interact with certain medications, but it is not a specific concern with Prednisone. Choice C is incorrect as Prednisone can be taken with or without food. Choice D is also incorrect because there is no direct relationship between Prednisone and sodium-rich foods.

4. A healthcare professional is reviewing the laboratory results of a client who is taking Lithium for Bipolar Disorder. Which of the following findings should the healthcare professional report to the provider immediately?

• A. Lithium level of 1.0 mEq/L
• B. Potassium level of 3.5 mEq/L
• C. Sodium level of 140 mEq/L
• D. Creatinine level of 1.0 mg/dL

Correct answer: D

Rationale: A creatinine level of 1.0 mg/dL should be reported to the provider immediately. While a lithium level of 1.0 mEq/L falls within the therapeutic range, a creatinine level of 1.0 mg/dL could suggest early signs of kidney dysfunction, especially concerning in a client on long-term lithium therapy. It is crucial to monitor kidney function closely because lithium can be nephrotoxic over time. Elevated creatinine levels may indicate impaired kidney function and should prompt immediate reporting to the healthcare provider. Potassium and sodium levels within normal range are not immediate concerns when compared to potential kidney issues.

5. A client has a prescription for Furosemide. Which of the following instructions should the nurse include?

• A. Take the medication in the morning.
• B. Increase your intake of potassium-rich foods.
• C. Expect your urine to turn orange.
• D. Avoid prolonged sunlight exposure.

Correct answer: B

Rationale: The correct answer is B: 'Increase your intake of potassium-rich foods.' Furosemide is a loop diuretic that can lead to hypokalemia (low potassium levels) due to increased excretion of potassium in the urine. To counteract this effect and maintain electrolyte balance, the client should be advised to increase their intake of potassium-rich foods. This instruction helps prevent potential complications associated with low potassium levels. Choices A, C, and D are incorrect. Taking Furosemide in the morning does not affect its effectiveness; urine turning orange is not an expected side effect of Furosemide; and avoiding prolonged sunlight exposure is not directly related to Furosemide use.

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