Nursing Elites

1. What class of laxative would the nurse recommend to a patient asking about the best way to prevent constipation?

• A. Stimulant laxatives
• B. Bulk-forming laxatives
• C. Emollient laxatives
• D. Hyperosmotic laxatives

Correct answer: B

Rationale: The correct answer is B: Bulk-forming laxatives. These laxatives are recommended to prevent constipation because they work by absorbing liquid in the intestines, forming a bulky, soft stool that is easier to pass. They are safe and considered the most natural option. Stimulant laxatives (choice A) work by promoting bowel movements through intestinal contractions and are more suitable for treating occasional constipation rather than preventing it. Emollient laxatives (choice C) soften the stool by increasing the incorporation of water into the feces and are more suitable for patients who need to avoid straining during defecation. Hyperosmotic laxatives (choice D) work by drawing water into the intestine through osmosis and are typically used for more severe cases of constipation, not for prevention.

2. 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.

3. A client with a history of deep vein thrombosis is prescribed dabigatran. The nurse should monitor for which potential adverse effect?

• A. Bleeding
• B. Weight gain
• C. Headache
• D. Nausea

Correct answer: A

Rationale: Dabigatran is an anticoagulant that increases the risk of bleeding. Therefore, the nurse should closely monitor the client for signs of bleeding, such as easy bruising, blood in the urine or stool, prolonged bleeding from cuts, or nosebleeds, to ensure early detection and intervention.

4. When should a client receiving insulin lispro administer this medication?

• A. Before meals
• B. After meals
• C. At bedtime
• D. Before sleep

Correct answer: A

Rationale: Insulin lispro is a rapid-acting insulin that should be administered shortly before meals. This timing helps to synchronize the peak action of insulin with the rise in blood glucose levels after eating, effectively managing blood glucose levels in the body.

5. 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.

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