Nursing Elites

1. The practical nurse administered carbidopa-levodopa to a client diagnosed with Parkinson's disease. Which outcome by the client would indicate a therapeutic response?

• A. Decreased blood pressure
• B. Lessening of tremors
• C. Increased salivation
• D. Increased attention span

Correct answer: B

Rationale: The correct answer is B: Lessening of tremors. Carbidopa-levodopa increases the amount of levodopa to the CNS, providing more dopamine to the brain. Increased dopamine levels help alleviate Parkinson's symptoms such as tremors, involuntary movements, and gait abnormalities. Choices A, C, and D are incorrect as carbidopa-levodopa is not expected to have a direct effect on blood pressure, salivation, or attention span in the context of treating Parkinson's disease.

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

• A. Report any signs of heart failure.
• B. Take this medication with meals.
• C. Avoid alcohol while taking this medication.
• D. Report any signs of bladder cancer.

Correct answer: A

Rationale: The correct answer is to instruct the client to report any signs of heart failure when taking pioglitazone. Pioglitazone is known to potentially exacerbate heart failure, so it is crucial for clients to monitor and report any symptoms of heart failure promptly to their healthcare provider for appropriate management. Choices B and C are important but not specific to pioglitazone use. Choice D is incorrect as bladder cancer is not a known side effect of pioglitazone.

3. When a client with hepatic encephalopathy is receiving lactulose, which parameter is essential to monitor for a response to the drug?

• A. Serum hepatic enzymes
• B. Fingerstick glucose
• C. Stool color and character
• D. Serum electrolytes and ammonia

Correct answer: D

Rationale: In hepatic encephalopathy, the goal of lactulose therapy is to reduce blood ammonia levels by promoting its excretion in the stool. Therefore, monitoring serum electrolytes and ammonia levels is crucial to assess the effectiveness of lactulose in lowering ammonia levels and improving the client's condition. Options A, B, and C are incorrect because serum hepatic enzymes, fingerstick glucose, and stool color/character are not directly related to monitoring the response to lactulose therapy in hepatic encephalopathy.

4. 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.

5. A client with an exacerbation of asthma is prescribed albuterol. The nurse should assess the client for which common side effect of this medication?

• A. Tremors
• B. Nausea and vomiting
• C. Insomnia
• D. Dry mouth

Correct answer: A

Rationale: The correct answer is A: Tremors. Albuterol, a beta-agonist medication commonly used to treat asthma exacerbations, can lead to tremors as a side effect. Tremors result from the stimulation of beta-2 receptors in muscles, particularly in the hands. Nausea and vomiting (Choice B) are generally not common side effects of albuterol. Insomnia (Choice C) is less likely to occur with albuterol, as it is a stimulant and can cause alertness rather than sleep disturbances. Dry mouth (Choice D) is not a typical side effect associated with albuterol use.

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