Nokea
A client is prescribed ropinirole (Requip). The nurse would anticipate an increase in dopamine agonist effects if which of the following medications are initiated? Select all that apply.
- A. Ranitidine (Zantac)
- B. Verapamil (Calan)
- C. Estradiol (Estrace)
- D. Perphenazine (Trilafon)
- E. Lisinopril (Prinivil)
Correct Answer: A,B,C
Rationale: A client taking ropinirole (Requip) will have increased dopamine agonist effects if ranitidine, verapamil, or estrogens such as estradiol are initiated.
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A nurse is assigned to care for a client who is to receive a cholinergic blocking drug. The nurse obtains the history from the client. Which of the following would alert the nurse to the need for cautious administration?
- A. The client has a decreased liver function.
- B. The client has a history of hallucinations or psychosis.
- C. The client has a cardiovascular disease.
- D. The client has a pulmonary disease.
Correct Answer: A
Rationale: It is important for the nurse to know if the client has decreased liver or kidney function so that the cholinergic blocking drug can be administered cautiously in the client. Other conditions in clients that require cautious use include tachycardia, cardiac arrhythmias, hypertension, hypotension, tendency toward urinary retention, and obstructive disease of the urinary system or gastrointestinal tract. The cholinergic blocking drugs are given with caution to older adults. The nurse should use dopamine receptor agonist drugs with caution in clients with a history of hallucinations or psychosis or cardiovascular disease. The nurse should use dopaminergic drugs with caution in clients with pulmonary diseases.
A client is admitted to the health care facility with a diagnosis of Parkinson's disease. When assessing the client, which of the following would the nurse expect to find? Select all that apply.
- A. Slurred speech
- B. Erect posture
- C. Step-like gait
- D. Tremors
- E. Rapid, jerky movements
Correct Answer: A,D
Rationale: The cardinal signs of Parkinson's disease include tremors, rigidity, and slow movement (bradykinesia). Other symptoms of Parkinson's disease include slurred speech, a mask-like and emotionless appearance of the face, and difficulty chewing and swallowing. The patient assumes a rigid, bent-forward posture and the gait becomes unsteady and shuffled.
After administering tolcapone (Tasmar) to a client, the nurse would be alert for which of the following as a possible adverse reaction? Select all that apply.
- A. Orthostatic hypotension
- B. Renal failure
- C. Dyskinesia
- D. Dry mouth
- E. Anorexia
Correct Answer: A,C,E
Rationale: Adverse reactions associated with tolcapone (Tasmar) include orthostatic hypotension, dyskinesia, sleep disorders, dystonia, excessive dreaming, somnolence, dizziness, nausea, anorexia, muscle cramps, and liver failure.
A client tells the nurse that he takes the drug Stalevo. The nurse understands that this drug is a combination of which of the following? Select all that apply.
- A. Benztropine
- B. Levodopa
- C. Carbidopa
- D. Tolcapone
- E. Entacapone
Correct Answer: B,C,E
Rationale: Stalevo is a brand-name combination product that contains carbidopa, levodopa, and entacapone.
A nurse is caring for a client who has received carbidopa/leyodopa. After administration of the first dose of the drug, the client has developed gastrointestinal disturbances. Which of the following nursing interventions would be most appropriate?
- A. Administer the next drug dose with milk.
- B. Withhold the next drug dose.
- C. Observe for alterations in blood pressure.
- D. Administer the next drug dose with meals.
Correct Answer: D
Rationale: The nurse should administer the next drug dose with meals to manage gastrointestinal disturbances in a client who has been administered antiparkinsonism drugs. Withholding the next drug dose, administering the next drug dose with milk, or observing alterations in the client's blood pressure are not appropriate interventions when caring for a client who is experiencing GI disturbances with the first dose of antiparkinsonism drugs.