Nokea
A client is receiving scheduled doses of carbidopa-levodopa. The nurse evaluates the medication as having the intended effect if which finding is noted?
- A. Improvement in short-term memory
- B. Improvement in spontaneous activity
- C. Reduction in number of visual hallucinations
- D. Reduction of dizziness with standing
Correct Answer: B
Rationale: Carbidopa-levodopa treats Parkinson's symptoms like bradykinesia, improving spontaneous activity, which is the primary therapeutic goal.
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The nurse has an order to administer ophthalmic drops and ophthalmic ointment to a client being treated for conjunctivitis. The nurse should:
- A. Apply the eye ointment and eye drops together.
- B. Apply the eye drops, wait 5 minutes, and apply the ointment.
- C. Apply the eye ointment, wait 30 minutes, and apply the eye drops.
- D. Ask the pharmacist to supply the two medications in the same form.
Correct Answer: B
Rationale: Applying drops first, then waiting 5 minutes before ointment, ensures proper absorption of both. Ointment first would block drops, and combining forms is unnecessary.
The nurse is screening clients with major depressive disorder for those at risk for suicide. The nurse should recognize the client at highest risk for suicide is the client with
- A. substance use disorder who is married and participates in community programs
- B. Parkinson disease who is divorced and has recently become unemployed
- C. breast cancer who is married and is newly diagnosed with alcohol use disorder
- D. type 2 diabetes mellitus who is recently divorced and has 3 children
Correct Answer: B
Rationale: Recent unemployment and divorce are significant stressors that increase suicide risk, especially in a client with a chronic condition like Parkinson disease, which can exacerbate depressive symptoms.
A client is taking tranylcypromine (Parnate) and has received dietary instruction. Which of the following food selections would be contraindicated for this client?
- A. Fresh juice, carrots, vanilla pudding
- B. Apple juice, ham salad, fresh pineapple
- C. Hamburger, fries, strawberry shake
- D. Red wine, fava beans, aged cheese
Correct Answer: D
Rationale: Red wine, fava beans, and aged cheese contain tyramine and other vasopressors that can interact with MAOIs, potentially causing malignant hypertension.
The mother of 6-month-old twins is in the doctor's office because one of the infants has an ear infection. The mother says to the nurse, 'I just don't know if I can handle another problem. It is all so overwhelming.' How should the nurse respond initially?
- A. You're their mother. I'm sure you know what's best for them.'
- B. Have you called social services to see if you qualify for assistance?'
- C. My sister had twins and she survived. You will too.'
- D. It must be tough to have two little ones. What seems to be the biggest problem?'
Correct Answer: D
Rationale: Acknowledging the mother's stress and exploring her challenges builds rapport and identifies support needs. Other responses dismiss or redirect her concerns.
A client is prescribed long-term pharmacologic therapy with hydroxychloroquine to treat systemic lupus erythematosus. The nurse should reinforce teaching about which intervention related to the drug's adverse effects?
- A. Have an ophthalmologic examination every 6 months
- B. Take the medication on an empty stomach
- C. Take vitamin D and calcium supplements
- D. Wear a MedicAlert bracelet
Correct Answer: A
Rationale: Hydroxychloroquine can cause retinal toxicity. Regular ophthalmologic exams every 6 months are essential to monitor for early signs of retinal damage.