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A client who is newly diagnosed with Parkinson's disease and beginning medication therapy asks the nurse, 'How soon will I see improvement?' The nurse's best response is:
- A. That varies from client to client
- B. You should discuss that with your physician
- C. You should notice a difference in a few days
- D. It might take several weeks before you notice improvement
Correct Answer: D
Rationale: Parkinson's medications often take several weeks to show improvement, as they gradually adjust neurotransmitter levels to manage symptoms.
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One of the major functions of the kidneys in maintaining normal fluid balance is:
- A. the manufacture of antidiuretic hormone.
- B. the regulation of calcium and phosphate balance.
- C. the regulation of the pH of the extracellular fluid.
- D. the control of aldosterone levels.
Correct Answer: C
Rationale: Major functions of the kidneys in maintaining normal fluid balance include regulation of extracellular fluid and osmolarity by selective retention and excretion of fluids, regulation of pH of the extracellular fluid by retention of hydrogen ions, and excretion of metabolic wastes and toxic substances. ADH is manufactured by the pituitary, and the parathyroid regulates calcium and phosphate balance.
The 16-year-old is taking acyclovir. Which statement, if made by the adolescent, should indicate to the nurse that the medication is having the desired therapeutic effect?
- A. I am having a regular menstrual cycle now.
- B. That bad odor from my vagina is now gone.
- C. All those sores on my labia are getting better.
- D. I don't have that green vaginal discharge anymore.
Correct Answer: C
Rationale: A: A side effect of acyclovir is a change in the menstrual cycle; however, having a regular menstrual cycle is not the desired therapeutic effect. B: A bad odor from the vagina is a symptom of bacterial vaginosis or trichomoniasis vaginalis, and usually not a symptom of genital herpes simplex. C: Acyclovir (Zovirax), an antiviral medication, is indicated for the treatment of genital herpes simplex virus, shingles, or chicken pox. Labial sores are associated with genital herpes simplex. Improvement of labial sores indicates that acyclovir is having the desired therapeutic effect. D: A green vaginal discharge may be a symptom of Trichomonas, which is treated with metronidazole (Flagyl), an amebicide.
An LPN is taking care of an elderly client who experiences the effects of Sundowner's Syndrome almost every evening. Which of these interventions implemented by the nurse would be the most helpful?
- A. Place a nightlight in the client's room.
- B. Administer the PRN sedative prescribed by the attending physician.
- C. Remind the client the things and people they are seeing are not real and that they are safe.
- D. Turn on the TV or radio to a station the client enjoys.
Correct Answer: A
Rationale: A nightlight will help reorient the client to his or her surroundings in the evening and nighttime hours. It is best not to challenge the reality of a client experiencing Sundowner's Syndrome, and sedatives may make the effects of the syndrome worse. Every effort should be made to keep the client's room calm, quiet, and peaceful, so noise should be kept to a minimum.
An LPN is reviewing medication lists for several clients recently admitted to the hospital. Which of the following scenarios would be least concerning?
- A. A client taking allopurinol for gout states they have been taking black cohosh to help with post-menopausal symptoms.
- B. A client has an order for warfarin and states they have been taking Ginkgo biloba to improve their memory.
- C. A client taking Lipitor states they have been taking ginseng for an energy boost.
- D. A client has a prescription for an SSRI and states they have been taking St. John's wort to also help with their depression.
Correct Answer: C
Rationale: Ginseng may cause an increased risk of bleeding but should not interact with Lipitor. St. John's wort should not be taken with an SSRI as it may cause serotonin syndrome. Black cohosh should not be taken with allopurinol as they can both cause hepatotoxicity, especially in combination. Ginkgo biloba should not be taken with warfarin as it causes an increased risk of bleeding.
The client has been receiving clonidine 0.1 mg via transdermal patch once every 7 days. The NA removes the patch with morning cares. Eight hours later, the nurse discovers that the clonidine patch is no longer present. Which assessment finding should be most concerning to the nurse?
- A. Skin tear is noted on the client's upper chest.
- B. Client reports having an excruciating headache.
- C. Blood pressure is noted to be 182/100 mm Hg.
- D. The ECG monitor shows a heart rate of 120 bpm.
Correct Answer: C
Rationale: A: Although a skin tear is concerning and may have occurred during removal, it is not the most concerning. B: Headache can occur from the abrupt removal of clonidine but is not the most concerning. C: Clonidine (Catapres) is an antihypertensive medication. Rebound hypertension occurs from abrupt withdrawal. Immediate intervention is required to lower the BP. D: Tachycardia is an adverse effect of clonidine.