Nokea
A client with a diagnosis of Parkinson's disease is prescribed levodopa-carbidopa (Sinemet). The nurse should teach the client that this medication works by:
- A. Reducing muscle spasms.
- B. Increasing dopamine levels in the brain.
- C. Blocking acetylcholine receptors.
- D. Decreasing serotonin levels.
Correct Answer: B
Rationale: Levodopa-carbidopa increases dopamine levels in the brain, helping to alleviate Parkinson's symptoms.
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The first thing that you should do immediately after a client accident is to:
- A. Notify the doctor.
- B. Render care.
- C. Assess the client.
- D. Notify the nurse manager.
Correct Answer: C
Rationale: The first action after a client accident is to assess the client to determine the extent of injury and immediate needs, following the nursing process.
A client with a history of depression is prescribed bupropion (Wellbutrin). The nurse should instruct the client to report which of the following side effects immediately?
- A. Mild headache.
- B. Seizures.
- C. Nausea.
- D. Fatigue.
Correct Answer: B
Rationale: Bupropion lowers the seizure threshold, and seizures are a serious side effect requiring immediate reporting.
A client has a reddened area over a bony prominence. The nurse finds a nursing assistant massaging this area. The nurse should:
- A. Reinforce the nursing assistant's use of this intervention over the bony prominence.
- B. Explain to the nursing assistant that massage is effective because it improves blood flow to the area.
- C. Inform the nursing assistant that massage is even more effective when combined with the use of lotion.
- D. Instruct the nursing assistant that massage is contraindicated because it decreases blood flow to the area.
Correct Answer: D
Rationale: Massage over a reddened area on a bony prominence is contraindicated as it can further damage tissue and reduce blood flow, increasing the risk of pressure ulcers. The nurse should instruct the assistant to stop massaging the area to prevent harm.
The nurse monitors the client for a hypoglycemic reaction, knowing that NPH insulin peaks in approximately how many hours following administration?
- A. 1 hour
- B. 2 to 3 hours
- C. 4 to 12 hours
- D. 16 to 24 hours
Correct Answer: C
Rationale: NPH is an intermediate-acting insulin with a peak time in 4 to 12 hours. The remaining options describe periods of time that are either too short or too long.
The nurse is assessing fetal presentation in a multiparous client. The fi gure below indicates which of the following types of presentations?
- A. Frank breech.
- B. Complete breech.
- C. Footling breech.
- D. Vertex.
Correct Answer: C
Rationale: Although breech presentations are rare, footling breech occurs when there is an extension of the fetal knees and one or both feet protrude through the pelvis. In frank breech, there is flexion of the fetal thighs and extension of the knees. The feet rest at the sides of the fetal head. In complete breech, there is fl exion of the fetal thighs and knees; the fetus appears to be squatting. Vertex position occurs in 95% of deliveries; in such cases, the head is engaged in the pelvis.