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A client with Parkinson's disease is prescribed levodopa/carbidopa (Sinemet). Which instruction should the nurse include?
- A. Take this medication with a high-protein meal.'
- B. Report dark urine immediately.'
- C. Rise slowly to avoid dizziness.'
- D. Stop the drug if you feel better.'
Correct Answer: C
Rationale: Levodopa/carbidopa treats Parkinson's by increasing dopamine, but vasodilation risks orthostatic hypotension. Rising slowly prevents falls, a key instruction for safety. High-protein meals reduce levodopa absorption via amino acid competition, decreasing efficacy. Dark urine isn't a typical concern'harmless pigment changes occur. Stopping if feeling better risks symptom return, as it's not a cure. Rising slowly aligns with the drug's side effect profile, critical in Parkinson's where mobility is impaired, making C the essential teaching point to ensure client stability and adherence.
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A client has a new prescription for Ondansetron for nausea and vomiting associated with chemotherapy. Which of the following statements should the nurse include?
- A. Take this medication one hour before chemotherapy.
- B. You may experience a headache while taking this medication.
- C. Increase your intake of potassium while taking this medication.
- D. This medication may cause temporary hearing loss.
Correct Answer: B
Rationale: The correct statement the nurse should include is that the client may experience a headache while taking Ondansetron. Headache is a common side effect of this medication, and clients need to be informed about this potential adverse reaction to enhance their understanding and management of side effects.
A client has a new prescription for Warfarin for atrial fibrillation. Which of the following findings should the nurse report to the provider immediately?
- A. INR of 4.0
- B. Potassium level of 4.5 mEq/L
- C. Sodium level of 140 mEq/L
- D. Creatinine level of 1.0 mg/dL
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The following is most suitable for thromboembolic prophylaxis in a patient with a left ventricular aneurysm following a myocardial infarction three months ago:
- A. Intravenous heparin
- B. Subcutaneous enoxaparin
- C. Oral warfarin
- D. Oral aspirin
Correct Answer: C
Rationale: A left ventricular aneurysm post-MI risks thrombus formation due to stasis, necessitating anticoagulation. IV heparin is acute, not outpatient prophylaxis, impractical here. Subcutaneous enoxaparin prevents thromboembolism short-term (e.g., post-surgery), but its duration suits weeks, not months. Oral warfarin, a vitamin K antagonist, provides long-term anticoagulation (INR 2-3), ideal for chronic prophylaxis against mural thrombi embolizing to systemic circulation, most suitable three months post-MI. Oral aspirin (antiplatelet) or aspirin plus clopidogrel targets arterial clots, less effective for ventricular stasis-related venous thrombi. Warfarin's sustained effect reduces stroke risk, critical in this structural heart defect.
Which drug undergoes extensive first-pass hepatic metabolism?
- A. Heparin
- B. Insulin
- C. Propranolol
- D. Nitroglycerin
Correct Answer: C
Rationale: Propranolol undergoes extensive first-pass metabolism in the liver. When administered orally, propranolol is extensively metabolized by the liver before reaching systemic circulation, leading to reduced bioavailability. This process is known as first-pass hepatic metabolism, which significantly affects the drug's effectiveness and necessitates higher oral doses compared to other routes of administration.
A client has a new prescription for Omeprazole. Which of the following statements should the nurse include in teaching the client?
- A. Take the medication before meals.
- B. You may experience a rapid heart rate.
- C. Increase your intake of high-calcium foods.
- D. Expect your urine to turn orange.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.