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After teaching a client newly diagnosed with spieplety, the nurse assesses the clients understanding. Which statement by the client indicates a correct understanding of the teaching?
- A. I will drink more water daily to prevent my mouth from getting dry.
- B. This medication will stop me from getting an aura before a seizure.
- C. I will not drive a motor vehicle while taking this medication.
- D. Even when my seizure stop I will continue to take this drug.
Correct Answer: D
Rationale: Discontinuing antiepileptic drugs can lead to the recurrence of seizures or status epilepticus. The client does not need to drink more water and can drive while taking this medication. The medication will not stop an aura before a seizure.
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A nurse plans care for a client with Parkinson disease. Which intervention should the nurse include in this clients plan of care?
- A. Ambulate the client in the hallway twice a day.
- B. Teach the client pursed-lip breathing techniques.
- C. Keep the head of the bed at 30 degrees or greater.
- D. Provide small, frequent meals to prevent aspiration.
Correct Answer: C
Rationale: Elevation of the head of the bed will help prevent aspiration, a common risk in Parkinson disease due to swallowing difficulties. Ambulation in the hallway prevents venous thrombosis but does not address aspiration. Pursed-lip breathing is not relevant, and small, frequent meals are beneficial but not the primary intervention listed.
A nurse plans care for a client with epilepsy. Which interventions should the nurse include in this clients plan of care? (Select all that apply.)
- A. Keep bed rails up at all times.
- B. Maintain the client on strict bedrest.
- C. Ensure that the client has IV access.
- D. Provide a high-protein diet.
- E. Keep oxygen and suction equipment available.
Correct Answer: A,C,E
Rationale: Oxygen and suctioning equipment with an airway must be readily available. Bed rails should be up at all times to prevent injury from a fall during a seizure. A saline lock provides venous access for IV drug therapy to manage seizures. Padded tongue blades are dangerous, dietary restrictions are not indicated, and strict bedrest is not necessary.
A nurse is teaching a client who experiences migraine headaches and is prescribed a beta blocker. Which a nurse should the nurse needs in this clients teaching?
- A. Take this drug only when you have prodforma symptoms indicating the onset of a migraine headache.
- B. Take this drug as ordered, even when feeling well, to prevent vascular changes associated with migraine headaches.
- C. This drug will relieve the pain during the arm phase soon after a headache has started.
- D. This medication will have no effect on your heart rate or blood pressure because you are taking it for migraines.
Correct Answer: B
Rationale: Beta blockers are prescribed as prophylactic treatment to prevent the vascular changes that initiate migraine headaches. Heart rate and blood pressure will also be affected, and the client should monitor these side effects. The other responses do not discuss appropriate uses of the medication.
A nurse assesses a client after administering prescribed levetrincatam (Kepprna). Which laboratory tests should the nurse monitor for potential adverse effects of this medication?
- A. Serum electrolyte levels
- B. Kidney function tests
- C. Complete blood cell count
- D. Liver function tests
Correct Answer: B
Rationale: Adverse effects of levetiracetam (Keppra) include coordination problems and renal toxicity. Kidney function tests should be monitored to detect potential adverse effects. The other laboratory tests are not typically affected by levetiracetam.
A nurse witnesses a client with late-stage Alchimers disease eat breakfast. Afterward the client states, I am hungry and want breakfast. How should the nurse respond?
- A. I see you are hungry; let's get you some toast.
- B. You ate your breakfast 30 minutes ago.
- C. It appears you are confused this morning.
- D. Your family will be here soon. Lets get you dressed.
Correct Answer: A
Rationale: Use of validation therapy with clients who have Alzheimer's disease involves acknowledging the client's feelings and concerns. This technique is more effective in later stages of the disease, as reality orientation may increase agitation. Offering toast validates the client's expressed hunger without confrontation.