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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 need for additional teaching?
- A. I will not drive a motor vehicle while taking this medication.
- B. While taking my epilepety medications, I will not drink any alcoholic beverages.
- C. I will tell my doctor about my prescription and over-the-counter medications.
- D. If I am nauseated, I will not take my epilepety medication.
Correct Answer: D
Rationale: The nurse must emphasize that antiepileptic drugs must be taken even if the client is nauseous. Discontinuing the medication can predispose the client to seizure activity and status epilepticus. The client should not drink alcohol while taking seizure medications. The client should wear a medical alert bracelet and inform the doctor about all medications to prevent complications of polypharmacy.
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A nurse assesses a client who has encephalitis. Which manifestations should the nurse recognize as signs of increased intracranial pressure (ICP), a complication of encephalitis? (Select all that apply.)
- A. Photophobia
- B. Dilated pupils
- C. Headache
- D. Widened pulse pressure
- E. Bradycardia
Correct Answer: B,D,E
Rationale: Increased ICP in encephalitis is indicated by dilated pupils, widened pulse pressure, bradycardia, irregular respirations, and less responsive pupils. Photophobia and headache are symptoms of encephalitis but not specific to increased ICP.
A nurse delegates care for a client with Parkinson disease to an unlicensed assistive personnel (UAP). Which statement should the nurse include when delegating this clients care?
- A. Assist the client with frequent and meticulous oral care.
- B. Assess the clients ability to eat and swallow before each meal.
- C. Schedule appointments early in the morning to ensure rest in the afternoon.
- D. Monitor the client's blood pressure every hour.
Correct Answer: A
Rationale: Frequent and meticulous oral care is important for clients with Parkinson disease due to swallowing difficulties and drooling, which increase the risk of oral complications. Assessing swallowing is a nursing responsibility, not suitable for UAP delegation. Scheduling appointments and frequent blood pressure monitoring are not specific to Parkinson disease care.
A nurse is caring for a client with meningitis. Which laboratory values should the nurse monitor to identify potential complications of this disorder? (Select all that apply.)
- A. Sodium levels
- B. Clotting factors
- C. White blood cell count
- D. C-reactive protein
- E. Liver enzymes
Correct Answer: A,B
Rationale: Inflammation from meningitis can stimulate the hypothalamus, leading to excessive antidiuretic hormone production, causing syndrome of inappropriate antidiuretic hormone (SIADH); thus, sodium levels should be monitored. Systemic inflammatory response syndrome (SIRS) can lead to coagulopathy and disseminated intravascular coagulation, requiring monitoring of clotting factors. Other values are not specific to meningitis complications.
A nurse cares for a client with advanced Alchimers disease. The clients caregiver states, She is always wandering off. What can I do to manage this restless behavior? How should the nurse respond?
- A. This is a sign of fatigue. The client would benefit from a daily nap.
- B. Engage the client in scheduled activities throughout the day.
- C. It sounds like this is difficult for you. I will consult the social worker.
- D. The provider can prescribe a mild sedative for restlessness.
Correct Answer: B
Rationale: Several strategies may be used to cope with restlessness and wandering in Alzheimer's disease. Engaging the client in structured activities throughout the day is effective. Daily naps and sedatives are less effective, and consulting a social worker does not directly address the behavior.
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.