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An older adult with PD is prescribed levodopa and carbidopa. What information should the nurse include when teaching the client and spouse?
- A. The client has an increased risk for falls.
- B. The client should stop taking multiple vitamins.
- C. The medication should not be taken with food.
- D. The medication has very few adverse effects.
Correct Answer: A
Rationale: When first taking levodopa/carbidopa (Sinemet), the client is likely to experience dizziness and orthostatic hypotension due to the dopamine agonist properties. The client and spouse must be alerted about the increased risk for falls. Levodopa/carbidopa can be taken with multiple vitamins. Levodopa/carbidopa can be taken with food to decrease GI upset. There are many, not few, adverse effects associated with levodopa/carbidopa, including involuntary movements, anxiety, memory loss, blurred vision, and mydriasis.
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The client has been diagnosed with a brain tumor. Which presenting signs and symptoms help to localize the tumor position?
- A. Widening pulse pressure and bounding pulse.
- B. Diplopia and decreased visual acuity.
- C. Bradykinesia and scanning speech.
- D. Hemiparesis and personality changes.
Correct Answer: B
Rationale: Visual symptoms like diplopia and decreased visual acuity (B) can localize a tumor to areas affecting the optic pathways or occipital lobe. Other options are less specific to tumor location.
When preparing the client for the upcoming positron emission tomography (PET) scan, the nurse instructs the client to avoid which substances the day before the test? Select all that apply.
- A. Caffeine
- B. Shampoo
- C. Diuretics
- D. Shellfish
- E. Alcohol
- F. Tobacco
Correct Answer: A,E,F
Rationale: Caffeine, alcohol, and tobacco can affect cerebral metabolism and blood flow, potentially altering PET scan results.
The nurse in the ED documents that the newly admitted client is 'postictal upon transfer.' What did the nurse observe?
- A. Yellowing of the skin due to a liver condition
- B. Drowsy or confused state following a seizure
- C. Severe itching of the eyes from an allergic reaction
- D. Abnormal sensations including tingling of the skin
Correct Answer: B
Rationale: Jaundice and icterus are terms for yellowing of the skin. The client had experienced a tonic-clonic seizure recently and is now in a state of deep relaxation and is breathing quietly. During this period the client may be unconscious or awaken gradually, but is often confused and disoriented. Often the client is amnesic regarding the seizure. Pruritus is a term for itching. Paresthesia is the term for abnormal sensations such as tingling and burning of the skin.
Before discharge, the nurse instructs the client about administering subcutaneous injections and correctly explains the client should rotate injections between which two areas?
- A. Thighs and hips
- B. Forearms and hips
- C. Thighs and abdomen
- D. Abdomen and buttocks
Correct Answer: C
Rationale: Rotating injections between the thighs and abdomen minimizes tissue damage and ensures consistent absorption.
The client is admitted with a diagnosis of trigeminal neuralgia. Which assessment data would the nurse expect to find in this client?
- A. Joint pain of the neck and jaw.
- B. Unconscious grinding of the teeth during sleep.
- C. Sudden severe unilateral facial pain.
- D. Progressive loss of calcium in the nasal septum.
Correct Answer: C
Rationale: Trigeminal neuralgia causes sudden, severe, unilateral facial pain (C) due to irritation of the trigeminal nerve. Joint pain (A) is unrelated, teeth grinding (B) is bruxism, and calcium loss (D) is not a feature.