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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 nurse has written a care plan for a client diagnosed with a brain tumor. Which is an important goal regarding self-care deficit?
- A. The client will maintain body weight within two (2) pounds.
- B. The client will execute an advance directive.
- C. The client will be able to perform three (3) ADLs with assistance.
- D. The client will verbalize feeling of loss by the end of the shift.
Correct Answer: C
Rationale: A realistic goal for self-care deficit is performing ADLs with assistance (C), addressing functional limitations due to the tumor. Weight maintenance (A), advance directives (B), and verbalizing loss (D) are not directly related to self-care.
The son of a client diagnosed with ALS asks the nurse, 'Is there any chance that I could get this disease?' Which statement by the nurse would be most appropriate?
- A. It must be scary to think you might get this disease.'
- B. No, this disease is not genetic or contagious.'
- C. ALS does have a genetic factor and runs in families.'
- D. If you are exposed to the same virus, you may get the disease.'
Correct Answer: C
Rationale: About 5–10% of ALS cases are familial, with a genetic component (C). Reflecting fear (A) is vague, denying genetics (B) is incorrect, and viral causes (D) are not established.
The client, who has type I DM, is scheduled for an MRI of the brain after an MVA. Which intervention should the nurse implement to prepare the client for the test?
- A. Make the client NPO for six hours before the MRI and hold the morning insulin dose.
- B. Inform the client that the machine is noisy and that earplugs can be worn during the test.
- C. Explain that the extremity used for injection must remain straight for a few hours after MRI.
- D. Ensure that the serum BUN and creatinine levels are obtained and evaluated prior to the MRI.
Correct Answer: B
Rationale: Clients undergoing positron emission tomography (PET) scans are made NPO and have insulin held, but not those undergoing MRI. Clients are given earplugs to wear while undergoing the test because the machine makes a loud clanging noise that is unpleasant. Clients undergoing cerebral angiography, not MRI, must be on bedrest with the extremity used for injection straight for several hours after the test. Serum BUN and creatinine levels to assess renal function are required before CT scans or other tests involving contrast material to prevent renal complications.
Which intervention is priority for a client with AIDS dementia complex experiencing agitation?
- A. Administer a sedative as prescribed.
- B. Provide a quiet, low-stimulus environment.
- C. Restrain the client to prevent injury.
- D. Encourage group activities to distract the client.
Correct Answer: B
Rationale: A quiet, low-stimulus environment reduces agitation in clients with AIDS dementia complex by minimizing sensory overload.
The nurse is assessing a client with a history of transient ischemic attacks (TIAs). Which finding is most concerning and should be reported immediately?
- A. Mild headache for 2 days
- B. Transient numbness in the left arm
- C. Slight dizziness when standing
- D. Occasional forgetfulness
Correct Answer: B
Rationale: Transient numbness in the left arm may indicate a TIA, which requires immediate reporting due to the risk of progression to a stroke.