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The client calls a clinic 2 weeks after taking oral carbidopa-levodopa, stating that the medication has been ineffective in controlling the symptoms of PD. What nursing action is most important?
- A. Review how to correctly take the carbidopa-levodopa.
- B. Contact the HCP to address a change in the dose.
- C. Reinforce that it may take 1 to 2 months to see effects.
- D. Reinforce eating a diet high in protein and vitamin B6.
Correct Answer: C
Rationale: A: Reviewing the method for taking carbidopa-levodopa, including foods to avoid, may be important, but option C is most important. More information is needed to determine whether the client is taking it correctly. B: A dosage change is unnecessary because it has been only two weeks since the client started carbidopa-levodopa. C: With oral administration of carbidopa-levodopa (Sinemet), it usually takes 1 to 2 months before an effect is noted, although in some cases it may require up to 6 months. D: A high-protein diet can slow or prevent absorption of carbidopa-levodopa. Vitamin B6 increases the action of decarboxylases that destroy levodopa in the body's periphery, reducing the effects of carbidopa-levodopa. Foods high in pyridoxine should be avoided.
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The LPN is admitting a client to the unit and the client has rapidly blinking eyes, stuck out tongue, and a distorted posture. Which of these medications is the patient most likely taking?
- A. Clozapine
- B. Fluoxetine
- C. Ondansetron
- D. Haloperidol
Correct Answer: D
Rationale: Haloperidol is a first-generation antipsychotic that blocks dopamine receptors and is most likely to cause extrapyramidal symptoms (EPS), such as tardive dyskinesia. Symptoms of tardive dyskinesia include rapid blinking, mouth movements, sticking out of the tongue, rapid body movements, and a distorted posture.
The nurse is preparing to administer the client's medication for treatment of TB. Which medication, if on the client's MAR, should the nurse plan to administer?
- A. Isoniazid
- B. Fluconazole
- C. Azithromycin
- D. Acyclovir
Correct Answer: A
Rationale: A: Isoniazid (INH) is an antimycobacterial medication affecting bacterial cell wall synthesis; it is used in the treatment of TB or other mycobacterial infections. B: Fluconazole (Diflucan) is an antifungal agent that inhibits synthesis of fungal sterols, a necessary component of the cell membrane. C: Azithromycin (Zithromax) is a macrolide antibiotic that is bacteriostatic against susceptible bacteria and is usually used for treating lower respiratory tract infections, skin infections, acute otitis media, tonsillitis, or Mycobacterium avium. D: Acyclovir (Zovirax) is an antiviral agent limited to treatment of herpes viruses.
A client had a colostomy done one day ago. Which of the following is an abnormal finding when assessing the stoma?
- A. Mild edema
- B. Minimal bleeding
- C. Rose color
- D. Dark red color
Correct Answer: D
Rationale: A dark red stoma indicates inadequate blood supply, an abnormal finding requiring intervention. Mild edema, minimal bleeding, and rose color are normal postoperative findings.
The nurse is assessing an 18-month-old. Which of these statements made by the parent or caregiver would require follow-up?
- A. I'm worried that my child is not using two-word phrases yet.
- B. My child has recently taken a few steps but does not seem stable when standing.
- C. My child seems to have developed separation anxiety when I leave.
- D. I'm letting my child use a spoon to eat.
Correct Answer: B
Rationale: Around 12 months of age, children should have taken their first steps and stand well. If a child hasn't made progress by 18 months old, a physical therapy evaluation may be necessary. At 18 months, the child should be using a spoon to eat. However, two-word phrases are not expected until 2 years. Separation anxiety is expected between 6 and 18 months.
The nurse is assessing the client with herpes zoster. The nurse determines that acyclovir is an effective treatment when which finding is noted?
- A. Drying and crusting of genital lesions
- B. Crusting and healing of vesicular skin lesions
- C. Urticaria decreased and pruritus relieved
- D. Decrease in intensity of chicken pox lesions
Correct Answer: B
Rationale: A: Drying and crusting of genital lesions would indicate acyclovir's effectiveness for treating genital herpes, not herpes zoster. B: Herpes zoster produces painful vesicular skin eruptions along the course of a nerve. Crusting and healing of the vesicular skin lesions indicate that acyclovir (Zovirax) is effective. C: Urticaria (swollen, raised areas) and pruritus (itching) are not symptoms of herpes zoster. D: The lesions of chicken pox are generalized, whereas herpes zoster lesions occur along the course of a nerve. Herpes zoster occurs when the chicken pox (varicella zoster) virus that has incorporated itself into nerve cells is reactivated years after the initial infection, but it is not chicken pox.