Nokea
The client diagnosed with Parkinson's disease is prescribed carbidopa/levodopa (Sinemet). Which intervention should the nurse implement prior to administering the medication?
- A. Discuss how to prevent orthostatic hypotension.
- B. Take the client's apical pulse for one (1) full minute.
- C. Inform the client that this medication is for short-term use.
- D. Tell the client to take the medication on an empty stomach.
Correct Answer: A
Rationale: Carbidopa/levodopa can cause orthostatic hypotension. Discussing prevention (A) ensures safety. Pulse (B) is not routine, the medication is long-term (C), and it can be taken with food (D) to reduce nausea.
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The client is admitted to the intensive care unit (ICU) experiencing status epilepticus. Which collaborative intervention should the nurse anticipate?
- A. Assess the client’s neurological status every hour.
- B. Monitor the client’s heart rhythm via telemetry.
- C. Administer an anticonvulsant medication by intravenous push.
- D. Prepare to administer a glucocorticosteroid orally.
Correct Answer: C
Rationale: Status epilepticus is a life-threatening continuous seizure requiring immediate IV anticonvulsants (C), such as lorazepam or phenytoin, to stop the seizure. Neurological assessment (A) and telemetry (B) are supportive, and glucocorticoids (D) are not indicated.
The client who has expressive aphasia is having difficulty communicating with the nurse. Which action by the nurse would be most helpful?
- A. Position the client facing the nurse
- B. Enunciate directions very slowly
- C. Use gestures and body language
- D. Ask the client to point to needed objects
Correct Answer: D
Rationale: Having the client face the nurse will not aid the client in expressing his or her needs. The nurse’s slow enunciation of directions will not aid the client in expressing his or her needs. Using gestures and body language will not aid the client in expressing his or her needs. Asking the client to point to needed objects would be most helpful when the client is having difficulty communicating with the nurse.
Which client statement indicates a need for further teaching about warfarin therapy?
- A. I'll avoid eating large amounts of spinach.'
- B. I'll take my medication at the same time daily.'
- C. I can take ibuprofen for headaches.'
- D. I'll report any unusual bruising.'
Correct Answer: C
Rationale: Ibuprofen increases bleeding risk with warfarin; the client should use acetaminophen instead.
The client is diagnosed with arboviral encephalitis. Which priority intervention should the nurse implement?
- A. Place the client in strict isolation.
- B. Administer IV antibiotics.
- C. Keep the client in the supine position.
- D. Institute seizure precautions.
Correct Answer: D
Rationale: Arboviral encephalitis increases seizure risk due to brain inflammation. Seizure precautions (D) are the priority. Isolation (A) is unnecessary, antibiotics (B) are ineffective for viral causes, and supine position (C) may increase ICP.
The client diagnosed with ALS is prescribed an antiglutamate, riluzole (Rilutek). Which instruction should the nurse discuss with the client?
- A. Take the medication with food.
- B. Do not eat green, leafy vegetables.
- C. Use SPF 30 when going out in the sun.
- D. Report any febrile illness.
Correct Answer: D
Rationale: Riluzole can cause liver toxicity, and febrile illness (D) may indicate infection or drug reaction, requiring prompt reporting. Taking with food (A) is not required, green vegetables (B) are unrelated, and sun protection (C) is not specific.