Nokea
The client diagnosed with PD is being discharged on carbidopa/levodopa (Sinemet), an antiparkinsonian drug. Which statement is the scientific rationale for combining these medications?
- A. There will be fewer side effects with this combination than with carbidopa alone.
- B. Dopamine D requires the presence of both of these medications to work.
- C. Carbidopa makes more levodopa available to the brain.
- D. Carbidopa crosses the blood-brain barrier to treat Parkinson’s disease.
Correct Answer: C
Rationale: Carbidopa inhibits peripheral breakdown of levodopa, allowing more levodopa to cross the blood-brain barrier and convert to dopamine (C). This enhances efficacy and reduces side effects. Other options are incorrect.
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The nurse is planning the care for a client diagnosed with Parkinson’s disease. Which would be a therapeutic goal of treatment for the disease process?
- A. The client will experience periods of akinesia throughout the day.
- B. The client will take the prescribed medications correctly.
- C. The client will be able to enjoy a family outing with the spouse.
- D. The client will be able to carry out activities of daily living.
Correct Answer: D
Rationale: A therapeutic goal for Parkinson’s disease is to maximize functional ability, such as carrying out ADLs (D). Akinesia (A) is a symptom to minimize, medication adherence (B) is a means to the goal, and family outings (C) are less specific.
The nurse is caring for the client who has limited intake due to dysphagia following an ischemic stroke. Which serum laboratory result should the nurse review to verify that the client is dehydrated?
- A. Elevated serum creatinine
- B. Elevated blood urea nitrogen
- C. Decreased hemoglobin
- D. Decreased prealbumin
Correct Answer: B
Rationale: The serum creatinine is elevated with renal insufficiency or renal failure. The BUN is elevated when the client is dehydrated due to the lack of fluid volume to excrete waste products. The Hgb is decreased with blood loss or anemia from nutritional deficiencies, not with dehydration. A decreased prealbumin indicates a nutritional deficiency.
The client asks the nurse, 'What causes Creutzfeldt-Jakob disease?' Which statement would be the nurse's best response?
- A. The person must have been exposed to an infected prion.'
- B. It is mad cow disease, and eating contaminated meat is the cause.'
- C. This disease is caused by a virus that is in stagnant water.'
- D. A fungal spore from the lungs infects the brain tissue.'
Correct Answer: A
Rationale: Creutzfeldt-Jakob disease is caused by prions (A), infectious proteins. Mad cow (B) is a variant but not the sole cause, and viral (C) or fungal (D) causes are incorrect.
The unlicensed assistive personnel (UAP) is attempting to put an oral airway in the mouth of a client having a tonic-clonic seizure. Which action should the primary nurse take?
- A. Help the UAP to insert the oral airway in the mouth.
- B. Tell the UAP to stop trying to insert anything in the mouth.
- C. Take no action because the UAP is handling the situation.
- D. Notify the charge nurse of the situation immediately.
Correct Answer: B
Rationale: Inserting objects during a seizure (B) risks injury to the mouth or airway and is contraindicated. The nurse must intervene immediately. Helping the UAP (A) is unsafe, taking no action (C) neglects responsibility, and notifying the charge nurse (D) delays correction.
The nurse is developing a plan of care for a client diagnosed with aseptic meningitis secondary to a brain tumor. Which nursing goal would be most appropriate for the client problem 'altered cerebral tissue perfusion'?
- A. The client will be able to complete activities of daily living.
- B. The client will be protected from injury if seizure activity occurs.
- C. The client will be afebrile for 48 hours prior to discharge.
- D. The client will have elastic tissue turgor with ready recoil.
Correct Answer: B
Rationale: Altered cerebral perfusion in meningitis may lead to seizures. Protecting from injury during seizures (B) addresses this risk. ADLs (A), fever (C), and tissue turgor (D) are unrelated to perfusion.