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The client is receiving multiple medications for treatment of PD. Which signs and symptoms should the nurse recognize as adverse effects of carbidopa-levodopa?
- A. Dystonia and akinesia
- B. Bradykinesia and agitation
- C. Muscle rigidity and cardiac dysrhythmias
- D. Orthostatic hypotension and dry mouth
Correct Answer: D
Rationale: A: Although dystonia is an adverse effect of carbidopa-levodopa, akinesia is a symptom associated with PD. B: Bradykinesia is a symptom associated with PD; agitation is an adverse effect of carbidopa-levodopa. C: Muscle rigidity is a symptom associated with PD; cardiac dysrhythmia is an adverse effect of carbidopa-levodopa. D: Orthostatic hypotension and dry mouth are common adverse effects of carbidopa-levodopa (Sinemet). These can be minimized by slow position changes and sucking on sugarless candy or chewing gum.
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An infection in a central venous access device is not eliminated by giving antibiotics through the catheter. How might bacterial glycocalyx contribute to this?
- A. It protects the bacteria from antibiotic and immunologic destruction.
- B. Glycocalyx neutralizes the antibiotic, rendering it ineffective.
- C. It competes with the antibiotic for binding sites on the microbe.
- D. Glycocalyx provides nutrients for microbial growth.
Correct Answer: A
Rationale: Glycocalyx is a viscous polysaccharide or polypeptide slime that covers microbes, enhancing adherence to surfaces, resisting phagocytic engulfment, and preventing antibiotics from contacting the microbe.
The nurse is working with the family whose child is taking atomoxetine for ADHD. Which instructions should the nurse include when teaching the parents? Select all that apply.
- A. Provide stimulation because atomoxetine causes sedation.
- B. Administer atomoxetine immediately after eating a meal.
- C. Administer atomoxetine at least 6 hours before bedtime.
- D. Weigh the child weekly to monitor for unintended weight loss.
- E. Consult with the prescriber before giving cold or allergy medication.
Correct Answer: B,C,D,E
Rationale: Atomoxetine (Strattera) should be taken after meals, at least 6 hours before bedtime, with weekly weight monitoring and caution with OTC medications.
The nurse is preparing to administer morphine sulfate IV to the child in severe pain. The child has an IV infusion of D5W at 50 mL/hr through a PICC. Which intervention is best when administering the medication?
- A. Disconnect the infusion, inject 3 mL of normal saline, and give the morphine sulfate undiluted.
- B. Question the prescribed medication because morphine sulfate cannot be given through a PICC line.
- C. Give the morphine sulfate undiluted into the existing IV tubing's medication port closest to the child.
- D. Dilute the morphine sulfate with 5 mL of NS and give over 5 minutes into the IV tubing port closest to the child.
Correct Answer: D
Rationale: A: Unnecessary IV disconnections increase the risk for infection. Morphine sulfate is compatible with D5W. B: Morphine sulfate can be administered into a PICC access device. C: Administering undiluted morphine sulfate to a child increases the risk of adverse effects. D: The nurse should dilute the morphine sulfate before administration to prevent too-rapid administration and adverse effects. A single dose should be given over 4 to 5 minutes.
A 37-year-old female client asks the nurse about contraception options, and says she would like to ask her doctor for a prescription for an oral contraception pill. Which of the following statements would indicate that oral contraception is appropriate for this client?
- A. I quit smoking last year, but I started again recently. Maybe I'll try to quit later this year.
- B. I am very diligent at taking my thyroid medications at the same time every day.
- C. I was hospitalized for deep vein thrombosis five years ago.
- D. I was recently diagnosed with breast cancer.
Correct Answer: B
Rationale: The client's statement about medication diligence shows that this client could be compliant with a daily oral contraceptive. Contraindications to oral contraception include breast cancer, a history of deep vein thrombosis, and smoking if over age 35.
The client seeking treatment for insomnia tells the nurse about researching complementary therapies for promoting sleep. Which are herbal remedies for promoting sleep that the client may wish to discuss with the nurse?
- A. Fennel and ginger tea
- B. Chamomile tea and hops
- C. Feverfew and peppermint
- D. Echinacea and goldenseal
Correct Answer: B
Rationale: Chamomile tea and hops are believed to relieve insomnia.