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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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A pregnant client asks how she can prevent getting Group B Strep. What is the LPN's best response?
- A. You should have your partner wear a condom every time you have intercourse.
- B. You cannot prevent getting Group B Strep, you can only treat it.
- C. You should be extra vigilant about hand-washing, especially in the third trimester.
- D. The Group B Strep vaccine is the only proven way to prevent the disease.
Correct Answer: B
Rationale: Group B Strep lives in the vagina, rectum, and intestines of about 25% of the female population. It is considered normal flora and is not a sexually transmitted disease. The same woman can test positive in one pregnancy and negative in another, which is why testing is done every pregnancy, usually within 5 weeks of expected delivery. If a woman tests positive for Group B Strep, she will be given antibiotics during delivery to greatly reduce the risk of complications for her and her baby.
Which spot is the safest place to administer an IM injection to an infant? Select the correct corresponding letter from the attached graphic.
- A. C
- B. B
- C. A
- D. D
Correct Answer: B
Rationale: The vastus lateralis muscle, highlighted by the letter B, should be used in infants as the muscle tends to be thickest in this area.
The nurse observes that the client being treated with antipsychotics is unsteady while standing and walking and that the client's hands are trembling slightly. What should the nurse do?
- A. Administer a pm dose of the anticholinergic Trihexyphenidyl.
- B. Offer assistance with ambulation back to the client's room for rest.
- C. Insist that the client remain seated. Applying limb restraints if needed.
- D. Call the HCP to report that early signs of tardive dyskinesia are present.
Correct Answer: A
Rationale: The client is experiencing extrapyramidal symptoms (EPS) of pseudoparkinsonism, requiring an antiparkinsonian agent like trihexyphenidyl.
The nurse is caring for the child from Italy. The child is crying, and the interpreter is stating that the child has extreme pain. What should be the nurse's priority?
- A. Administer morphine sulfate 1 mg intravenously as prescribed.
- B. Have the child's mother, who knows limited English, ask the child what hurts.
- C. Assess the level of the child's pain using an appropriate FACES pain rating scale.
- D. Ask the HCP to change the pain medication dosage due to inadequate pain control.
Correct Answer: C
Rationale: A: The nurse's judgment regarding the choice of pain medication and dose should be based on the reported level of pain. B: The nurse should do an independent assessment because sometimes information can be misinterpreted if there is limited knowledge of the language. C: Assessment should be completed prior to a pain intervention. The FACES pain-rating scale has been translated into a variety of languages. D: There is no information indicating the need for the pain medication dose to be changed.
The nurse is reviewing the medications for all assigned clients on an inpatient psychiatric unit. The nurse anticipates assessing for extrapyramidal symptoms (EPS) in clients taking which antipsychotic medication?
- A. Clozapine
- B. Risperidone
- C. Haloperidol
- D. Ziprasidone
Correct Answer: C
Rationale: Haloperidol (Haldol), a conventional antipsychotic, has a high probability of causing EPS.