Nokea
The client taking tranylcypromine develops a list of possible meal plans. Which meal plans should the nurse identify as safe for the client? Select all that apply.
- A. Pepperoni pizza, Caesar salad, 16 oz iced tea
- B. Grilled pork loin, rice, green beans, 12 oz diet clear soda
- C. Grilled salmon, steamed broccoli, 12 oz lemon-lime soda
- D. Baked chicken, mashed potatoes and gravy, 8 oz 2% milk
- E. Granola with raisins and almonds, low-fat yogurt, and 8 oz coffee
- F. Beef burritos with sour cream and guacamole topping, corn chips, 12 oz beer
Correct Answer: B,C,D
Rationale: Meals without tyramine (e.g., pepperoni, raisins, yogurt, sour cream, avocados, beer) are safe for clients taking MAOIs like tranylcypromine.
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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.
The 8-year-old child with gastroenteritis is prescribed to receive 500 mL of lactated Ringer's (LR) solution over the next 10 hours. How many milliliters per hour should the nurse administer?
Correct Answer: 50
Rationale: 500 mL / 10 hr = 50 mL/hr
The client undergoing detoxification from chronic alcohol abuse is to receive Phenobarbital 120 mg IM and promethazine 50 mg IM. Which explanation by the nurse about using this medication combination is correct?
- A. Promethazine will prevent a potential allergic reaction to the phenobarbital.
- B. Combining promethazine and phenobarbital will have a greater sedative effect.
- C. Promethazine will decrease the nausea from phenobarbital when it is given IM.
- D. Combining these reduces the sedative effects and prevents a ‘hangover' feeling.
Correct Answer: B
Rationale: Promethazine (Phenergan) potentiates the CNS depression of phenobarbital, producing a greater sedative effect.
The LPN is taking care of a 176-pound client who has recently been diagnosed with diabetes. The primary healthcare provider has written an order for Lantus (insulin glargine injection) 100 units/mL, using weight-based dosing of 0.2 units/kg per day. The LPN should prepare ___ units for administration.
- A. 12
- B. 35
- C. 16
- D. 9
Correct Answer: C
Rationale: To find the answer, you must convert 176 pounds to kilograms. 2.2 pounds = 1 kg. You must divide 176 by 2.2, which equals 80 kg. The client is 80 kg, and they should receive 0.2 units for every kilogram they weigh, so 80 × 0.2 = 16 units.
The client is admitted to the ED with tachypnea, tachycardia, and hypotension. The client has been taking theophylline for treatment of asthma and erythromycin for an upper respiratory tract infection. Which conclusion and action taken by the nurse is correct?
- A. The client is having an asthma attack; the nurse requests an order for albuterol.
- B. The client is experiencing septicemia; the nurse requests an order for blood cultures.
- C. The client has theophylline toxicity; the nurse requests an order for a serum theophylline level.
- D. The client is allergic to erythromycin; the nurse requests an order for diphenhydramine.
Correct Answer: C
Rationale: A: Symptoms of an asthma attack would include wheezing and other signs of air hunger. B: Additional signs would need to be present to suspect septicemia, such as an elevated temperature and skin flushing. C: Tachypnea, tachycardia, and hypotension are signs of theophylline (Theo-Dur) toxicity. These occur because macrolide antibiotics such as erythromycin inhibit the metabolism of theophylline. Obtaining an order for a theophylline level will expedite the client's treatment. D: Symptoms could suggest an allergic reaction, but epinephrine would be ordered, not diphenhydramine.