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The nurse completes teaching the client who has PD about taking benztropine. Which statements made by the client indicate that teaching is effective? Select all that apply.
- A. I plan to crush the tablets so that they are easier to swallow.
- B. I should refrain from taking over-the-counter medications.
- C. Once my symptoms improve, I can stop taking benztropine.
- D. Benztropine can cause drooling and excessive secretions.
- E. I should avoid driving until I know how benztropine affects me.
Correct Answer: A,B,E
Rationale: A: Benztropine (Cogentin) may be crushed; this statement indicates teaching is effective. B: Many OTC medications contain alcohol. Alcohol should be avoided because it is another CNS depressant, and additive drowsiness can occur. This statement indicates teaching is effective. C: Benztropine should not be abruptly discontinued; symptoms will recur, and it may precipitate parkinsonian crisis. D: Benztropine is an anticholinergic that will cause a dry mouth, not drooling and increased secretions. E: Because benztropine (Cogentin) is a CNS depressant, driving should be avoided until the effects of the medication are known. This statement indicates teaching is effective.
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Which of the following diseases or conditions is least likely to be associated with increased potential for bleeding?
- A. metastatic liver cancer
- B. gram-negative septicemia
- C. pernicious anemia
- D. iron-deficiency anemia
Correct Answer: C
Rationale: Pernicious anemia results from vitamin B12 deficiency due to lack of intrinsic factor. This can result from inadequate dietary intake, faulty absorption from the GI tract due to a lack of secretion of intrinsic factor normally produced by gastric mucosal cells and certain disorders of the small intestine that impair absorption. The nurse should instruct the client in the need for lifelong replacement of vitamin B12, as well as the need for folic acid, rest, diet, and support.
The client taking glyburide 5 mg orally once daily presents in the ED with headache, flushing, nausea, and abdominal cramps. The client's fingerstick blood sugar result is 56 mg/dL. Which question is most important for the nurse to ask the client?
- A. How many grams of protein do you normally eat?
- B. What time did you eat your dinner last night?
- C. How often do you check your blood sugar level?
- D. What was your alcohol intake like this past week?
Correct Answer: D
Rationale: A: Carbohydrate intake, not protein, is more important to consider in diabetic clients in relation to blood sugar levels. B: Glyburide once daily dose is taken with breakfast, so asking the client about dinner is not consistent with drug administration. C: Asking the client frequency of checking blood sugar levels will not help determine the possible causes of the client's symptoms. D: Alcohol use while taking sulfonylureas such as glyburide (DiaBeta, Micronase) can cause a disulfiram-like reaction, manifested by abdominal cramps, nausea, headache, flushing, and hypoglycemia.
The nurse administers risperidone to the client experiencing hallucinations. Which physiological disorder should the nurse assess for considering the risk of developing this disorder as a side effect of risperidone?
- A. Asthma
- B. Hypertension
- C. Crohn's disease
- D. Diabetes mellitus
Correct Answer: D
Rationale: Risperidone (Risperdal) increases the risk of diabetes, especially in the first few months of therapy.
The new nurse asks the experienced nurse why the first dose of the MMR vaccine is normally given at 12 to 15 months of age and not earlier, except with international travel. Which explanation by the experienced nurse is correct?
- A. Giving the first dose of the vaccine at 12 to 15 months of age allows the correct interval before the next booster at age 12 years.
- B. A live virus is being given; the chance of measles, mumps, or rubella developing is much higher if given at an earlier age.
- C. A first dose at this age provides passive immunity and decreases the incidence of a child developing any of the diseases.
- D. If given earlier, the vaccine may neutralize the passive immunity to measles from the child's mother and no immunity may result.
Correct Answer: D
Rationale: A: The second dose of the MMR vaccine can be given earlier, provided that at least 4 weeks has elapsed since the first dose. However, a second dose is usually not given earlier because sufficient immunity is usually present. B: The chance of developing only measles is greater if the vaccine is given at a younger age because the vaccine may neutralize the passive antibodies. C: The MMR provides active (not passive) immunity. D: Because the MMR vaccine is a live virus, a person develops a mild form of the diseases after administration, stimulating the body to develop immunity. The passively acquired antibodies to measles can interfere with the child's immune response to the vaccine, and no immunity may result.
One day postoperative, the client complains of dyspnea, and his respiratory rate (RR) is 35, slightly labored, and there are no breath sounds in the lower-right base. The nurse should suspect:
- A. Cor pulmonale
- B. Atelectasis
- C. Pulmonary embolus
- D. Cardiac tamponade
Correct Answer: B
Rationale: No breath sounds in the lower-right base postoperative suggest atelectasis, a lung collapse common after surgery, causing dyspnea and tachypnea.