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The nurse is teaching a client with a new diagnosis of Parkinson’s disease about levodopa-carbidopa (Sinemet). Which of the following statements by the client indicates a need for further teaching?
- A. I should take this medication on an empty stomach.
- B. I should avoid high-protein meals with this medication.
- C. I should report any muscle twitching to my doctor.
- D. I should expect my urine to turn dark.
Correct Answer: D
Rationale: Dark urine is not an expected side effect of levodopa-carbidopa; it may indicate another issue, such as hematuria, requiring investigation. Options A, B, and C are correct: taking on an empty stomach improves absorption, high-protein meals interfere with efficacy, and muscle twitching may indicate toxicity.
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The nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following findings would be of GREATest concern to the nurse?
- A. Blood glucose level of 180 mg/dL.
- B. Temperature of 100.4°F (38°C).
- C. Weight gain of 1 kg in 24 hours.
- D. Potassium level of 3.8 mEq/L.
Correct Answer: B
Rationale: A temperature of 100.4°F suggests infection, a serious complication in TPN due to catheter-related bloodstream infections. Options A, C, and D are less urgent: hyperglycemia is common and manageable, rapid weight gain may indicate fluid overload, and potassium 3.8 mEq/L is normal.
A child is admitted in sickle cell crisis. Which factor in the child's history is most likely related to the onset of the crisis?
- A. The child just completed final exams at school.
- B. The child ran a marathon yesterday.
- C. The child recently had a cold.
- D. The child received a hepatitis A immunization two weeks ago.
Correct Answer: C
Rationale: Infections, like a recent cold, can trigger sickle cell crisis by increasing oxygen demand and causing dehydration, leading to sickling of red blood cells.
The nurse is caring for a client with a history of type 2 diabetes who is receiving sitagliptin (Januvia) 100 mg PO daily. Which of the following symptoms should the nurse report immediately?
- A. Mild fatigue.
- B. Upper abdominal pain.
- C. Occasional thirst.
- D. Mild headache.
Correct Answer: B
Rationale: Upper abdominal pain may indicate pancreatitis, a serious sitagliptin side effect. Options A, C, and D are less urgent.
The nurse is caring for a client who is postoperative day 1 after a mastectomy. Which of the following actions is the PRIORITY?
- A. Encourage the client to perform arm exercises.
- B. Administer pain medication as needed.
- C. Monitor the surgical drain for output.
- D. Check the incision for redness.
Correct Answer: A
Rationale: Encouraging arm exercises is the priority to prevent lymphedema and restore mobility post-mastectomy. Options B, C, and D are important but secondary: pain management, drain monitoring, and incision checks follow mobility promotion.
The spouse of a client who had an angioplasty following a heart attack says to the nurse, 'What is an angioplasty? It sounds like plastic surgery. My husband had a heart attack.' What information should be included in the nurse's response?
- A. An angioplasty repairs the heart damage caused by the heart attack.
- B. During an angioplasty, the physician creates a bypass around blocked arteries, increasing the blood flow to the heart muscle.
- C. Angioplasty is a diagnostic procedure to see if there are any blocked coronary arteries.
- D. During an angioplasty, the physician uses a balloon-tipped catheter to open up an artery that is blocked by a clot, thus increasing blood flow to the heart muscle.
Correct Answer: D
Rationale: An angioplasty is the insertion of a balloon-tipped catheter into a coronary artery. The balloon is inflated, opening up the artery and increasing blood flow through the coronary artery to the heart muscle. Angioplasty does not repair heart damage. A left heart cardiac catheterization is the diagnostic procedure that precedes angioplasty. Answer 2 describes a coronary artery bypass graft (CABG) procedure.