Nursing Elites

1. The practical nurse administered carbidopa-levodopa to a client diagnosed with Parkinson's disease. Which outcome by the client would indicate a therapeutic response?

• A. Decreased blood pressure
• B. Lessening of tremors
• C. Increased salivation
• D. Increased attention span

Correct answer: B

Rationale: The correct answer is B: Lessening of tremors. Carbidopa-levodopa increases the amount of levodopa to the CNS, providing more dopamine to the brain. Increased dopamine levels help alleviate Parkinson's symptoms such as tremors, involuntary movements, and gait abnormalities. Choices A, C, and D are incorrect as carbidopa-levodopa is not expected to have a direct effect on blood pressure, salivation, or attention span in the context of treating Parkinson's disease.

2. A client with severe depression is prescribed sertraline. Which statement by the client indicates the need for further teaching?

• A. I can stop taking this medication once I feel better.
• B. It may take 1 to 4 weeks to notice improvement in symptoms.
• C. I should avoid alcohol while taking this medication.
• D. I should take this medication in the morning with food.

Correct answer: A

Rationale: The correct answer is A. Clients should not stop taking sertraline abruptly once they feel better without consulting their healthcare provider. It is important to complete the full course of treatment as prescribed to prevent a relapse of symptoms. Stopping the medication suddenly can lead to withdrawal symptoms and may worsen the condition. Choice B is correct because sertraline may take 1 to 4 weeks to show noticeable improvement in symptoms. Choice C is correct as alcohol should be avoided while taking sertraline due to the increased risk of side effects. Choice D is also correct as taking sertraline in the morning with food can help reduce gastrointestinal side effects.

3. A client with epilepsy is prescribed lamotrigine. The nurse should monitor for which potential side effect?

• A. Drowsiness
• B. Nausea and vomiting
• C. Skin rash
• D. Dizziness

Correct answer: C

Rationale: When a client is prescribed lamotrigine, the nurse should closely monitor for the potential side effect of skin rash. Lamotrigine is known to cause skin rashes, which can be mild or severe, indicating a serious adverse reaction like Stevens-Johnson syndrome. Monitoring for skin rash is crucial to detect any signs of severe allergic reactions early and prevent further complications. Choices A, B, and D are incorrect as drowsiness, nausea and vomiting, and dizziness are not typically associated with lamotrigine use. While dizziness can be a side effect of some antiepileptic medications, it is not a common side effect of lamotrigine.

4. A client with chronic kidney disease is prescribed sevelamer. The nurse should monitor for which potential side effect?

• A. Hypercalcemia
• B. Hypocalcemia
• C. Hyperkalemia
• D. Hypokalemia

Correct answer: B

Rationale: When a client with chronic kidney disease is prescribed sevelamer, the nurse should monitor for hypocalcemia. Sevelamer works by binding dietary phosphorus in the gastrointestinal tract, which can lead to decreased calcium absorption and potentially cause hypocalcemia.

5. A client with hypertension is prescribed metoprolol. The healthcare provider should monitor the client for which potential side effect?

• A. Bradycardia
• B. Tachycardia
• C. Hyperglycemia
• D. Hyponatremia

Correct answer: A

Rationale: Metoprolol is a beta-blocker that works by slowing the heart rate and reducing blood pressure. One of the potential side effects of metoprolol is bradycardia, which is a slow heart rate. Monitoring for bradycardia is crucial as it can be an adverse effect of this medication.

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