Parkinsons Disease
A nurse is assisting a patient with Parkinson’s disease in eating. Which of the following is an appropriate intervention to help with nutrition?
A. Instruct the patient to eat three large meals daily
B. Check the patient’s weight weekly
C. Offer soft, high-calorie foods only
D. Avoid the use of assistive devices for feeding
Correct answer: B. Check the patient’s weight weekly
Rationale: Regular weight checks are important to monitor for weight loss, which can occur due to difficulty eating and swallowing in Parkinson's disease.
A nurse is reviewing lab results for a patient suspected of sepsis. The serum lactate level is reported as 3.5 mmol/L. Which of the following actions should the nurse take?
A. No intervention is needed, as this is a normal value.
B. Notify the healthcare provider
C. Administer a glucose check to rule out hypoglycemia.
D. Prepare for a blood transfusion as the patient may have anemia.
Correct Answer: B
Rationale: A serum lactate level >2 mmol/L is an abnormal finding and suggests poor tissue perfusion, which can be indicative of sepsis. Immediate notification of the healthcare provider and appropriate interventions are necessary.
A nurse is educating a patient with hypothyroidism on how to manage their condition at home. The nurse emphasizes the importance of which of the following?
A. Taking levothyroxine at night to improve absorption.
B. Limiting fluid intake to reduce the risk of edema.
C. Taking the medication with food to prevent gastrointestinal upset.
D. Taking the medication on an empty stomach for optimal absorption.
Correct Answer: D
Rationale: Levothyroxine should be taken on an empty stomach for optimal absorption, typically 30 to 60 minutes before breakfast.
A patient with hypothyroidism is experiencing shallow breathing, low oxygen saturation, and crackles in the lungs. What should the nurse do first?
A. Administer a nebulizer treatment for bronchospasm.
B. Encourage the patient to cough and deep breathe.
C. Increase the patient’s fluid intake to loosen secretions.
D. Place the patient in a supine position to help with lung expansion.
Correct Answer: B
Rationale: Encouraging coughing and deep breathing helps to expand the lungs and mobilize secretions, improving gas exchange in patients with hypothyroidism.
Which of the following is an appropriate nursing intervention for a patient with acute pancreatitis?
A) Administer opioids as needed for pain control, following regular dosing schedules
B) Encourage the patient to lie flat to reduce abdominal discomfort
C) Discontinue the nasogastric tube (NGT) as soon as possible to prevent discomfort
D) Avoid positioning changes, as they may worsen pain
Correct Answer:
A) Administer opioids as needed for pain control, following regular dosing schedules
A nurse is educating a patient with Parkinson’s disease about the importance of taking levodopa/carbidopa as prescribed. Which of the following should the nurse include in the teaching?
A. "Take the medication only when you feel symptoms are worsening."
B. "You may need to take a break from this medication every few days."
C. "Taking the medication at the same time each day helps with symptom control."
D. "You can stop taking the medication if you experience dizziness or nausea."
Correct answer: C. "Taking the medication at the same time each day helps with symptom control."
Rationale: Consistency in taking levodopa/carbidopa at the same time each day helps maintain steady dopamine levels for better symptom control.
Which of the following statements best describes sepsis?
A. Sepsis occurs when the body’s immune response to infection is overly regulated, leading to localized inflammation.
B. Sepsis is a life-threatening condition that can lead to organ dysfunction due to an exaggerated immune response, causing widespread fluid shifts and vasodilation.
C. Sepsis is a severe form of pneumonia that only occurs in elderly patients with respiratory conditions.
D. Sepsis is primarily characterized by a decrease in blood pressure and low heart rate in response to an infection.
Correct Answer:
Rationale:
Sepsis is a serious, life-threatening condition that results from a dysregulated or exaggerated immune response to infection. This leads to widespread vasodilation, fluid shifting, and organ dysfunction. It does not primarily manifest as pneumonia or as a simple decrease in blood pressure and heart rate.
What should a patient with Parkinson's disease do if the effectiveness of their levodopa starts to decrease or if signs of toxicity occur?
A) Increase the dosage of levodopa on their own to improve effectiveness
B) Continue taking levodopa as prescribed and wait for the symptoms to subside
C) Consult with a healthcare provider about taking a week off from levodopa to reassess therapy
D) Stop taking levodopa immediately and go to the emergency room for immediate intervention
Correct Answer:
C) Consult with a healthcare provider about taking a week off from levodopa to reassess therapy
A nurse is preparing to discharge a patient with hypothyroidism who has been prescribed levothyroxine. Which statement by the patient indicates the need for further teaching?
A. "I should take my medication in the morning on an empty stomach."
B. "I should monitor my temperature regularly for any changes."
C. "I will increase my activity level as soon as I feel better."
D. "It is normal to feel tired and weak after taking my medication."
Correct Answer: D
Rationale: Levothyroxine is used to treat hypothyroidism and should lead to increased energy. Persistent fatigue may indicate that the dose is not adequate or there is another underlying issue, requiring follow-up with the healthcare provider.
A nurse is caring for a patient with cirrhosis. Which of the following findings would most likely indicate a need for immediate intervention?
A. Mild jaundice and a decrease in appetite.
B. RUQ pain with a slight increase in weight.
C. Development of ascites and confusion.
D. A decrease in liver size and a stable mental status.
Correct Answer:
Rationale:
Ascites and confusion can be signs of hepatic encephalopathy and worsening liver function, which requires immediate intervention. While mild jaundice, weight changes, and RUQ pain can be part of cirrhosis, the development of ascites and confusion are more concerning and suggest severe liver dysfunction and possible complications.
13. A patient with Parkinson’s disease is considering deep brain stimulation. Which of the following is a benefit of this treatment?
A. Complete elimination of tremors
B. A decrease in the need for levodopa
C. A cure for Parkinson’s disease
D. An increase in dopamine production in the brain
Correct answer: B. A decrease in the need for levodopa
Rationale: Deep brain stimulation can reduce the severity of tremors and rigidity, often allowing for a decrease in levodopa dosage and thereby reducing side effects.
A nurse is preparing a patient for blood cultures in the evaluation of sepsis. Which of the following steps is essential when performing blood culture collection?
A. Collect only one set of blood cultures to minimize discomfort.
B. Administer broad-spectrum antibiotics before collecting blood cultures.
C. Collect blood cultures from two different sites using antiseptic for preparation.
D. Wait for 72 hours to administer antibiotics until the final blood culture result is available.
Correct Answer: C
Rationale: Blood cultures must be collected from two different sites, and the collection site should be properly cleaned with antiseptic. It is essential to collect blood cultures before administering antibiotics, as starting antibiotics before culture collection can interfere with the results.
A patient with pancreatitis is prescribed pancrelipase to improve nutrient absorption. Which of the following is the most important instruction the nurse should give the patient when administering this medication?
A. "Take the medication on an empty stomach for better absorption."
B. "Swallow the tablets whole or sprinkle the contents on non-protein food."
C. "Take the medication only before meals to avoid stomach discomfort."
D. "Drink plenty of fluids to prevent constipation while on this medication."
Correct Answer:
Rationale:
Pancrelipase should be taken with food, and the capsules may be sprinkled on non-protein food. This helps improve nutrient absorption. The other options are incorrect: taking it on an empty stomach can interfere with absorption, it should be taken during or after meals, and there is no indication for drinking excessive fluids to prevent constipation, as diarrhea is a common side effect.
A nurse is reviewing diagnostic results for a patient suspected of having hyperthyroidism. Which of the following lab results would be consistent with this condition? Select all that apply.
A. Increased TSH
B. Decreased T3 and T4
C. Decreased TSH
D. Increased T3 and T4
E. Elevated thyroglobulin levels
Correct Answers: C, D
A nurse is assessing a patient with suspected cirrhosis. Which findings would you possibly see in this patient? Select all that apply.
A) Jaundice and scleral icterus
B) Increased appetite and weight gain
C) RUQ pain and an enlarged liver
D) A history of deep vein thrombosis (DVT)
E) Significant weight loss and anorexia
Correct Answers:
A) Jaundice and scleral icterus
C) RUQ pain and an enlarged liver
E) Significant weight loss and anorexia
A nurse is planning care for a patient with Parkinson’s disease. Which of the following interventions should the nurse include to address the patient’s mobility, bowel and bladder, swallowing, and nutrition needs? Select all that apply.
A. Encourage the patient to use assistive devices, such as a walker, to aid in mobility.
B. Suggest the patient consume a diet of thin liquids to prevent dehydration.
C. Recommend the patient engage in daily exercise with a focus on gait training, emphasizing long strides and arm swinging.
D. Encourage the patient to sit upright while eating and offer a semisolid diet with thickened liquids to prevent aspiration.
E. Advise the patient to use stool softeners and follow a regular toileting schedule to prevent constipation.
Correct Answers: A, C, D, E
Rationale:
A patient diagnosed with sepsis has hypotension and a lactate level greater than or equal to 4 mmol/L. What is the nurse’s priority action?
A. Administer a bolus of 0.9% sodium chloride (NS) or lactated Ringer’s (LR) solution at a dose of 30 mL/kg.
B. Administer vasopressors immediately to raise the blood pressure.
C. Begin blood transfusion to increase blood volume.
D. Reassess blood pressure and reassess for the need for vasopressors.
Correct Answer: A
Rationale: If a patient with sepsis has hypotension or a lactate level ≥4 mmol/L, the first priority is administering an initial bolus of 30 mL/kg of 0.9% sodium chloride (NS) or lactated Ringer’s (LR) solution. Fluid resuscitation is crucial before considering vasopressors.
A nurse is assessing a patient in the late/cold stage of sepsis. Which of the following findings should the nurse expect to observe? Select all that apply.
A. Warm and flushed skin
B. Hypotension despite vasopressor therapy
C. Oliguria or anuria
D. Tachypnea and febrile temperature
E. Mottled extremities
F. Comatose or lethargic mental status
Correct Answers:
Rationale:
In the late/cold stage of sepsis, patients typically exhibit severe organ failure with findings such as hypotension despite vasopressor therapy, oliguria or anuria, mottled extremities, and a comatose or lethargic mental state. Warm and flushed skin, tachypnea, and a febrile temperature are more characteristic of the early/warm stage of sepsis.
A nurse is preparing to administer propylthiouracil (PTU) to a patient with hyperthyroidism. Which of the following actions should the nurse take prior to administering this medication? Select all that apply.
A. Check the patient's CBC
B. Monitor the patient for vision changes
C. Assess for signs of hyperthyroidism, such as weight loss and irritability.
D. Evaluate the patient's liver function
E. Ensure that the patient's T4 levels are within the therapeutic range.
Correct Answers: A, B, D
Rationale:
A nurse is caring for a patient prescribed a beta blocker. Which of the following statements are true regarding the administration of beta blockers? Select all that apply.
A) The patient's systolic blood pressure must be above 100 mmHg to administer the medication.
B) The patient will be placed on telemetry while receiving the medication.
C) Beta blockers should be administered even if the patient has a second-degree heart block.
D) The nurse should hold the IV dose of beta blocker if the patient's heart rate is less than 45 bpm.
E) Beta blockers decrease afterload and heart rate, improving cardiac output.
Correct Answers:
A) The patient's systolic blood pressure must be above 100 mmHg to administer the medication.
B) The patient will be placed on telemetry while receiving the medication.
D) The nurse should hold the IV dose of beta blocker if the patient's heart rate is less than 45 bpm.
E) Beta blockers decrease afterload and heart rate, improving cardiac output.
Which of the following are potential side effects of levodopa/carbidopa therapy for Parkinson’s disease? (Select all that apply)
A) Nausea
B) Orthostatic hypotension
C) Increased heart rate
D) Drowsiness
E) Bradycardia
Answer: A) Nausea, B) Orthostatic hypotension, C) Increased heart rate
A nurse is assessing a patient in the early/warm stage of sepsis. Which of the following findings should the nurse expect to observe? Select all that apply.
A. Warm and flushed skin
B. Blood pressure less than 65 mmHg without vasopressors
C. Oliguria despite ongoing fluid replacement
D. Tachypnea and febrile temperature
E. Mottled extremities
F. Comatose mental status
Correct Answers:
Rationale: In the early/warm stage of sepsis, the patient often presents with warm, flushed skin, tachypnea, and a febrile temperature. Blood pressure may be low (but usually above 65 mmHg), and the patient may experience oliguria despite fluid resuscitation. Mottled extremities, comatose mental status, and MAP less than 65 mmHg without vasopressors are more indicative of the late/cold stage of sepsis.
What are some nursing interventions for a patient with hypothyroidism? Select all that apply.
A) Give them a heating pad to help with cold intolerance
B) Increase the room temperature to help with cold intolerance
C) Encourage strict bed rest to conserve energy
D) Recommend a low-calorie, high-fiber diet to prevent constipation
E) Assess for pedal edema as part of routine monitoring
Correct Answers:
B) Increase the room temperature to help with cold intolerance
D) Recommend a low-calorie, high-fiber diet to prevent constipation
Explanation:
A nurse is caring for a postoperative patient following a thyroidectomy. Which of the following actions should the nurse implement when caring for this patient? Select all that apply.
A. Position the patient in a semi-Fowler's position with pillows to support the head and neck.
B. Encourage the patient to avoid speaking for the first 24 hours to prevent vocal strain.
C. Assess for signs of respiratory distress, hematoma, and bleeding at the incision site.
D. Allow the patient to lie flat to reduce the risk of neck tension.
E. Avoid neck extension to prevent damage to the surgical site and reduce strain on the neck muscles.
Correct Answers: A, C, E
Rationale:
Which of the following are common symptoms of metabolic acidosis? Select all that apply.
A) Weakness and fatigue
B) Hyperventilation with Kussmaul respirations
C) Low potassium and chloride
D) Decreasing level of consciousness and arrhythmias
E) Paresthesia in fingers and around the mouth
Correct Answers:
A) Weakness and fatigue
B) Hyperventilation with Kussmaul respirations
D) Decreasing level of consciousness and arrhythmias