A client recently diagnosed with Parkinson's disease receives a new prescription for carbidopa-levodopa. To reduce the client's risk for injury, which instruction should the nurse provide?

Caution when changing from a sitting to a standing position.

Ambulate using a four point cane or a walker with wheels.

Place small rugs on smooth surfaces such as tile or wood floors.

Obtain a hospital bed with side rails and an over bed trapeze.

Answer and Explanation

The Correct Answer is A

A. Caution when changing from a sitting to a standing position: Carbidopa-levodopa can cause orthostatic hypotension, leading to dizziness and falls. Teaching the client to rise slowly and carefully helps prevent sudden drops in blood pressure and significantly reduces the risk of injury.

B. Ambulate using a four point cane or a walker with wheels: Assistive devices can help with mobility in Parkinson’s disease, but their use should be based on a physical therapist’s evaluation. Not every client will immediately require a walker or cane upon starting treatment.

C. Place small rugs on smooth surfaces such as tile or wood floors: Small rugs actually increase the risk of tripping and falling, especially for clients with Parkinson’s disease, who already have gait instability. It is safer to remove rugs rather than add them.

D. Obtain a hospital bed with side rails and an over bed trapeze: A hospital bed with side rails and an overbed trapeze might be necessary for clients with advanced Parkinson's disease who have significant mobility limitations or require assistance with repositioning in bed. However, for a newly diagnosed client, this level of equipment is likely unnecessary and could foster dependence.

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Correct Answer is B

Explanation

A. Total bilirubin 4 mg/dL (68.4 μmol/L): Elevated bilirubin suggests possible liver dysfunction or hemolysis but is not directly associated with vitamin D toxicity. Vitamin D overdose primarily leads to disturbances in calcium metabolism rather than bilirubin elevations.

B. Total calcium level 12 mEq/L (3 mmol/L): Hypercalcemia is a hallmark of vitamin D overdose because vitamin D increases calcium absorption from the gastrointestinal tract. A calcium level above the normal range signals potential toxicity that needs immediate attention.

C. Sodium level 140 mEq/L (140 mmol/L): A sodium level of 140 mEq/L falls squarely within the normal reference range. This value does not suggest any connection to vitamin D toxicity or indicate any immediate concern regarding electrolyte imbalance.

D. Serum glucose 170 mg/dL (9.4 mmol/L): Elevated blood glucose may point to uncontrolled diabetes or stress response but is not linked to excessive vitamin D intake. Vitamin D toxicity primarily affects calcium regulation, not glucose metabolism.

A. Acetaminophen. B. Prednisone. C. Captopril. D. Omeprazole.

Correct Answer is A

Explanation

A. Acetaminophen: Acetaminophen is metabolized by the liver, and excessive or chronic use can lead to hepatotoxicity, which presents with signs such as jaundice. Observing jaundice in a client taking acetaminophen requires prompt notification of the healthcare provider to assess for potential liver damage.

B. Prednisone: Prednisone can have many systemic effects, including fluid retention and immune suppression, but it is not typically associated with liver toxicity or jaundice as a primary adverse effect.

C. Captopril: Captopril is used to manage hypertension and can cause renal dysfunction, but it is not commonly linked to liver dysfunction or jaundice. Liver-related side effects are rare with ACE inhibitors.

D. Omeprazole: Omeprazole is a proton pump inhibitor used for gastroesophageal reflux and has minimal hepatic side effects. It is not commonly associated with jaundice in clinical practice.

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A client recently diagnosed with Parkinson's disease receives a new prescription for carbidopa-levodopa. To reduce the client's risk for injury, which instruction should the nurse provide?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

Correct Answer is A

Explanation

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