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 C

Explanation

A. Avoid driving or operating machinery: Drowsiness and dizziness can occur with atenolol, especially when initiating therapy, but these effects are usually mild. While it's reasonable to use caution initially, this is not the most critical teaching point compared to orthostatic safety.

B. Take a missed dose as soon as possible: Although this may seem helpful, patients should not double doses or take extra doses close together. If a significant amount of time has passed, the missed dose may need to be skipped to prevent bradycardia or hypotension.

C. Standing slowly when getting up from bed: Atenolol, a beta-blocker, can cause orthostatic hypotension, especially in older adults. Teaching the client to rise slowly helps reduce the risk of dizziness and falls, making this a high-priority safety instruction following discharge.

D. Avoid intake of alcoholic beverages: Alcohol may enhance the hypotensive effects of beta-blockers, but moderate consumption is not strictly contraindicated. This advice is relevant but less urgent than preventing injury from orthostatic hypotension.

A. Give insulin lispro 4 units B. Restart the IV fluids until the tray arrives C. Give insulin glargine 12 units D. Mix the insulin lispro and insulin glargine in one syringe E. Verify that the client intake matches the carbohydrate count

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"A"}}

Explanation

Give insulin lispro 4 units: Administering insulin lispro before the meal tray arrives is contraindicated because it can cause hypoglycemia if the client does not eat immediately. Insulin lispro should be given based on the exact carbohydrate intake, which cannot be determined until food is present.

Restart the IV fluids until the tray arrives: Restarting the IV fluids is indicated because it helps maintain hydration, especially important for a client with hyperglycemia and recent surgery. Fluids support perfusion and protect against dehydration while waiting for the client's nutritional intake to resume.

Give insulin glargine 12 units: Giving insulin glargine now is contraindicated because the client already received her scheduled dose earlier in the morning before surgery. Re-administering it could cause insulin stacking and dangerously low blood sugar later.

Mix the insulin lispro and insulin glargine in one syringe: Mixing insulin lispro and insulin glargine together is contraindicated because glargine is designed to maintain a stable, long-acting release. Mixing it can alter its absorption profile, making it unsafe to combine in the same syringe.

Verify that the client intake matches the carbohydrate count: This action is indicated because insulin lispro is prescribed to match the carbohydrate content of meals. Verifying the number of carbohydrates ensures the correct lispro dose is administered and helps prevent dosing errors and hypoglycemia.

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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?

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Naxlex Comprehensive Predictor Exams

An older adult client is being discharged after a myocardial infarction (MI) and receives a new prescription for atenolol. Which instruction is most important for the nurse to include in this client's teaching plan?

Correct Answer is C

Explanation

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"A"}}

Explanation

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