A patient has been given a prescription for levodopa-carbidopa (Sinemet) for her newly diagnosed Parkinson’s disease. She asks the nurse, “Why are there two drugs in this pill?” The nurse’s best response reflects which fact?

Carbidopa allows for larger doses of levodopa to be given.

Carbidopa prevents the breakdown of levodopa in the periphery.

There are concerns about drug-food interactions with levodopa therapy that do not exist with the combination therapy.

Carbidopa is the biologic precursor of dopamine and can penetrate into the central nervous system.

Answer and Explanation

The Correct Answer is B

Choice A reason: Carbidopa does not allow larger levodopa doses but reduces the dose needed by preventing peripheral breakdown. This increases levodopa’s availability to cross the blood-brain barrier, improving efficacy without increasing side effects like nausea from peripheral dopamine.
Choice B reason: Carbidopa inhibits peripheral dopa decarboxylase, preventing levodopa’s conversion to dopamine outside the brain. This increases levodopa’s central nervous system availability, enhancing dopamine production in the basal ganglia to alleviate Parkinson’s symptoms, making it the primary reason for the combination.
Choice C reason: Drug-food interactions (e.g., protein competing with levodopa absorption) persist with levodopa-carbidopa, as carbidopa does not affect intestinal absorption. This is not the primary reason for the combination, which focuses on peripheral metabolism inhibition.
Choice D reason: Carbidopa is not a dopamine precursor and cannot cross the blood-brain barrier. Levodopa is the precursor, converted to dopamine in the brain. Carbidopa’s role is to block peripheral conversion, not to act as a precursor itself.

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Correct Answer is A

Explanation

Choice A reason: A seizure lasting over 5 minutes is considered status epilepticus, a medical emergency requiring immediate intervention to prevent brain hypoxia or injury. Prolonged seizures increase glutamate release, causing excitotoxicity, neuronal damage, and systemic complications like respiratory failure, necessitating urgent 911 response.
Choice B reason: Postictal sleepiness and lethargy are common after generalized seizures due to neuronal exhaustion and temporary metabolic changes in the brain. This is expected and not an emergency unless prolonged or accompanied by other concerning symptoms like respiratory distress.
Choice C reason: Falling at seizure onset is typical in generalized seizures due to loss of muscle control. Unless injury (e.g., head trauma) is suspected, it does not warrant an immediate 911 call, as it is a common seizure manifestation.
Choice D reason: Postictal confusion and slurred speech are normal after a generalized seizure, reflecting temporary cortical dysfunction. These resolve within minutes to hours and do not require emergency services unless persistent or associated with other critical symptoms like unresponsiveness.

A. Obtain IV access. B. Keep the lights on when the client is sleeping. C. Place the client’s bed in the high position. D. Keep a padded tongue blade available at the client’s bedside.

Correct Answer is A

Explanation

Choice A reason: Obtaining IV access is critical for seizure precautions, allowing rapid administration of antiepileptic drugs (e.g., lorazepam) in case of prolonged seizures. IV access ensures prompt treatment to prevent status epilepticus, which can cause neuronal damage or hypoxia.
Choice B reason: Keeping lights on during sleep is not a seizure precaution. It may disrupt sleep, increasing seizure risk by lowering the seizure threshold due to fatigue, and does not directly contribute to safety during a seizure event.
Choice C reason: Placing the bed in a high position increases the risk of falls during a seizure, as uncontrolled movements may cause the client to fall from a greater height, leading to injury. A low bed is safer.
Choice D reason: Keeping a padded tongue blade is outdated and unsafe, as inserting objects during a seizure risks dental injury or airway obstruction. Current guidelines prioritize airway protection and environmental safety, not tongue blades.

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A patient has been given a prescription for levodopa-carbidopa (Sinemet) for her newly diagnosed Parkinson’s disease. She asks the nurse, “Why are there two drugs in this pill?” The nurse’s best response reflects which fact?

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Naxlex Comprehensive Predictor Exams

An adolescent has just had a generalized seizure and collapsed in the school nurse’s office. When should the nurse call 911?

Correct Answer is A

Explanation

A nurse working on a medical unit is caring for a client who is prescribed seizure precautions. Which of the following interventions should the nurse include in the client’s plan of care?

Correct Answer is A

Explanation

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