The nurse is assessing a client who was recently diagnosed with Parkinson’s disease and is taking carbidopa-levodopa. The client is concerned that the medication is not working. Which intervention should the nurse implement first?

Ask if the client’s morning voids are dark colored.

Evaluate the client for signs of dyskinesia.

Determine if the client is taking the medication before meals.

Explore what the client means by the drug “is not working.”

Answer and Explanation

The Correct Answer is D

A) Ask if the client’s morning voids are dark colored:
This intervention pertains to monitoring for potential adverse effects of carbidopa-levodopa, such as urine discoloration due to the breakdown of levodopa into dopamine. However, it does not directly address the client’s concern about the medication not working. While assessing for adverse effects is important, it may not provide immediate insight into the effectiveness of the medication in managing Parkinson’s disease symptoms.

B) Evaluate the client for signs of dyskinesia:
Dyskinesia refers to involuntary, abnormal movements that can occur as a side effect of long-term treatment with carbidopa-levodopa. While assessing for dyskinesia is essential during the management of Parkinson’s disease, it does not directly address the client’s immediate concern about the medication’s efficacy. It would be more appropriate to address the client’s primary concern first before assessing for potential adverse effects.

C) Determine if the client is taking the medication before meals:
The timing of medication administration, particularly with carbidopa-levodopa, can affect its absorption and effectiveness. Taking the medication with or without food can influence its onset of action and duration of effect. However, this intervention assumes that the client may not be taking the medication correctly, which may not necessarily be the case. It’s important to first clarify the client’s perception of the medication’s effectiveness before addressing administration instructions.

D) Explore what the client means by the drug “is not working.”
This option is correct. The nurse should prioritize exploring the client’s perception of the medication’s efficacy. Understanding the client’s specific concerns, such as which symptoms are not adequately controlled or how they define “not working,” can provide valuable information for further assessment and intervention. By actively listening to the client’s perspective, the nurse can collaboratively address any misconceptions, adjust the treatment plan if necessary, and provide education or reassurance accordingly.

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Correct Answer is B

Explanation

Answer: B. Administer a second dose of naloxone.

Rationale:

A) Prepare to assist with chest tube insertion:
Chest tube insertion is not relevant in this situation. A chest tube is typically used for conditions like pneumothorax or pleural effusion, not opioid-induced respiratory depression. The immediate concern here is the opioid overdose and the need for further naloxone administration to reverse the opioid effects, not the placement of a chest tube.

B) Administer a second dose of naloxone:
Administering a second dose of naloxone is the most appropriate action. Naloxone is a short-acting opioid antagonist, and its effects can wear off before the opioids have fully cleared from the client’s system. Given that the client’s respiratory rate is severely depressed and the oxygen saturation is dangerously low, another dose of naloxone is necessary to reverse the opioid's effects and restore adequate breathing. Immediate action is required to prevent further hypoxia.

C) Determine Glasgow Coma Scale score:
While assessing the client’s level of consciousness using the Glasgow Coma Scale (GCS) is important, it is not the immediate priority in this situation. The client’s low respiratory rate and oxygen saturation indicate a critical need for immediate treatment to improve ventilation and oxygenation. Administering naloxone should take precedence over neurological assessment.

D) Initiate cardiopulmonary resuscitation (CPR):
While the client’s respiratory depression is severe, initiating CPR may not yet be necessary if the client still has a pulse. Administering naloxone can potentially reverse the respiratory depression and prevent the need for CPR. If the client's condition continues to decline despite naloxone administration, CPR may become necessary later, but the first step is to administer a second dose of naloxone to restore breathing.

A. Begin therapy 1 week before the next normal menstrual cycle. B. Use condoms and a backup method of birth control to prevent pregnancy. C. Ensure a negative pregnancy test result 2 weeks before therapy. D. Call the healthcare provider immediately if there is a chance of conception.

Correct Answer is A

Explanation

A) Begin therapy 1 week before the next normal menstrual cycle:
Misoprostol is often prescribed to prevent gastric ulcers induced by nonsteroidal anti-inflammatory drugs (NSAIDs) and is typically taken regularly with meals and at bedtime. The timing of therapy initiation is not necessarily linked to the menstrual cycle. Therefore, instructing the client to begin therapy specifically 1 week before the next normal menstrual cycle is incorrect and indicates a need for further teaching.

B) Use condoms and a backup method of birth control to prevent pregnancy:
Misoprostol is contraindicated during pregnancy due to its potential to induce uterine contractions and cause miscarriage or fetal abnormalities. Therefore, advising the client to use condoms and a backup method of birth control to prevent pregnancy while taking misoprostol is appropriate and aligns with safety precautions.

C) Ensure a negative pregnancy test result 2 weeks before therapy:
Confirming a negative pregnancy test result before initiating misoprostol therapy is essential because the medication can cause harm to a developing fetus. This instruction is correct and reinforces the importance of avoiding pregnancy while taking misoprostol.

D) Call the healthcare provider immediately if there is a chance of conception:
Given the teratogenic effects of misoprostol, advising the client to contact the healthcare provider immediately if there is a chance of conception is crucial. This instruction emphasizes the importance of avoiding pregnancy while taking the medication and seeking medical guidance promptly if pregnancy is suspected.

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The nurse is assessing a client who was recently diagnosed with Parkinson’s disease and is taking carbidopa-levodopa. The client is concerned that the medication is not working. Which intervention should the nurse implement first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse administers naloxone to a client with opioid-induced respiratory depression. One hour later, nursing assessment reveals that the client has a respiratory rate of 4 breaths/minute, oxygen saturation of 75%, and is unable to be aroused. Which action should the nurse implement?

Correct Answer is B

Explanation

Rationale:

A female client with a history of peptic ulcer disease receives a prescription for misoprostol. Which information provided by the client indicates to the nurse a need for further teaching?

Correct Answer is A

Explanation

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