The nurse working in the Neuro ICU is caring for a client with Guillain Barre Syndrome. Which of the following activities would be best assigned to the Licensed practical nurse (LPN)?

Begin initial discharge teaching on home care activities

Begin administration of red blood cells

Reassess the clients mobility in the upper extremity

Administration of morphine for pain

Answer and Explanation

The Correct Answer is D

A) Begin initial discharge teaching on home care activities:
While discharge teaching is a vital part of the care process, it is typically an activity assigned to a registered nurse (RN) because it involves comprehensive patient education on topics such as medication management, follow-up care, and recognizing signs of complications. Guillain-Barré syndrome (GBS) often requires intensive care in the acute phase, and the RN is responsible for evaluating the client’s readiness for discharge and ensuring they fully understand the care required at home

B) Begin administration of red blood cells:
Administering blood products, such as red blood cells, requires close monitoring for potential reactions, and it is typically the responsibility of the RN. The RN must assess the client’s baseline status, monitor for transfusion reactions, and adjust care accordingly during the procedure. This task requires a higher level of clinical judgment and nursing knowledge than an LPN.

C) Reassess the client's mobility in the upper extremity:
Reassessing a client’s mobility, especially in a neurological condition like Guillain-Barré syndrome, requires detailed and ongoing assessment to determine changes in the patient’s strength, motor function, and overall neurological status. This activity is a more complex task that requires a registered nurse's clinical expertise.

D) Administration of morphine for pain:
The administration of pain medications, including morphine, can be appropriately assigned to the LPN under the supervision of an RN. The LPN is trained to administer medications and monitor for common side effects such as respiratory depression, especially in clients who may be at risk due to their neurological condition. However, it is essential for the LPN to communicate with the RN and report any significant changes in the client’s condition during pain management.

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Correct Answer is A

Explanation

A) The UAP stands by the patient's bed for 60 minutes talking with the patient:
This action requires immediate intervention because of the potential radiation exposure to the UAP. A temporary radioactive cervical implant involves placing a radioactive source in or near the patient's cervix. This implant emits radiation, and safety precautions are essential to limit exposure to others, including healthcare workers. Prolonged close contact, such as standing by the patient's bed for 60 minutes, increases the risk of radiation exposure to the UAP.

B) The UAP gives the patient a saline mouthwash to use for oral care:
There are no specific contraindications to using a saline mouthwash for oral care in patients with a radioactive implant. Saline mouthwash is commonly recommended for patients undergoing radiation therapy to soothe the mouth and prevent dryness or irritation. As long as the UAP is following standard infection control and safety precautions.

C) The UAP places the patient's bedding in the laundry container inside the client's room:
Bedding and linens from a patient with a radioactive implant can usually be handled and disposed of according to hospital guidelines for radioactive waste. Often, these linens are not considered to pose a significant radiation hazard after removal from the patient’s immediate area, especially if the patient is not emitting radiation outside the prescribed safety guidelines.

D) The UAP flushes the toilet twice after emptying the patient's bedpan:
After the patient has a radioactive implant, any bodily waste (urine, stool) can potentially contain small amounts of radiation. Flushing the toilet twice helps to ensure that any radioactive materials are effectively cleared. However, the UAP should be instructed to wear gloves and take other precautions to prevent contamination while handling the bedpan and ensuring proper disposal of waste.

A. Jaundice B. Hyperglycemia C. Hypertension D. Orthostatic hypotension

Correct Answer is D

Explanation

A) Jaundice:
Carbidopa-levodopa works by increasing dopamine levels in the brain to help alleviate symptoms of Parkinson's disease, but it is not typically associated with liver dysfunction that would lead to jaundice. If jaundice were to occur, it could indicate liver problems, which would need to be evaluated further, but this is not a typical side effect of Sinemet.

B) Hyperglycemia:
Sinemet primarily affects dopamine levels in the brain and does not have a direct impact on blood sugar regulation. However, long-term use of certain medications, especially corticosteroids or other specific treatments, can affect glucose levels, but carbidopa-levodopa is not typically linked to hyperglycemia.

C) Hypertension:

Carbidopa-levodopa may lead to fluctuations in blood pressure, including lowering blood pressure, especially when the patient is changing positions. However, hypertension is not a typical response to this medication. Instead, patients may experience orthostatic hypotension, which is more common with carbidopa-levodopa.

D) Orthostatic hypotension:
Orthostatic hypotension is a well-recognized and common side effect of carbidopa-levodopa. This occurs because Sinemet affects the autonomic nervous system, which can cause a decrease in blood pressure when moving from a sitting or lying position to standing. Patients on carbidopa-levodopa should be advised to rise slowly to minimize the risk of dizziness or fainting due to orthostatic hypotension.

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The nurse working in the Neuro ICU is caring for a client with Guillain Barre Syndrome. Which of the following activities would be best assigned to the Licensed practical nurse (LPN)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse supervises the care of a patient with a temporary radioactive cervical implant. Which action by unlicensed assistive personnel (UAP), if observed by the nurse, would require immediate intervention?

Correct Answer is A

Explanation

A client with Parkinson's disease is prescribed carbidopa-levadopa [Sinemet]. Which of the following side effects does the nurse recognize can occur with this medication?

Correct Answer is D

Explanation

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