Question

Which intervention is appropriate to include in the plan of care for a patient with Parkinson's disease?

Answer 1

Correct Answers:

Assess for orthostatic hypotension

Rationale :

🧠Parkinson's disease affects the autonomic nervous system, often leading to orthostatic hypotension due to impaired baroreceptor response.

💊Many medications used to manage Parkinson’s, such as levodopa/carbidopa, may further exacerbate blood pressure instability.

🥣A soft diet with thin liquids may increase aspiration risk due to dysphagia associated with Parkinson’s.

🚽Limiting fluids may increase the risk of dehydration and is not appropriate for preventing urinary incontinence in this context.

📌Core Message

Monitor for orthostatic hypotension in Parkinson’s disease due to autonomic dysfunction.

Answer 2

Correct Answers:

Serum lactate level 3.9 mmol/L (normal range: 0.5-2 mmol/L)

Rationale :

📈A serum lactate level above 2 mmol/L indicates tissue hypoperfusion and possible progression toward septic shock.

⚠️A value of 3.9 mmol/L is critically elevated and requires immediate attention as it suggests anaerobic metabolism.

🌬️The vital signs and oxygen saturation are within manageable ranges and are not immediately life-threatening.

💁‍♂️Bilateral rhonchi are expected in pneumonia but do not indicate imminent perfusion failure.

📌Core Message

Elevated lactate levels signal tissue hypoperfusion in sepsis and require urgent action.

Answer 3

Correct Answers:

Take at the same time each day.

Rationale :

💊Consistent timing of levodopa/carbidopa helps maintain stable dopamine levels, improving motor function.

🧬This medication has a short half-life, so fluctuations can worsen Parkinson’s symptoms like tremors or rigidity.

🍽️Taking it with food may be recommended if GI upset occurs, but protein-rich meals can interfere with absorption, not timing.

🦠The drug does not increase infection risk or directly cause insomnia.

📌Core Message

Levodopa/carbidopa should be taken consistently to maintain dopaminergic balance.

Answer 4

Correct Answers:

Hypotension and periorbital edema

Rationale :

🧪A T4 level of 2.9 mcg/dL is significantly low, indicating hypothyroidism.

💤Common symptoms of hypothyroidism include fatigue, hypotension, and facial puffiness due to fluid retention.

💁‍♂️Tachycardia and diarrhea are signs of hyperthyroidism, not low T4.

🧠Tremors and dyskinesias are more associated with neurological disorders, not endocrine dysfunction.

📌Core Message

Low T4 levels indicate hypothyroidism, presenting as hypotension and facial edema.

Answer 5

Correct Answers:

Increased abdominal pain

Rationale :

🔥Spontaneous bacterial peritonitis (SBP) is a serious complication of cirrhosis with ascites, often presenting with increased abdominal pain.

🦠It results from bacterial infection of ascitic fluid, which causes inflammation and tenderness.

🟡Jaundice and petechiae may occur in advanced liver disease but are not specific indicators of SBP.

🩸Blood in emesis suggests variceal bleeding, not peritonitis.

📌Core Message

SBP should be suspected when a cirrhotic client has increased abdominal pain.

Answer 6

Correct Answers:

Vasodilation and fluid shift out of the vascular space

Rationale :

🦠In sepsis, endotoxins trigger vasodilation and increased capillary permeability, leading to hypotension.

💧This allows fluid to leak from the intravascular to interstitial space, reducing effective circulating volume.

🧬Thrombosis may occur later in DIC, but the primary mechanism for early hypotension is fluid shift.

❌Hypoxemia and hypoglycemia contribute to other complications but are not the direct cause of hypotension in early sepsis.

📌Core Message

Septic hypotension is due to vasodilation and fluid shift from the vascular space.

Answer 7

Correct Answers:

Assess for hematuria.

Rationale :

🧪A platelet count of 98,000/mm³ is below normal, placing the client at risk for bleeding, including hematuria.

📉This is a concern in sepsis due to possible development of disseminated intravascular coagulation (DIC).

🌡️While monitoring temperature is important, bleeding risk takes priority here.

🖐️Skin turgor and heparin administration are not appropriate priorities at this time.

📌Core Message

Low platelets in sepsis require assessment for bleeding, such as hematuria.

Answer 8

Correct Answers:

"My face is not so puffy now."

Rationale :

💊Propylthiouracil (PTU) is used to treat hyperthyroidism, which causes symptoms like facial puffiness and fluid retention.

💁‍♂️Improvement in facial swelling is a sign of therapeutic response as thyroid hormone levels normalize.

📉Weight loss and constipation are more linked to hypo- or hyperthyroidism states and are not reliable for medication efficacy.

👀Improved vision may relate to Graves’ ophthalmopathy, but PTU’s role is limited in reversing eye symptoms.

📌Core Message

Reduction in facial puffiness suggests effective PTU therapy for hyperthyroidism.

Answer 9

Correct Answers:

Monitor for cyanosis

Rationale :

🩸Cyanosis is a late indicator of hypoperfusion and tissue hypoxia, which can result from worsening sepsis.

📉Identifying early signs of decreased tissue perfusion is essential for preventing multi-organ failure.

🧊Pupil checks and reflex assessments are not direct indicators of perfusion.

🌡️Temperature changes help trend infection but are not as sensitive to perfusion status.

📌Core Message

Cyanosis is a key indicator of decreased tissue perfusion in sepsis.

Answer 10

Correct Answers:

Arrhythmias

Rationale :

⚠️As septic shock progresses, cardiac perfusion deteriorates, leading to electrical instability and arrhythmias.

📉This is considered a late-stage sign and indicates decompensation, requiring immediate intervention.

🌡️A temperature of 99.6°F and 45 mL/hr urine output are still within acceptable ranges.

🖐️Flushed skin is more typical in early sepsis, not the late stage.

📌Core Message

Arrhythmias signal late-stage septic shock due to cardiac dysfunction.

1 :
Which intervention is appropriate to include in the plan of care for a patient with Parkinson's disease?

2 :
The nurse is assessing a client admitted for treatment of pneumonia and possible sepsis. Which information is most important for the nurse to report?

3 :
The nurse is planning discharge teaching for a client with Parkinson's disease. What information regarding levodopa/carbidopa therapy should the nurse include in this session?

4 :
The nurse caring for a client with thyroid disease notes a current T4 level of 2.9 mcg/dL (normal range: 5-11.5 mcg/dL). Which findings are consistent with this result?

5 :
The client with cirrhosis has developed spontaneous bacterial peritonitis (SBP). Which data indicates this complication of cirrhosis is occurring?

6 :
The nurse recognizes that a patient with sepsis is at risk to develop hypotension. Which pathophysiological process is responsible for this symptom?

8 :
A client with thyroid disease is being treated with propylthiouracil (PTU). Which statement made by the client indicates the medication therapy is effective?

9 :
The nurse is caring for a client with sepsis. Which intervention would the nurse include to monitor for decreased tissue perfusion?

10 :
When assessing a client with sepsis, which finding would be consistent with the late phase of septic shock?

1 : Which intervention is appropriate to include in the plan of care for a patient with Parkinson's disease?

2 : The nurse is assessing a client admitted for treatment of pneumonia and possible sepsis. Which information is most important for the nurse to report?

3 : The nurse is planning discharge teaching for a client with Parkinson's disease. What information regarding levodopa/carbidopa therapy should the nurse include in this session?

4 : The nurse caring for a client with thyroid disease notes a current T4 level of 2.9 mcg/dL (normal range: 5-11.5 mcg/dL). Which findings are consistent with this result?

5 : The client with cirrhosis has developed spontaneous bacterial peritonitis (SBP). Which data indicates this complication of cirrhosis is occurring?

6 : The nurse recognizes that a patient with sepsis is at risk to develop hypotension. Which pathophysiological process is responsible for this symptom?

8 : A client with thyroid disease is being treated with propylthiouracil (PTU). Which statement made by the client indicates the medication therapy is effective?

9 : The nurse is caring for a client with sepsis. Which intervention would the nurse include to monitor for decreased tissue perfusion?

10 : When assessing a client with sepsis, which finding would be consistent with the late phase of septic shock?

1 :
Which intervention is appropriate to include in the plan of care for a patient with Parkinson's disease?

2 :
The nurse is assessing a client admitted for treatment of pneumonia and possible sepsis. Which information is most important for the nurse to report?

3 :
The nurse is planning discharge teaching for a client with Parkinson's disease. What information regarding levodopa/carbidopa therapy should the nurse include in this session?

4 :
The nurse caring for a client with thyroid disease notes a current T4 level of 2.9 mcg/dL (normal range: 5-11.5 mcg/dL). Which findings are consistent with this result?

5 :
The client with cirrhosis has developed spontaneous bacterial peritonitis (SBP). Which data indicates this complication of cirrhosis is occurring?

6 :
The nurse recognizes that a patient with sepsis is at risk to develop hypotension. Which pathophysiological process is responsible for this symptom?

8 :
A client with thyroid disease is being treated with propylthiouracil (PTU). Which statement made by the client indicates the medication therapy is effective?

9 :
The nurse is caring for a client with sepsis. Which intervention would the nurse include to monitor for decreased tissue perfusion?

10 :
When assessing a client with sepsis, which finding would be consistent with the late phase of septic shock?