NU 272 Mobility Concept – Complete Review & NCLEX-Style Questions with answers
Chamberlain
Common |side |effects |of |anticholinergics |include:
dry |mouth, |urinary |retention, |constipation, |and |increased |pulse |rate.
blurred |vision, |decreased |liver |enzymes, |increased |B/P, |and |papillary |constriction.
decreased |GI |absorption, |nausea, |heartburn, |and |hypotension.
skin |rashes, |decreased |urinary |output, |constipation, |and |increased |WBCs. |- |answersdry |mouth, |
urinary |retention, |constipation, |and |increased |pulse |rate.
Anticholinergic |drugs |may |cause |blurred |vision, |dry |mouth, |tachycardia, |and |urinary |retention. |They |
also |decrease |sweating |and |may |cause |fever |or |heatstroke. |Fever |may |occur |in |any |age |group, |but |
heatstroke |is |more |likely |to |occur |in |older |adults, |especially |with |cardiovascular |disease, |strenuous |
activity, |and |high |environmental |temperatures. |When |centrally |active |anticholinergics |are |given |for |
Parkinson's |disease, |agitation, |mental |confusion, |hallucinations, |and |psychosis |may |occur.
A |client's |dose |of |Sinemet |has |recently |been |increased |due |to |an |exacerbation |of |the |client's |
parkinsonian |symptoms. |What |assessment |finding |would |suggest |that |the |client |is |experiencing |
adverse |effects?
The |client |is |retaining |urine |and |has |required |a |urinary |catheter
The |client's |blood |pressure |is |152/93 |mm |Hg |and |the |client |has |no |history |of |hypertension
The |client |is |diaphoretic |despite |being |afebrile
The |client |has |had |diarrhea |twice |in |the |past |two |days |- |answersThe |client |is |retaining |urine |and |has |
required |a |urinary |catheter
Adverse |effects |of |levodopa |include |urinary |retention. |Diarrhea, |increased |blood |pressure |and |
diaphoresis |would |likely |be |attributable |to |other |factors.
A |nurse |is |educating |a |client |who |has |Parkinson's |disease |and |family |regarding |possible |adverse |
effects |of |carbidopa-levodopa. |The |nurse |emphasizes |which |should |be |a |closely |monitored |effect?
,involuntary |movements.
perspiration.
appetite |or |thirst.
mobility. |- |answersinvoluntary |movements
Abnormal |and |involuntary |movements |are |among |the |most |common |and |serious |adverse |effects |of |
carbidopa-levodopa |therapy. |Increased |appetite, |thirst, |and |perspiration |are |not |common |adverse |
effects, |and |increased |mobility |is |a |desired |outcome |of |treatment.
A |client |who |sustained |a |complete |C6 |spinal |cord |injury |6 |months |ago |has |been |admitted |to |the |
hospital |for |pneumonia. |The |nurse |observes |the |client |with |diaphoresis |above |the |level |of |C6 |and |the
|blood |pressure |is |260/140 |mm |Hg. |What |is |the |first |intervention |the |nurse |should |provide?
Elevate |the |head |of |the |bed.
Disimpact |the |stool |from |the |anal |vault.
Insert |an |indwelling |catheter.
Give |the |client |some |orange |juice |and |sugar. |- |answersElevate |the |head |of |the |bed.
Autonomic |dysreflexia |is |a |clinical |emergency, |and |without |prompt |and |adequate |treatment, |
convulsions, |loss |of |consciousness, |and |even |death |can |occur. |The |major |components |of |treatment |
include |monitoring |blood |pressure |while |removing |or |correcting |the |initiating |cause |or |stimulus. |The |
person |should |be |placed |in |an |upright |position, |and |all |support |hose |or |binders |should |be |removed |
to |promote |venous |pooling |of |blood |and |reduce |venous |return.
Indications |for |use |of |anticholinergic |drugs |in |the |treatment |for |Parkinsonism |include |to:
decrease |headaches.
improve |blurred |vision.
decrease |salivation, |spasticity, |and |tremors.
decrease |motor |movement. |- |answersdecrease |salivation, |spasticity, |and |tremors.
Anticholinergic |drugs |are |used |in |idiopathic |parkinsonism |to |decrease |salivation, |spasticity, |and |
tremors. |They |are |used |primarily |in |people |who |have |minimal |symptoms |or |who |cannot |tolerate |
levodopa, |or |in |combination |with |other |antiparkinson |drugs.
,A |nurse |is |caring |for |70-year-old |patient |who |is |undergoing |anticholinergic |drug |therapy. |The |nurse |
should |assess |for |which |condition |when |caring |for |this |elderly |patient?
Confusion |and |disorientation
Choreiform |movements
Suicidal |tendencies
Psychotic |episodes |- |answersConfusion |and |disorientation
The |nurse |should |assess |for |confusion |and |disorientation |when |caring |for |this |elderly |patient |
undergoing |anticholinergic |drug |therapy. |Individuals |older |than |60 |years |frequently |develop |increased
|sensitivity |to |anticholinergic |drugs |and |require |careful |monitoring. |Lower |doses |may |also |be |required
|in |such |cases. |Choreiform |movements, |suicidal |tendencies, |and |psychotic |episodes |are |serious |
adverse |reactions |associated |with |the |use |of |levodopa, |which |is |a |dopaminergic |drug.
A |client |diagnosed |with |Parkinson's |disease |has |been |prescribed |rasagiline. |When |educating |this |
client |on |this |medication, |which |herbal |supplement |should |be |identified |as |having |the |potential |to |
produce |hyperpyrexia |and |death?
ginger
dextromethorphan
garlic
St. |John's |wort |- |answersSt. |John's |wort
Rasagiline |administered |with |the |herbal |supplement |St. |John's |wort |will |enhance |the |stimulation |of |
serotonergic |receptors |to |cause |hyperpyrexia |and |death. |Dextromethorphan |can |produce |the |same |
reaction |but |is |not |an |herbal |supplement. |Ginger |and |garlic |are |herbal |supplements |but |will |not |
produce |hyperpyrexia |and |death.
Which |of |the |following |is |the |earliest |sign |of |increasing |intracranial |pressure |(ICP)?
Change |in |level |of |consciousness |(LOC)
Seizures
Restlessness
Pupil |changes |- |answersChange |in |level |of |consciousness |(LOC)
, The |earliest |sign |of |increasing |ICP |is |a |change |in |LOC. |Any |changes |in |LOC |should |be |reported |
immediately. |Seizures, |restlessness, |and |pupil |changes |may |occur, |but |these |are |not |the |earliest |signs.
The |home |care |nurse |is |caring |for |an |80-year-old |patient |who |is |receiving |carbidopa-levodopa, |a |
dopaminergic |drug |used |to |treat |Parkinson's |disease. |The |nurse |knows |that |this |drug |may |place |the |
patient |at |increased |risk |for:
infection.
falls.
excessive |sedation.
uncontrolled |bleeding. |- |answersfalls.
Adverse |effects |of |dopaminergic |drugs |such |as |carbidopa-levodopa |include |orthostatic |hypotension. |
The |dizziness |and |potential |for |fainting |associated |with |this |effect |can |increase |the |risk |of |falls.
The |nurse |caring |for |a |client, |who |has |been |treated |for |a |hip |fracture, |instructs |the |client |not |to |cross
|their |legs |and |to |have |someone |assist |with |tying |their |shoes. |Which |additional |instruction |should |the
|nurse |provide |to |client?
Do |not |flex |the |hip |more |than |30 |degrees.
Do |not |flex |the |hip |more |than |60 |degrees.
Do |not |flex |the |hip |more |than |90 |degrees.
Do |not |flex |the |hip |more |than |120 |degrees. |- |answersDo |not |flex |the |hip |more |than |90 |degrees.
Proper |alignment |and |supported |abduction |are |encouraged |for |hip |repairs. |Flexion |of |the |hip |more |
than |90 |degrees |can |cause |damage |to |the |a |repaired |hip |fracture.
A |client |with |a |closed |reduction |of |a |wrist |fracture |has |a |plaster |cast |applied. |Which |nursing |
intervention |is |the |highest |priorityimmediately |after |the |procedure?
Elevating |the |extremity |on |a |pillow
Performing |a |peripheral |circulation |assessment
Immobilizing |the |arm |in |a |sling
Chamberlain
Common |side |effects |of |anticholinergics |include:
dry |mouth, |urinary |retention, |constipation, |and |increased |pulse |rate.
blurred |vision, |decreased |liver |enzymes, |increased |B/P, |and |papillary |constriction.
decreased |GI |absorption, |nausea, |heartburn, |and |hypotension.
skin |rashes, |decreased |urinary |output, |constipation, |and |increased |WBCs. |- |answersdry |mouth, |
urinary |retention, |constipation, |and |increased |pulse |rate.
Anticholinergic |drugs |may |cause |blurred |vision, |dry |mouth, |tachycardia, |and |urinary |retention. |They |
also |decrease |sweating |and |may |cause |fever |or |heatstroke. |Fever |may |occur |in |any |age |group, |but |
heatstroke |is |more |likely |to |occur |in |older |adults, |especially |with |cardiovascular |disease, |strenuous |
activity, |and |high |environmental |temperatures. |When |centrally |active |anticholinergics |are |given |for |
Parkinson's |disease, |agitation, |mental |confusion, |hallucinations, |and |psychosis |may |occur.
A |client's |dose |of |Sinemet |has |recently |been |increased |due |to |an |exacerbation |of |the |client's |
parkinsonian |symptoms. |What |assessment |finding |would |suggest |that |the |client |is |experiencing |
adverse |effects?
The |client |is |retaining |urine |and |has |required |a |urinary |catheter
The |client's |blood |pressure |is |152/93 |mm |Hg |and |the |client |has |no |history |of |hypertension
The |client |is |diaphoretic |despite |being |afebrile
The |client |has |had |diarrhea |twice |in |the |past |two |days |- |answersThe |client |is |retaining |urine |and |has |
required |a |urinary |catheter
Adverse |effects |of |levodopa |include |urinary |retention. |Diarrhea, |increased |blood |pressure |and |
diaphoresis |would |likely |be |attributable |to |other |factors.
A |nurse |is |educating |a |client |who |has |Parkinson's |disease |and |family |regarding |possible |adverse |
effects |of |carbidopa-levodopa. |The |nurse |emphasizes |which |should |be |a |closely |monitored |effect?
,involuntary |movements.
perspiration.
appetite |or |thirst.
mobility. |- |answersinvoluntary |movements
Abnormal |and |involuntary |movements |are |among |the |most |common |and |serious |adverse |effects |of |
carbidopa-levodopa |therapy. |Increased |appetite, |thirst, |and |perspiration |are |not |common |adverse |
effects, |and |increased |mobility |is |a |desired |outcome |of |treatment.
A |client |who |sustained |a |complete |C6 |spinal |cord |injury |6 |months |ago |has |been |admitted |to |the |
hospital |for |pneumonia. |The |nurse |observes |the |client |with |diaphoresis |above |the |level |of |C6 |and |the
|blood |pressure |is |260/140 |mm |Hg. |What |is |the |first |intervention |the |nurse |should |provide?
Elevate |the |head |of |the |bed.
Disimpact |the |stool |from |the |anal |vault.
Insert |an |indwelling |catheter.
Give |the |client |some |orange |juice |and |sugar. |- |answersElevate |the |head |of |the |bed.
Autonomic |dysreflexia |is |a |clinical |emergency, |and |without |prompt |and |adequate |treatment, |
convulsions, |loss |of |consciousness, |and |even |death |can |occur. |The |major |components |of |treatment |
include |monitoring |blood |pressure |while |removing |or |correcting |the |initiating |cause |or |stimulus. |The |
person |should |be |placed |in |an |upright |position, |and |all |support |hose |or |binders |should |be |removed |
to |promote |venous |pooling |of |blood |and |reduce |venous |return.
Indications |for |use |of |anticholinergic |drugs |in |the |treatment |for |Parkinsonism |include |to:
decrease |headaches.
improve |blurred |vision.
decrease |salivation, |spasticity, |and |tremors.
decrease |motor |movement. |- |answersdecrease |salivation, |spasticity, |and |tremors.
Anticholinergic |drugs |are |used |in |idiopathic |parkinsonism |to |decrease |salivation, |spasticity, |and |
tremors. |They |are |used |primarily |in |people |who |have |minimal |symptoms |or |who |cannot |tolerate |
levodopa, |or |in |combination |with |other |antiparkinson |drugs.
,A |nurse |is |caring |for |70-year-old |patient |who |is |undergoing |anticholinergic |drug |therapy. |The |nurse |
should |assess |for |which |condition |when |caring |for |this |elderly |patient?
Confusion |and |disorientation
Choreiform |movements
Suicidal |tendencies
Psychotic |episodes |- |answersConfusion |and |disorientation
The |nurse |should |assess |for |confusion |and |disorientation |when |caring |for |this |elderly |patient |
undergoing |anticholinergic |drug |therapy. |Individuals |older |than |60 |years |frequently |develop |increased
|sensitivity |to |anticholinergic |drugs |and |require |careful |monitoring. |Lower |doses |may |also |be |required
|in |such |cases. |Choreiform |movements, |suicidal |tendencies, |and |psychotic |episodes |are |serious |
adverse |reactions |associated |with |the |use |of |levodopa, |which |is |a |dopaminergic |drug.
A |client |diagnosed |with |Parkinson's |disease |has |been |prescribed |rasagiline. |When |educating |this |
client |on |this |medication, |which |herbal |supplement |should |be |identified |as |having |the |potential |to |
produce |hyperpyrexia |and |death?
ginger
dextromethorphan
garlic
St. |John's |wort |- |answersSt. |John's |wort
Rasagiline |administered |with |the |herbal |supplement |St. |John's |wort |will |enhance |the |stimulation |of |
serotonergic |receptors |to |cause |hyperpyrexia |and |death. |Dextromethorphan |can |produce |the |same |
reaction |but |is |not |an |herbal |supplement. |Ginger |and |garlic |are |herbal |supplements |but |will |not |
produce |hyperpyrexia |and |death.
Which |of |the |following |is |the |earliest |sign |of |increasing |intracranial |pressure |(ICP)?
Change |in |level |of |consciousness |(LOC)
Seizures
Restlessness
Pupil |changes |- |answersChange |in |level |of |consciousness |(LOC)
, The |earliest |sign |of |increasing |ICP |is |a |change |in |LOC. |Any |changes |in |LOC |should |be |reported |
immediately. |Seizures, |restlessness, |and |pupil |changes |may |occur, |but |these |are |not |the |earliest |signs.
The |home |care |nurse |is |caring |for |an |80-year-old |patient |who |is |receiving |carbidopa-levodopa, |a |
dopaminergic |drug |used |to |treat |Parkinson's |disease. |The |nurse |knows |that |this |drug |may |place |the |
patient |at |increased |risk |for:
infection.
falls.
excessive |sedation.
uncontrolled |bleeding. |- |answersfalls.
Adverse |effects |of |dopaminergic |drugs |such |as |carbidopa-levodopa |include |orthostatic |hypotension. |
The |dizziness |and |potential |for |fainting |associated |with |this |effect |can |increase |the |risk |of |falls.
The |nurse |caring |for |a |client, |who |has |been |treated |for |a |hip |fracture, |instructs |the |client |not |to |cross
|their |legs |and |to |have |someone |assist |with |tying |their |shoes. |Which |additional |instruction |should |the
|nurse |provide |to |client?
Do |not |flex |the |hip |more |than |30 |degrees.
Do |not |flex |the |hip |more |than |60 |degrees.
Do |not |flex |the |hip |more |than |90 |degrees.
Do |not |flex |the |hip |more |than |120 |degrees. |- |answersDo |not |flex |the |hip |more |than |90 |degrees.
Proper |alignment |and |supported |abduction |are |encouraged |for |hip |repairs. |Flexion |of |the |hip |more |
than |90 |degrees |can |cause |damage |to |the |a |repaired |hip |fracture.
A |client |with |a |closed |reduction |of |a |wrist |fracture |has |a |plaster |cast |applied. |Which |nursing |
intervention |is |the |highest |priorityimmediately |after |the |procedure?
Elevating |the |extremity |on |a |pillow
Performing |a |peripheral |circulation |assessment
Immobilizing |the |arm |in |a |sling
