Question

A client with Parkinson’s disease (PD) is being discharged home with his wife. To ensure success with the management plan, which discharge action is most effective?

Answer 1

Correct Answers:

Involving the client and his wife in developing a plan of care.

Rationale :

🟢 Client and caregiver collaboration enhances understanding, motivation, and shared responsibility in managing chronic conditions like Parkinson’s.

🟢 Family involvement fosters consistency in treatment and helps with daily routine management.

🟢 Patient-centered care emphasizes individualized plans tailored to actual needs and preferences.

🟢 Education reinforcement is more effective when both caregiver and patient are actively engaged.

🟢 Improved adherence to care interventions is observed when clients are part of the planning process.

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Answer 2

Correct Answers:

QT interval
Heart rate
Heart rhythm

Rationale :

🟢 QT interval monitoring is critical because amiodarone can prolong QT, leading to torsades de pointes.

🟢 Heart rate must be assessed to detect bradycardia, a common adverse effect.

🟢 Heart rhythm monitoring helps detect arrhythmias or new ectopic beats.

🟢 Continuous cardiac monitoring is essential due to potential conduction delays.

🟢 Electrolyte imbalances can worsen amiodarone toxicity, so rhythm analysis helps identify complications.

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Answer 3

Correct Answers:

Activate the hospital’s emergency or rapid response system.

Rationale :

🟢 Stridor and neck swelling are signs of airway obstruction—an emergency.

🟢 Rapid response activation ensures immediate intervention by critical care specialists.

🟢 Airway compromise post-thyroidectomy may result from hematoma or tracheal compression.

🟢 Timely action is vital to prevent respiratory arrest or irreversible hypoxia.

🟢 This is a classic "do first" priority intervention in a potentially life-threatening situation.

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Answer 4

Correct Answers:

Continue to monitor.

Rationale :

🟢 The client’s heart rate and rhythm are within normal limits, requiring no medication.

🟢 The PR interval of 0.20 seconds is at the upper end of normal but not pathological.

🟢 Vital signs are stable, indicating no immediate cardiac compromise.

🟢 No symptoms of bradycardia or hypotension are reported.

🟢 Continuing to monitor avoids unnecessary intervention or medication side effects.

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Answer 5

Correct Answers:

Administer lorazepam intravenously.

Rationale :

🟢 Status epilepticus is defined as a seizure lasting longer than 5 minutes, needing immediate treatment.

🟢 Lorazepam is the first-line benzodiazepine used to stop active seizures rapidly.

🟢 Quick IV access and administration is essential to prevent hypoxia and brain damage.

🟢 Seizure activity can compromise airway, breathing, and circulation, making medication time-sensitive.

🟢 Delaying benzodiazepine administration increases mortality risk in prolonged seizures.

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Answer 6

Correct Answers:

Substernal discomfort
Restlessness

Rationale :

🟢 Substernal chest pain or discomfort is a classic early sign of oxygen toxicity.

🟢 Restlessness indicates hypoxia or neurological irritability due to oxygen imbalance.

🟢 High oxygen concentrations (above 50% for prolonged periods) can cause lung damage.

🟢 Clients with chronic lung disease are sensitive to oxygen levels—close monitoring is key.

🟢 Early signs must be caught to prevent progression to respiratory failure.

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Answer 7

Correct Answers:

Heart rate
Heart rhythm

Rationale :

🟢 Heart rate monitoring is necessary due to the risk of bradycardia with amiodarone.

🟢 Heart rhythm analysis helps detect any new arrhythmias or conduction abnormalities.

🟢 QT prolongation and ventricular arrhythmias are serious risks with amiodarone.

🟢 Routine telemetry monitoring helps guide ongoing drug safety.

🟢 Amiodarone can affect AV node conduction, requiring ECG evaluations.

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Answer 8

Correct Answers:

Low pulse rate

Rationale :

🟢 Bradycardia is a known side effect of donepezil due to increased cholinergic activity.

🟢 Monitoring pulse rate can help detect life-threatening cardiac issues.

🟢 Parasympathetic stimulation from donepezil can slow AV node conduction.

🟢 Elderly clients are particularly vulnerable to syncope from low heart rates.

🟢 Teaching families to monitor for dizziness or fainting helps prevent falls.

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Answer 9

Correct Answers:

Chocolate

Rationale :

🟢 Chocolate contains caffeine and fat, which both relax the lower esophageal sphincter.

🟢 This leads to acid reflux worsening GERD symptoms.

🟢 Dietary education focuses on avoiding known triggers such as fatty foods, caffeine, alcohol.

🟢 Proper food choices help reduce acid exposure to the esophagus.

🟢 GERD clients are encouraged to consume non-irritating, low-acidic foods.

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Answer 10

Correct Answers:

1 cup of milk
1 slice of bread

Rationale :

🟢 1 cup of milk contains approximately 12–15 grams of carbohydrates, making it a perfect carb serving for hypoglycemia prevention.

🟢 1 slice of bread is a standard 15g carbohydrate serving used in diabetic exchanges.

🟢 Managing glucose during exercise requires intake of simple carbohydrates.

🟢 Preventing exercise-induced hypoglycemia helps ensure safe activity levels.

🟢 Diabetic education includes understanding carb counts for meals and snacks.

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Final Med Surg Comprehensive exam-BROOKLYN UNIVERSITY

No.

1 :
A client with Parkinson’s disease (PD) is being discharged home with his wife. To ensure success with the management plan, which discharge action is most effective?

2 :
The nurse administers amiodarone to a client with ventricular tachycardia. Which monitoring by the nurse is necessary with this drug? (Select all that apply)

3 :
A postoperative client following a thyroidectomy suddenly develops difficulty breathing, stridor, and an increase in swelling of the anterior neck area. What should the nurse do first?

5 :
An adult client who has been experiencing a seizure for approximately 15 minutes is brought to the emergency department by private vehicle. Which intervention should the nurse implement first?

6 :
A client with chronic lung disease is prescribed 40% oxygen via face mask. Which finding indicates to the nurse that the client is experiencing oxygen toxicity? Select all that apply.

7 :
The nurse administers amiodarone to a client with ventricular tachycardia. Which monitoring by the nurse is necessary with this drug? (Select all that apply)

8 :
The nurse is planning health teaching for a client starting on donepezil for Alzheimer’s disease (AD). For which side effect will the nurse teach the family to monitor?

9 :
A nurse is providing teaching for a client who has a new diagnosis of gastroesophageal reflux disease (GERD). The client asks about foods he should avoid eating. Which of the following foods should the nurse tell him to avoid?

10 :
A nurse is providing teaching to a client who has diabetes mellitus about carbohydrate intake needs when exercising. Which of the following foods should the nurse include as containing a 15 g serving of carbohydrates?

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Final Med Surg Comprehensive exam-BROOKLYN UNIVERSITY

No.

1 : A client with Parkinson’s disease (PD) is being discharged home with his wife. To ensure success with the management plan, which discharge action is most effective?

2 : The nurse administers amiodarone to a client with ventricular tachycardia. Which monitoring by the nurse is necessary with this drug? (Select all that apply)

3 : A postoperative client following a thyroidectomy suddenly develops difficulty breathing, stridor, and an increase in swelling of the anterior neck area. What should the nurse do first?

5 : An adult client who has been experiencing a seizure for approximately 15 minutes is brought to the emergency department by private vehicle. Which intervention should the nurse implement first?

6 : A client with chronic lung disease is prescribed 40% oxygen via face mask. Which finding indicates to the nurse that the client is experiencing oxygen toxicity? Select all that apply.

7 : The nurse administers amiodarone to a client with ventricular tachycardia. Which monitoring by the nurse is necessary with this drug? (Select all that apply)

8 : The nurse is planning health teaching for a client starting on donepezil for Alzheimer’s disease (AD). For which side effect will the nurse teach the family to monitor?

9 : A nurse is providing teaching for a client who has a new diagnosis of gastroesophageal reflux disease (GERD). The client asks about foods he should avoid eating. Which of the following foods should the nurse tell him to avoid?

10 : A nurse is providing teaching to a client who has diabetes mellitus about carbohydrate intake needs when exercising. Which of the following foods should the nurse include as containing a 15 g serving of carbohydrates?

1 :
A client with Parkinson’s disease (PD) is being discharged home with his wife. To ensure success with the management plan, which discharge action is most effective?

2 :
The nurse administers amiodarone to a client with ventricular tachycardia. Which monitoring by the nurse is necessary with this drug? (Select all that apply)

3 :
A postoperative client following a thyroidectomy suddenly develops difficulty breathing, stridor, and an increase in swelling of the anterior neck area. What should the nurse do first?

5 :
An adult client who has been experiencing a seizure for approximately 15 minutes is brought to the emergency department by private vehicle. Which intervention should the nurse implement first?

6 :
A client with chronic lung disease is prescribed 40% oxygen via face mask. Which finding indicates to the nurse that the client is experiencing oxygen toxicity? Select all that apply.

7 :
The nurse administers amiodarone to a client with ventricular tachycardia. Which monitoring by the nurse is necessary with this drug? (Select all that apply)

8 :
The nurse is planning health teaching for a client starting on donepezil for Alzheimer’s disease (AD). For which side effect will the nurse teach the family to monitor?

9 :
A nurse is providing teaching for a client who has a new diagnosis of gastroesophageal reflux disease (GERD). The client asks about foods he should avoid eating. Which of the following foods should the nurse tell him to avoid?

10 :
A nurse is providing teaching to a client who has diabetes mellitus about carbohydrate intake needs when exercising. Which of the following foods should the nurse include as containing a 15 g serving of carbohydrates?