A client with Parkinson's disease who is taking carbidopa/levodopa reports the urine appears to be darker in color. Which action should the nurse take?

Obtain a specimen for a urine culture.

Explain the color change is normal.

Measure the client's urinary output.

Encourage an increase in oral intake.

Answer and Explanation

The Correct Answer is B

A. Obtain a specimen for a urine culture: A urine culture is necessary when infection is suspected, typically indicated by symptoms like burning, urgency, or foul odor. Darker urine alone in a client on carbidopa/levodopa is not an indication for infection testing.

B. Explain the color change is normal: Carbidopa/levodopa can cause harmless discoloration of bodily fluids, including darker urine, sweat, and saliva due to the metabolism and excretion of the medication. This is a well-known and non-threatening side effect that does not require intervention beyond client reassurance.

C. Measure the client's urinary output: Monitoring urinary output is important in cases of suspected dehydration or renal dysfunction, but simply darker urine without changes in volume or symptoms does not justify additional measurement in this scenario.

D. Encourage an increase in oral intake: While adequate hydration is always encouraged, the urine color change reported here is due to the medication itself, not dehydration. Therefore, increasing fluid intake will not reverse or prevent the discoloration.

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Correct Answer is A

Explanation

A. Positive guaiac of stool: A positive guaiac test indicates the presence of blood in the stool, suggesting gastrointestinal bleeding. Given the client’s history of frequent ibuprofen use, which can cause gastric ulcers and GI bleeding, this is a critical finding that must be reported immediately to the healthcare provider.

B. Hemoglobin 13 g/dL (130 g/L): Although slightly below the normal reference range for males, a hemoglobin of 13 g/dL is not critically low. It suggests mild anemia but is not an urgent finding compared to evidence of active gastrointestinal bleeding.

C. Hematocrit 42% (0.42 volume fraction): A hematocrit of 42% falls within the normal reference range for a male client. Therefore, this finding is stable and does not require immediate reporting in the context of the client's current symptoms.

D. Gastric pH 2: A gastric pH of 2 is within the normal range for stomach acid levels (1.5 to 3.5). The current gastric pH suggests that their acid production is within expected limits and is not the immediate concern. This value does not indicate any acute problem by itself and would not require immediate notification of the healthcare provider.

A. Take the medication an hour after antacids. B. Notify the healthcare provider (HCP) of lethargy. C. Monitor for any signs of sexual dysfunction. D. Decrease cigarette use to a pack per day.

Correct Answer is D

Explanation

A. Take the medication an hour after antacids: Antacids can interfere with the absorption of cimetidine, so spacing them apart is a correct approach. This statement indicates appropriate understanding of medication timing and does not require further instruction.

B. Notify the healthcare provider (HCP) of lethargy: Cimetidine can cause central nervous system effects like confusion or lethargy, particularly in older adults or those with renal impairment. Reporting such symptoms is appropriate and reflects safe medication awareness.

C. Monitor for any signs of sexual dysfunction: Cimetidine has been associated with gynecomastia, decreased libido, and impotence in some cases. The client should be aware of and monitor for these potential effects.

D. Decrease cigarette use to a pack per day: Smoking impairs ulcer healing and increases gastric acid secretion, which can counteract the effects of cimetidine. Reducing to a pack per day is still harmful; the client should be encouraged to stop smoking entirely, not just cut back.

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A client with Parkinson's disease who is taking carbidopa/levodopa reports the urine appears to be darker in color. Which action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A client with peptic ulcer disease (PUD) receives a new prescription for cimetidine. Which statement provided by the client requires additional instruction by the nurse?

Correct Answer is D

Explanation

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