The client diagnosed with Parkinson's Disease (PD) is being admitted with a fever and patchy infiltrates in the lung fields on the chest x-ray. Which clinical manifestations of PD would explain this assessment data?

Mask-like face and shuffling gait

Lack of arm swing and bradykinesia

Pill rolling of fingers and flat affect

Difficulty swallowing and immobility

Answer and Explanation

The Correct Answer is D

A) Mask-like face and shuffling gait:
While the mask-like face and shuffling gait are common clinical features of Parkinson's Disease (PD), they do not directly explain the fever or the patchy infiltrates seen on the chest x-ray. The mask-like face is due to reduced facial muscle activity and is associated with the motor symptoms of PD, while the shuffling gait results from bradykinesia (slowness of movement).

B) Lack of arm swing and bradykinesia:
Lack of arm swing and bradykinesia are motor symptoms of PD that are indicative of decreased movement and muscle rigidity. While they impact a patient’s mobility and dexterity, they are not directly associated with lung infiltrates or fever.

C) Pill rolling of fingers and flat affect:
Pill rolling (a characteristic tremor where patients move their fingers as if rolling a pill) and flat affect (a reduced emotional expression) are hallmark features of Parkinson's Disease, but again, they do not explain the fever or lung infiltrates.

D) Difficulty swallowing and immobility:
Difficulty swallowing (dysphagia) is a common and serious symptom in patients with Parkinson's Disease. Due to the loss of control over the muscles involved in swallowing, patients with PD are at high risk for aspiration (food, liquids, or saliva entering the lungs), which can lead to aspiration pneumonia. This condition often presents with fever, chest infiltrates, and respiratory distress, which directly correlates with the patient's fever and lung infiltrates seen on the chest x-ray.

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Correct Answer is B

Explanation

A) Encourage the client to ambulate and perform deep breathing exercises:
While ambulation and deep breathing exercises are important for post-operative recovery, they are not the priority intervention in this scenario. The client is presenting with abdominal distension and pain, which could indicate a potential complication such as bowel obstruction, ileus, or internal bleeding. These symptoms need to be thoroughly evaluated by the healthcare provider to rule out serious complications.

B) Notify the healthcare provider and prepare the client for further testing:
The combination of abdominal pain and distension in a client who is four days post-operative for an abdominal aortic aneurysm repair is concerning for potential complications such as bowel ischemia, internal bleeding, or post-operative ileus. It is essential to notify the healthcare provider immediately for further assessment and possible diagnostic tests, such as imaging or a physical exam to evaluate for signs of ischemia or obstruction

C) Document the client's symptoms and continue to monitor:
Although documenting and monitoring the client's symptoms is important in nursing care, it is not the most appropriate immediate response. Given the symptoms, including pain and abdominal distension, there is a potential for a serious complication, and simply continuing to monitor without notifying the healthcare provider could delay diagnosis and treatment.

D) Administer pain medication and explain this is normal:
While it is important to manage the client's pain, explaining that the symptoms are "normal" could lead to a delay in identifying a potentially serious issue. Abdominal distension and pain post-operatively in a patient who has undergone abdominal surgery should never be assumed to be a normal part of recovery without further investigation.

Correct Answer is ["90"]

Explanation

Given:

Ordered dose of Alteplase: 0.9 mg/kg

Client weight: 220 pounds

Step 1: Convert the client's weight from pounds to kilograms:

1 pound (lb) = 0.453592 kilograms (kg)

Client weight in kg = 220 lbs x 0.453592 kg/lb = 99.76824 kg

Step 2: Calculate the total dose of Alteplase:

Total dose (mg) = Ordered dose (mg/kg) xClient weight (kg)

Total dose (mg) = 0.9 mg/kg x 99.76824 kg

Total dose (mg) = 89.801416 mg

Step 3: Round to the nearest whole number:

Total dose (mg) ≈ 90 mg

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The client diagnosed with Parkinson's Disease (PD) is being admitted with a fever and patchy infiltrates in the lung fields on the chest x-ray. Which clinical manifestations of PD would explain this assessment data?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Explanation

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