When teaching a client with Parkinson's disease, which rationale for the prescription of carbidopa-levodopa should the nurse include?

Rationale for correct answers:

1. "The client is able to answer questions every few words to catch his breath."
   • Indicates severe shortness of breath, which requires immediate medical attention.
2. "He reports using his rescue inhaler three times, but he couldn't catch his breath."
   • Demonstrates that his asthma attack is not responding to usual interventions, indicating the need for additional or advanced treatment.
3. "He says that it has been a couple of months since his last asthma attack, and he came to the ED today because he noticed his inhaler was expired and was worried the medication was not working."
   • Highlights a lapse in medication management (expired inhaler), suggesting the need for health education and prescription renewal.

Rationale for incorrect answers:

1. "Episodes like this make him extremely nervous."
   • While anxiety is relevant, it is a secondary issue compared to the physiological needs in this situation.
2. "The client presents to the emergency department (ED) for an asthma attack that began after jogging through a local park."
   • The activity triggering the attack (jogging) is not an immediate factor needing intervention but rather an avoidable trigger to address long-term.
3. "He reports that his symptoms are worse when outdoors and when exercising."
   • While important for identifying triggers, this is not an immediate priority for intervention in the emergency setting.

Choice A reason: Substances that change a cell so that it becomes cancerous are potential sources of cancer. Carcinogens are agents that cause genetic mutations or damage to cells, leading to uncontrolled cell growth and the development of cancer. This definition accurately reflects the nature of carcinogens and their role in cancer development.

Choice B reason: Carcinogens are not substances that contain cancerous cells. Instead, they are substances or factors that can induce cancer by causing genetic mutations or cellular damage. The statement is incorrect because it misrepresents the nature of carcinogens.

Choice C reason: While it is true that some carcinogens are present in the environment, the statement that they cannot be avoided is not entirely accurate. Many carcinogens can be avoided or minimized through lifestyle choices, such as avoiding tobacco smoke, reducing exposure to harmful chemicals, and using protective measures against ultraviolet (UV) radiation. The statement is overly deterministic and does not account for preventive measures.

Choice D reason: Environmental factors such as sunlight and chemicals can contribute to the development of cancer, but they do not cause cancer to spread. The spread of cancer (metastasis) occurs when cancer cells break away from the original tumor and travel to other parts of the body. The statement conflates the causes of cancer with the mechanisms of cancer spread, making it inaccurate.