What should the nurse explain about levodopa?

Correct Answer: C

Rationale: Levodopa is a crucial medication used in the treatment of Parkinson's disease. The correct answer is C) It is a precursor of dopamine that is converted to dopamine in the brain. Levodopa crosses the blood-brain barrier and is converted to dopamine in the brain, where it helps replenish the depleted dopamine levels in patients with Parkinson's disease. This conversion process occurs in the presynaptic terminals of neurons. Option A) It stimulates dopamine receptors in the basal ganglia is incorrect because levodopa itself does not directly stimulate dopamine receptors but rather serves as a precursor for dopamine synthesis. Option B) It promotes the release of dopamine from brain neurons is incorrect as levodopa does not promote the release of dopamine but rather acts as a building block for dopamine production. Option D) It prevents the excessive breakdown of dopamine in the peripheral tissues is incorrect because levodopa primarily acts within the brain to increase dopamine levels, rather than preventing its breakdown in peripheral tissues. Understanding the mechanism of action of levodopa is essential for nurses caring for patients with Parkinson's disease. By knowing that levodopa is converted to dopamine in the brain, nurses can better educate patients on the importance of medication adherence, timing of doses, and potential side effects related to dopamine replacement therapy. This knowledge also helps nurses monitor for therapeutic effectiveness and manage medication regimens in collaboration with healthcare providers.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Neurovascular checks below the site of the injury. The priority in managing a possible fracture is to assess for neurovascular compromise, which includes checking the circulation, sensation, and movement below the site of the injury. This is crucial to detect any signs of impaired blood flow or nerve damage that could indicate a more serious condition requiring immediate intervention. Option A) Elevation of the arm may help reduce swelling but is not the priority when assessing for neurovascular compromise in a potential fracture situation. Option B) Application of ice to the site is generally recommended for acute injuries to reduce swelling and pain, but in this case, assessing for neurovascular compromise takes precedence. Option C) Notification of the healthcare provider is important, but immediate assessment and management of potential neurovascular issues are critical before informing the provider. Educationally, understanding the importance of neurovascular checks in suspected fractures is vital for nurses and healthcare providers to ensure timely and appropriate care for patients with musculoskeletal injuries. It highlights the significance of thorough assessment skills and the ability to prioritize interventions based on the patient's condition.

Correct Answer: D

Rationale: In providing discharge instructions for a patient following a hip prosthesis with a posterior approach, option D, "Have a family member put on the patient's shoes and socks," is the correct choice. This is important because after hip surgery, especially with a posterior approach, there are restrictions on bending at the hip to prevent dislocation of the prosthesis. The action of putting on shoes and socks requires bending at the hip, which the patient should avoid. Option A, "Restrict walking for 2 to 3 months," is incorrect as early mobilization is essential for post-operative recovery and to prevent complications like blood clots and muscle weakness. Option B, "Take a bath rather than a shower to prevent falling," is incorrect as both baths and showers are acceptable as long as proper precautions are taken to prevent falling. Option C, "Keep the leg internally rotated while sitting and standing," is incorrect as maintaining the leg in an internally rotated position is not a standard post-operative instruction for a hip prosthesis with a posterior approach. Educationally, understanding the rationale behind post-operative instructions is crucial for nurses to provide safe and effective care to patients. By knowing the reasons behind each instruction, nurses can confidently educate patients and their families, ensuring better outcomes and preventing complications.

Correct Answer: D

Rationale: The correct answer is D) Antibiotics are not effective against microorganisms that cause chronic osteomyelitis. In chronic osteomyelitis, the infection persists due to the formation of biofilms that protect bacteria from antibiotics and the immune system. Surgical debridement is necessary to remove the infected tissue and biofilm, as antibiotics alone cannot penetrate these barriers effectively. Option A is incorrect because while removal of the infection is crucial, it does not necessarily prevent the need for bone and skin grafting, which may be required to repair tissue damage caused by the infection. Option B is incorrect because the formation of scar tissue does not necessarily lead to a protected area of bacterial growth in chronic osteomyelitis. The primary issue lies in the bacterial biofilm that resists antibiotic treatment. Option C is incorrect because the process of depositing new bone does not directly block the vascular supply to the bone in chronic osteomyelitis. The vascular compromise in osteomyelitis is mainly due to inflammation and infection rather than the process of new bone formation. In an educational context, understanding the rationale behind surgical treatment for chronic osteomyelitis is crucial for healthcare professionals to provide effective care to patients. Knowing why antibiotics alone are insufficient and why surgical intervention is necessary helps in making informed clinical decisions and providing thorough patient education.

Correct Answer: C

Rationale: In promoting healthy feet, it is crucial for the nurse to recognize that improperly fitting shoes are associated with most foot problems. The correct answer (C) is based on the fact that wearing shoes that do not fit properly can lead to a wide range of foot issues such as corns, calluses, bunions, blisters, and even more serious conditions like plantar fasciitis or metatarsalgia. Ill-fitting shoes can cause pressure points, alter gait mechanics, and lead to long-term structural problems in the feet. Option A, poor foot hygiene, is not the primary factor associated with most foot problems. While proper hygiene is important to prevent infections, it is not the leading cause of foot issues. Congenital deformities (Option B) are pre-existing conditions that individuals are born with and are not necessarily the most common cause of foot problems in the general population. Peripheral vascular disease (Option D) is a serious condition that affects blood flow to the extremities, including the feet. While it can certainly contribute to foot problems, it is not as prevalent or as directly linked to most foot issues as improperly fitting shoes. Educationally, understanding the impact of shoe fit on foot health is essential for nurses and healthcare professionals when providing patient education on preventive foot care. It highlights the importance of wearing properly fitting shoes, choosing appropriate footwear for different activities, and conducting regular foot assessments to identify potential problems early on. Proper footwear can significantly reduce the risk of foot discomfort, pain, and complications, promoting overall foot health and mobility.