Chapter 20 Degenerative

The nurse has provided education for a client who received a new prescription for the treatment of Parkinson's disease. Which statements made by the client indicate an understanding of the information? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "I guess I will have to give up eating my wife's banana pudding." 2) "I should add some wheat germ to my breakfast cereal." 3) "I should add olive oil to the salads I eat at noon each day." 4) "I will most likely have to become a vegetarian." 5) "I will take my medication on an empty stomach."

1) "I guess I will have to give up eating my wife's banana pudding." 5) "I will take my medication on an empty stomach." (Pg. 276)

The nurse is preparing to provide client education on degenerative diseases of the nervous system. Which information should the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Amyotrophic lateral sclerosis 2) Multiple sclerosis 3) Alzheimer's disease 4) Myasthenia Gravis 5) Parkinson's disease

1) Amyotrophic lateral sclerosis 2) Multiple sclerosis 3) Alzheimer's disease 5) Parkinson's disease (Pg. 264 table 20.1)

Which should the nurse understand are the primary goals for the pharmacological treatment of multiple sclerosis? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Modifying the progression of the disease 2) Treating acute exacerbations 3) Managing symptoms 4) Curing the disease 5) Remyelinating nerve fibers

1) Modifying the progression of the disease (Pg. 274) 2) Treating acute exacerbations (Pg. 274) 3) Managing symptoms (Pg. 273)

Which should the nurse include in the plan of care for the patient with Parkinson's disease? 1) Monitor the client for the ability to chew and swallow. 2) Check peripheral circulation for thrombophlebitis. 3) Monitor the client for psychotic symptoms. 4) Limit exercise to decrease the possibility of fractures.

1) Monitor the client for the ability to chew and swallow. (Pg. 276, NurPra--> 2nd box left; 265)

A client with Parkinson's disease is experiencing an increase in bradykinesia. Which assessment findings should the nurse anticipate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Slow speech 2) Difficulty chewing 3) Shuffling the feet when walking 4) Stooped posture 5) Lack of facial expression

1) Slow speech 2) Difficulty chewing 3) Shuffling the feet when walking (Pg. 265)

The nurse is preparing the education for a client with progressive multiple sclerosis prescribed alemtuzumab (Lemtrada). Which information should the nurse plan to include in the education? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Monitoring for hypertension 2) Evaluation of a complete blood count (CBC) 3) Requirement of two doses of treatment 12 months apart 4) Dietary decrease of protein and vitamin B6 5) Intravenous administration of prescription

2) Evaluation of a complete blood count (CBC) 3) Requirement of two doses of treatment 12 months apart 5) Intravenous administration of prescription (Pg. 275)

Which prescription should the nurse anticipate will most likely be prescribed for a client with Alzheimer's disease? 1) Levodopa (Larodopa) 2) Haloperidol (Haldol) 3) Benztropine mesylate (Cogentin) 4) Donepezil hydrochloride (Aricept)

4) Donepezil hydrochloride (Aricept) (Pg. 272 prototype box)

A client is prescribed trihexyphenidyl (Artane). Which assessment finding should the nurse report to the healthcare provider? 1) Dry mouth 2) Anorexia 3) Hypertension 4) Urinary retention

4) Urinary retention (Pg. 269 table to see it is anticholinergic, pg. 270 lists urinary retention as an SE, Ch 12 for safety r/t urinary retention)

Which best describes the action of Glatiramer (Copaxone)? 1) Stimulates the production of neurons 2) Stimulates the growth of myelin 3) Inhibits the destruction of myelin 4) Reduces the creation of new brain lesions

4) Reduces the creation of new brain lesions (Pg. 274)

The nurse is providing education to the family member of a client with Alzheimer's disease. Which information should the nurse include in the discussion? 1) "The prescription may help with the symptoms for a little while." 2) "The prescription may have serious side effects if used for a long time." 3) "Symptoms will improve as long as the prescription is taken regularly." 4) "Symptoms should begin improving within a few days."

1) "The prescription may help with the symptoms for a little while." (Pg. 268, 270-271)

The nurse is caring for an older adult prescribed benztropine (Cogentin). For which adverse effect should the nurse monitor the patient? 1) Confusion 2) Bradycardia 3) Diarrhea 4) Agitation

1) Confusion (Pg. 269 prototype box; AE include sedation, dizziness, restlessness, irritability, nervousness and insomnia...)

Which should the nurse recognize is the benefit of a prescription for levodopa for a client with Parkinson's disease? 1) Crosses the blood-brain barrier 2) Has fewer adverse effects 3) Less risk for addiction 4) Can be administered intravenously

1) Crosses the blood-brain barrier (Pg. 266)

A client receiving pharmacotherapy for the treatment of Parkinson's disease has experienced increased eye twitching tremors. Which treatment interventions should the nurse anticipate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Increase in the dosage of the prescription 2) Changing the interval between the doses of prescriptions 3) Changing the route of administration of the prescription 4) A scheduled drug holiday 5) Implementing an adjunctive prescription

1) Increase in the dosage of the prescription 2) Changing the interval between the doses of prescriptions 5) Implementing an adjunctive prescription (Pg. 266-268 signs indicate a wearing off has occurred)

Which should the nurse understand is the action of the pharmacotherapy used to treat Parkinson's disease? 1) Increase the amount of dopamine and reduce the amount of acetylcholine. 2) Increase the amount of dopamine and acetylcholine. 3) Reduce the amount of dopamine and increase the amount of acetylcholine. 4) Reduce the amount of dopamine and acetylcholine.

1) Increase the amount of dopamine and reduce the amount of acetylcholine. (Pg. 265)

The nurse is preparing to assess a client with amyotrophic lateral sclerosis (Lou Gehrig's disease). Which assessment findings should the nurse anticipate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Muscle weakness 2) Muscle atrophy 3) Mood alterations 4) Slow shuffling gait 5) Abnormal posture

1) Muscle weakness 2) Muscle atrophy (table on Pg. 264)

The nurse is preparing to assess a client with Parkinson's disease. Which finding should the nurse recognize interferes with the client's ability to control their hand movements? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Pill rolling 2) Tremor 3) Stooped posture 4) Lack of arm swing 5) Difficulty bending the arms

1) Pill rolling 2) Tremor (Pg. 264)

The nurse has completed the education for a client prescribed levodopa (Stalevo). Which statement made by the client indicates an understanding of the information? 1) "I will increase the intake of vitamin B6 in my diet." 2) "I will weigh myself weekly." 3) "I will increase the protein in my diet." 4) "I will notify my healthcare provider if my urine darkens."

2) "I will weigh myself weekly." (Pg. 276)

Which assessment finding warrants the nurse to hold the dosage of benztropine (Cogentin) and notify the healthcare provider? 1) A respiratory rate of 14 2) A pulse of 112 3) Blood pressure of 142/80 mmHg 4) A temperature of 100.2°F

2) A pulse of 112 (Pg. 269 prototype box; tachycardia)

The nurse is preparing education for a caregiver of a patient with Alzheimer's disease. Which information should the nurse include in the teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Glutamergic inhibitors are the most common class of drugs for treating Alzheimer's disease. 2) Depression and aggressive behavior are common with the disease. 3) Memory difficulties are an early symptom of the disease. 4) Chronic inflammation of the brain can be a causative actor in the condition. 5) Pharmacologic therapies are given to help improve memory in Alzheimer's disease.

2) Depression and aggressive behavior are common with the disease. 3) Memory difficulties are an early symptom of the disease. 4) Chronic inflammation of the brain can be a causative actor in the condition. 5) Pharmacologic therapies are given to help improve memory in Alzheimer's disease. (Pg. 270)

The nurse is preparing to assess a client with multiple sclerosis. Which assessment finding should the nurse anticipate? 1) Skeletal muscle atrophy 2) Tremors 3) Visual disturbances 4) Muscle rigidity

3) Visual disturbances (Pg. 264, 273; visual impairment)

The nurse is caring for a client suspected of overdosing on donepezil (Aricept). Which prescription should the nurse prepare to administer? 1) Physostigmine 2) Epinephrine 3) Atropine 4) Gastric lavage with charcoal

3) Atropine (Pg. 272 prototype box)

The nurse is reviewing the prescription history for a client receiving levodopa (Stalevo). Which routine prescription is most concerning? 1) Aspirin 2) Metformin 3) Calcium antacid 4) Synthroid

3) Calcium antacid (Pg. 268 prototype box; may increase absorption and lead to toxicity)

Which statement best describes the contributing factor to the structural change that occurs in the brain of a patient with Alzheimer's disease? 1) Increased acetylcholine levels 2) Increases in blood pressure and cholesterol levels 3) Chronic inflammation and oxidative cellular damage 4) Cerebral bleeding and associated hypoxia

3) Chronic inflammation and oxidative cellular damage (Pg. 270)

The nurse is providing education for a client about the characteristics of Alzheimer's disease. Which information should the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) More women than men have Alzheimer's disease. 2) The disease is characterized by the degeneration of the neurons. 3) Chronic inflammation of the brain may be a cause of the disease. 4) The disease mainly affects people over 50 years of age.

3) Chronic inflammation of the brain may be a cause of the disease. (Pg. 264, 270) 2- PD is characterized by degen neurons 4 - over 65 yrs

A client who takes benztropine (Cogentin) has developed constipation. Which interventions should the nurse implement? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Instruct the client to administer an enema. 2) Encourage the client to take docusate (Colace) daily. 3) Instruct the client to increase their fluid intake. 4) Encourage the client to walk daily 5) Instruct the client to discontinue their prescription until their bowel function returns to normal.

3) Instruct the client to increase their fluid intake. 4) Encourage the client to walk dailynot a serious side effect unless it persists; lead with nonpharmacological interventions p. 269

Which assessment finding in an older adult prescribed levodopa (Stalevo) should the nurse be most concerned with? 1) Hypertension 2) Diarrhea 3) Muscle twitching 4) Dark urine

3) Muscle twitching (Pg. 268 prototype box; early sign of toxicity)

The nurse is preparing to provide education for a client prescribed carbidopa (Sinemet). Which information should the nurse include? 1) Avoid drinking caffeinated beverages. 2) Take the medication with meals. 3) Take the medication on an empty stomach. 4) Take the medication with a protein food.

3) Take the medication on an empty stomach. (Pg. 268; high protein or vit. B decreases absorption)

A client with multiple sclerosis asks the nurse how Dalfampridine (Ampyra) will help them. Which response should the nurse provide? 1) "Dalfampridine will lessen the cognitive deficits that occur with MS." 2) "Dalfampridine will decrease the number of mood alterations." 3) "The prescription will disrupt the visual disturbances that occur with MS." 4) "The prescription will improve your ability to walk."

4) "The prescription will improve your ability to walk." (Pg. 275)

A client with Parkinson's disease asks the nurse how his or her prescriptions will help him or her. Which response should the nurse provide? 1) "The prescriptions will help prevent muscle wasting." 2) "The prescriptions will increase your appetite and energy." 3) "The prescriptions will balance serotonin and acetylcholine in your brain." 4) "The prescriptions will help you to eat and walk."

4) "The prescriptions will help you to eat and walk." (Pg. 265)

Which statement describes the purpose for the use of acetylcholinesterase inhibitors prescribed to treat Alzheimer's disease? 1) Reverse the structural damage within the brain 2) Increase synthesis of acetylcholine 3) Increase enzymatic breakdown leading to increased neuronal production 4) Intensify the effect of acetylcholine at the receptor

4) Intensify the effect of acetylcholine at the receptor (Pg. 270)