Exemplar- Parkinson's Disease

A nurse is reinforcing teaching with a client who has Parkinson's disease and has a new prescription for bromocriptine. Which of the following instructions should the nurse include? A. rise slowly when standing B. expect urine to become dark-colored C. avoid foods containing tyramine D. report any skin discoloration

A. rise slowly when standing

A nurse is caring for a client who has a new prescription for pramipexole to treat Parkinson's disease. The nurse should recognize that which of the following lab tests requires monitoring? A. C-reactive protein B. Creatinine clearance C. Thyroid function D. CBC

B. Creatinine clearance

A nurse is administering segellimine for Parkinson's an MAOI. What food should the client eliminate

Cheddar cheese

A nurse is providing information to a client who has early Parkinson's disease and a new prescription for pramipexole. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? A. Hallucinations B. Increased salivation C. Diarrhea D. Discoloration of urine

A. Hallucinations

A nurse is caring for a client with a new diagnosis of Parkinson's Disease. The nurse notices the client has bilateral hand tremors and balance problems when walking to the bathroom. Which of the ofllowing patholical processes are the basis of the client's clinical manifestations? A. There is a major decrease in dopamine-producing nerve cells of the substantia nigra B. The serotonin-producing nerve cells of the brain are duplicating C. There is demyelination of the nerve cells that control the nerve signals from the spinal cord to the brain D. The aging of the nerve results in decreased and interrupted nerve transmission

A. There is a major decrease in dopamine-producing nerve cells of the substantia nigra

A nurse is teaching a client who is taking levodopa carbidopa to treat Parkinson's disease. Which of the following instructions should the nurse include? A.Change position slowly to prevent orthostatic hypotension. B.Eat a high-protein snack to increase absorption. C.Take the drug at bedtime to avoid daytime drowsiness. D.Expect eye twitching to develop with long-term therapy.

A.Change position slowly to prevent orthostatic hypotension.

A nurse is assessing a client for manifestations of Parkinson's disease. Which of the following are expected findings? (Select all that apply.) A. decreased vision B. pill-rolling tremor of the fingers C. shuffling gaitD. drooling E. bilateral ankle edema F. lack of facial expression

B. pill-rolling tremor of the fingers C. shuffling gait D. drooling F. lack of facial expression

A nurse is developing a plan of care for the nutritional needs of a client who has stage IV Parkinson's disease. Which of the following actions should the nurse include? (Select all that apply.) A. provide three large balanced meal daily B. record diet and fluid intake daily C. document weight every other week D. offer cold fluids such as milkshakesE. offer nutritional supplements between meals

B. record diet and fluid intake daily D. offer cold fluids such as milkshakes E. offer nutritional supplements between meals

A nurse is caring for a client who has Parkinson's disease, who comes into the clinic every six months for check-ups. The nruse notices the client has slower arm and leg movements and is losing balance when walking down the hall. Which o f the following stages of the disease should the nurse document in the client's record? A. Stage 1 B. Stage 2 C. Stage 3 D. Stage 4

C. Stage 3

A nurse is teaching a client who has a new prescription for levodopa/carvedopa for Parkinson's disease. Which of the following instructions should the nurse include? A. Increase intake of protein-rich foods B. Expect muscle twitching to occur C. Take this medication with food D. Anticipate relief of manifestations in 24 hours

C. Take this medication with food

A nurse is caring for a client who displays manifestations of stage III Parkinson's disease. Which of the following actions should the nurse include? A. recommend a community support group B. integrate a daily exercise routine C. provide a walker for ambulation D. perform ADLs for the client

C. provide a walker for ambulation

A nurse is teaching a client who has Parkinsons disease and is precribed carbidopa-levodopa. Which of the following statements indicates an understanding of the teaching? A."I should expect an increase in my blood pressure while taking this medication." B."I should take this medication 2 hours after meals to increase absorption." C."I should expect that this medication can cause me to be drowsy." D."I should expect this medication to be effective within 48 hours."

C."I should expect that this medication can cause me to be drowsy."

A nurse is preparing to administer benztropine 8 mg PO daily in 2 divided doses to a client who has Parkinson's disease. The amount available is benztropine 2 mg tablets. How many tablets should the nurse administer with each dose? (Fill in the blank with the numeric value only, round the answer to the nearest whole number, and use a leading zero if applicable. Do not use a trailing zero.)

Correct Answer: 2

A nurse is teaching about levodopa with a family member of a client who has Parkinson's disease. Which of the following pieces of information should the nurse include? A."A full therapeutic response may take several months to happen." B."The medication should be taken with high-protein foods." C."A full therapeutic response might cause vivid dreams." D."The medication is given at the onset of mild symptoms."

Correct Answer: A. "A full therapeutic response may take several months to happen." The nurse should inform the family member that although levodopa is the most effective medication for Parkinson's disease, a full therapeutic response might not occur for several months. Incorrect Answers:B. Amino acids compete with levodopa for intestinal absorption. Therefore, high-protein foods decrease the therapeutic effects of levodopa. C. Vivid dreams may occur with levodopa as an adverse effect, not as a therapeutic response. D. Mild symptoms of Parkinson's are usually treated with selegiline, an MAO-B inhibitor. Levodopa is generally prescribed for the management of more severe symptoms.

A nurse is providing teaching about degenerative complications to the partner of a client who has a new diagnosis of Parkinson's disease. Which of the following manifestations is the priority? A.Dysphagia B.Emotional lability C.Impaired speech D.Self-care dependency

Correct Answer: A. Dysphagia The nurse should apply the ABC priority-setting framework, which emphasizes the basic core of human functioning: having an open airway, being able to breathe in adequate amounts of oxygen, and circulating oxygen to the body's organs via the blood. An alteration in any of these areas can indicate a threat to life and should be the nurse's priority concern. When applying the ABC priority-setting framework, the airway is the priority because it must be open for oxygen exchange to occur. Breathing is the second priority framework because adequate ventilatory effort is essential for oxygen exchange to occur. Circulation is the third priority because the delivery of oxygen to critical organs only occurs if the heart and blood vessels are capable of efficiently carrying oxygen to them. Therefore, dysphagia is the priority manifestation because it can lead to aspiration. Incorrect Answers:B. The nurse should teach the partner of the client about emotional lability and depression associated with Parkinson's disease; however, another manifestation is the priority. C. The nurse should teach the partner of the client about the development of impaired speech associated with Parkinson's disease; however, another manifestation is the priority. D. The nurse should teach the partner of the client about the self-care dependency associated with Parkinson's disease; however, another manifestation is the priority.

A nurse is teaching a client who has a new diagnosis of Parkinson's disease about how levodopa/carbidopa can help control symptoms. The nurse should identify that the drug has which of the following pharmacologic effects? A. Increases available acetylcholine in the brain B. Inhibits norepinephrine metabolism in the brain C. Inhibits serotonin metabolism in the brain D. Increases available dopamine in the brain

D. Increases available dopamine in the brain

A nurse is caring for a client who has been taking selegiline to treat Parkinson's disease. The provider is considering the use of analgesics for the client but should be aware that a drug interaction between selegiline and meperidine can result in which of the following? A. Frequent Urination B. Jaundice C. Cellulitis D. Muscle rigidity

D. Muscle rigidity

A nurse is caring for a client who has Parkinson's disease and is starting to display bradykinesia. Which of the following is an appropriate action by the nurse? A. teach the client to walk more quickly when ambulating B. complete passive range-of-motion exercises daily C. place the client on a low-protein, low-calorie diet D. give the client extra time to perform activities

D. give the client extra time to perform activities

A nurse who is caring for a client who has Parkinson's and is taking diphenhydramine. Which of the following therapeutic outcomes should the nurse expect to see?

Decreased tremors

A nurses providing teaching regarding a new prescription for carbidopa-levodopa for a client who has parkinson disease. which of the following client statements indicates an understanding of the treatment

I should expect my urine to be a darker color

A nurse is providing teaching to a patient about Parkinson's disease. Which medication should the nurse prepare to educate the patient on?

Levodopa/carbidopa