Chapter 39, Neurodegenerative Disorders

"Strictly avoid foods with cheese or cheese products.

When a patient with Parkinson disease is to begin taking rasagiline mesylate to relieve freezing episodes, which instruction would the nurse provide the patient and caregiver?

Confusion about events Disorientation to time and place Impairment of all cognitive functions Incompetency in handling money and finances

When assessing an older-adult patient, which clinical manifestation would the nurse associate with stage II Alzheimer disease (AD)? Select all that apply. One, some, or all responses may be correct.

Mini-Mental State Examination (MMSE)

When determining the onset and severity of the cognitive impairment of a patient with Alzheimer disease (AD), which test requires the patient to be able to read?

It delays the destruction of acetylcholine by acetylcholinesterase.

When preparing to administer donepezil to a patient with Alzheimer disease, the nurse would associate which action with the prescribed medication?

Safe Return Program

When presenting the discharge teachings for a patient with dementia and Alzheimer disease, the daughter states, "My father wanders so much; I am afraid he'll slip away from me." Which dementia and Alzheimer disease resource would the nurse suggest to the daughter?

Provide instruction with pictures

When providing care for a patient in the last stage of Alzheimer disease, which strategy would the nurse implement to promote communication?

"It may be passed to your biologic child.

When providing care for a patient newly diagnosed with Huntington disease (HD), the nurse would include which statement when teaching the specifics of the disease?

Arrange for respite care for the caregiver.

When the spouse of a patient with Alzheimer disease mentions a loving relationship and the required care as exhausting, which action would the home health nurse implement to alleviate the caregiver's stress?

Memory Family history Sense of smell

Which area would the nurse assess in a patient whose MRI report indicates a reduced brain weight and atrophy of the cerebral cortex? Select all that apply. One, some, or all responses may be correct.

"Donepezil will treat the symptoms of AD."

Which caregiver response indicates understanding of the nurse's instruction regarding a patient's medication regimen for the treatment of Alzheimer disease (AD)?

"I will assess the sleeping habits of the patient." "I will provide a good sleep environment for the patient." "I will attempt to keep the patient awake during the day."

Which caregiver statement characterizes an understanding of the nurse's teachings regarding the sleep patterns associated with a patient with Parkinson disease (PD)? Select all that apply. One, some, or all responses may be correct.

"I should install smoke alarms. "I should allow my mom to be independent." "I should provide lights in all the rooms

Which caregiver's statement indicates understanding of the nurse's teachings about the necessary steps to manage the patient's Alzheimer disease (AD)? Select all that apply. One, some, or all responses may be correct

The group assists in identifying patients and returning them safely to their family.

Which characteristic would the nurse associate with the Alzheimer Association's Safe Return Program?

Inability to make decisions

Which clinical manifestation would a patient with Alzheimer disease exhibit when the disease impairs the patient's frontal lobe?

Loss of facial recognition Totally dependent regarding ADLs

Which clinical manifestation would support the nurse's suspicions that a patient is in the third stage of Alzheimer disease? Select all that apply. One, some, or all responses may be correct.

Postural instability and increased gait disturbances

Which clinical manifestation would the nurse associate with a patient in the moderate stage of Parkinson disease (PD)?

Assume the patient is not completely confused.

Which communication technique would the nurse use when providing care for a patient with advanced Alzheimer disease?

"Consider attending local support group meetings conducted by the Alzheimer's Association."

Which information would the nurse relay to a stressed caregiver who provides care for an older-adult family member with Alzheimer disease?

"Give the drug before meals."

Which instruction would the nurse include when teaching a patient's family about the administration of carbidopa/levodopa to treat the patient's severe symptoms of Parkinson disease?

Administer medications promptly on schedule to maintain therapeutic drug levels.

Which instruction would the nurse provide a patient's spouse or caregiver when providing discharge instructions for home care of the patient with Parkinson disease?

Involve the patient and spouse in developing a plan of care.

As part of the discharging home process for a patient with Parkinson disease and his or her spouse, which action would the nurse implement to ensure successful plan management?

Rotigotine

For a hospitalized patient diagnosed with Parkinson disease (PD), which prescribed medication would the nurse administer via a continuous transdermal patch to maintain a consistent level of dopamine?

Provide the name of the assigned case manager.

For a patient beginning the discharge home process with progressive stage I Alzheimer disease, which priority action would the nurse implement to ensure continuity of care when the family expresses concern about providing care for the parent?

Stage 2

For a patient diagnosed with Parkinson disease (PD), which stage of PD would the nurse associate with the patient's bilateral limb involvement, masklike face, and slow, shuffling gait?

Change the medication or its frequency of administration.

For a patient with Parkinson disease (PD), which prescribed intervention would the nurse anticipate when the patient develops a medication tolerance?

Perform an MRI Place a stereotactic head frame Administer IV sedation Insert an electrode into the target area Pass electric stimulation through the electrode

For a patient with Parkinson disease, in which order would the nurse explain the steps required for a scheduled stereotactic pallidotomy?

Sundowning

For a patient with advanced Alzheimer disease, which term reflects the behavior of increased confusion, belligerence, and wandering toward the end of the day, rather than any other time?

Paranoia Hallucinations Aggressiveness

For family members of a patient diagnosed with Alzheimer disease, which behavior and personality change would the nurse teach coping strategies for? Select all that apply. One, some, or all responses may be correct.

Haloperidol

For patients with dementia, which prescribed medication would the nurse administer to treat those patients who also experience hallucinations?

Behavior Language Personality

For the patient with Alzheimer disease (AD), which aspect would the nurse include with the primary focus of identifying abnormalities in cognition? Select all that apply. One, some, or all responses may be correct.

Give extra time for the patient to respond to questions. Monitor the patient for prescribed medication side effects. Collaborate with physical and occupational therapists.

For the patient with Parkinson disease, which intervention would the nurse include in the patient's plan of care? Select all that apply. One, some, or all responses may be correct.

Provide music and art therapy. Keep the patient away from exits. Keep the patient away from the stairs

To prevent patient injury, which intervention would the nurse implement for a patient with Alzheimer disease? Select all that apply. One, some, or all responses may be correct.

Potential for injury related to chronic confusion and physical deficits

To provide interprofessional care, which patient problem would the nurse identify as the priority when admitting a patient with early stage Alzheimer disease to the surgical unit for a biopsy?

Genetic testing

To diagnose Alzheimer disease, the health care provider would order which test to detect apolipoprotein E4 (APOE 4)?

Practice yoga and tai chi. Avoid driving automobiles. Avoid sleeping during the daytime

To help a patient with Parkinson disease (PD), which teaching would the nurse provide the patient to manage the condition? Select all that apply. One, some, or all responses may be correct.

Reminisce about pleasant experiences from the past Keep environmental distractions and noise to a minimum. Remove or cover any abstract painting or wallpaper if the patient becomes frightened.

Which instruction would the nurse provide to family members of a patient with Alzheimer disease? Select all that apply. One, some, or all responses may be correct.

Cognitive stimulation Reminiscence therapy Promoting communication

Which intervention would the nurse implement to manage patients with Alzheimer disease? Select all that apply. One, some, or all responses may be correct.

Monitor the patient's sleep patterns

Which intervention would the nurse implement to protect a patient with Parkinson disease (PD) from injury?

Donepezil Paroxetine Memantine

Which medication would the nurse anticipate administering to older-adult patients with Alzheimer disease (AD)? Select all that apply. One, some, or all responses may be correct.

Zolpidem tartrate

Which medication would the nurse anticipate the health care provider prescribing for a patient with Parkinson disease to aid the patient's sleep?

Decrease in the amount of ACh

Which pathophysiologic event may be responsible for the nurse suspecting a patient has Alzheimer disease?

A medication holiday Change in the selected medications Reduction in medication dosage Change in dose frequency

Which potential alteration to the medication regimen would the nurse anticipate when a patient with Parkinson disease states that the previously controlled symptoms return well before the time scheduled for the next dose of carbidopa/levodopa? Select all that apply. One, some, or all responses may be correct.

Memantine

Which prescribed medication would the nurse anticipate administering to a patient whose caregiver reports loss of memory and thinking skills?

Paroxetine

Which prescribed medication would the nurse associate with reducing the depression experienced by a patient with Alzheimer disease?

Depression Impaired cognition Sleep disturbances

Which psychosocial manifestation would the nurse correlate with Parkinson disease? Select all that apply. One, some, or all responses may be correct.

Have you taken her for a checkup recently?"

Which response would the nurse make when a friend expresses fears regarding his or her mother becoming older, extremely forgetful and disoriented, and beginning to wander?

III

Which stage of Alzheimer disease would the nurse document in the electronic medical record when the patient is completely bedridden, has lost all motor and verbal skills, and is unable to recognize family members?

I

Which stage of Alzheimer disease would the nurse document when the patient demonstrates independent ADLs, has no social or employment difficulties, forgets names and misplaces items, and experiences short-term memory loss?

Mild stage

Which stage of Parkinson disease (PD) would the nurse suspect when a patient with PD displays a masklike face and bilateral limb involvement?

If she has children, she'll pass the gene on to her kids."

Which statement demonstrates good understanding of the nurse's teachings about the genetic aspects of Huntington disease (HD) provided for a patient and parents?

HD is associated with an increased amount of dopamine levels.

Which statement reflects a understanding of Huntington disease (HD)?

Neuroleptic agents

Which therapy would the nurse anticipate the primary health care provider prescribing for the older-adult patient with Alzheimer disease who presents with hallucinations and delusions?

Mini-Mental State Examination

Which tool would the nurse use to test cognitive changes related to Alzheimer disease?

Selective serotonin reuptake inhibitor

Which type of prescribed medication would the nurse anticipate when a patient with Alzheimer disease begins to exhibit clinical manifestations of depression for the first time?