Parkinson's: Science-forums

The nurse is assessing a client who is diagnosed with Parkinson's disease and documents that he is demonstrating bradykinesia. The nurse bases this on the observation of the client: 1. Having difficulty initiating a walk to the bathroom. 2. Presenting little facial expression. 3. Maintaining his balance by holding on to the furniture. 4. Speaking both slowly and deliberately.

1

The nurse notes tremors and muscle rigidity in an older adult patient diagnosed with Parkinson's disease. Which medication would the nurse expect to administer to combat these symptoms? 1. Benztropine (Cogentin) 2. Dantrolene (Dantrium) 3. Riluzole (Rilutek) 4. Nitroglycerin (Nitro-bid)

1

When interviewing a client suspected of exhibiting signs of Parkinson's disease, the nurse shows an understanding of the disease's etiology when asking: 1. "Do you recall if any of your relatives had difficulty holding on to things with his or her hands?" 2. "Did I understand correctly that your memory problems started about 5 years ago?" 3. "Is it painful to flex your chin to your chest?" 4. "Did your muscle weakness first occur in your arms or in your legs?"

1

The nurse is providing community education about Parkinson's disease (PD) symptomology. Which information would the nurse include in this discussion? Select all that apply. Select all that apply. 1. "'Pill-rolling' motions are often seen in the hands.". 2. "Muscle stiffness is a common manifestation.". 3. "People with Parkinson's disease often complain that they move slowly.". 4. "Many people with PD are injured because they tend to fall more than others.". 5. "People with PD tend to have drooping of the eyelids.".

1, 2, 3, 4

The nurse is assessing a patient who has been diagnosed with Parkinson's disease and documents that he is demonstrating bradykinesia. The nurse bases this on which observation? 1. The patient sloshes coffee out of his cup when eating breakfast. 2. The patient has difficulty initiating a walk to the bathroom. 3. The patient maintains his balance by holding on to the furniture. 4. The patient's skin is moist and his clothing is damp

2

When interviewing a patient suspected of exhibiting signs of Parkinson's disease, the nurse shows an understanding of the disease's etiology by asking which question? 1. "Is it painful to flex your chin to your chest?" 2. "Do you recall if any of your relatives had difficulty holding on to things with their hands?" 3. "Did your muscle weakness first occur in your arms or in your legs?" 4. "Did I understand correctly that your memory problems started about 5 years ago?

2

A patient who was diagnosed with Parkinson's disease is exhibiting hypomimia. What will the nurse likely observe in this patient? 1. Slow movements of the arms and legs 2. Falling when attempting to step backward 3. Blank facial expression 4. Very slow talk

3

A patient diagnosed with Parkinson's disease (PD) 11 years ago is being cared for at home by the spouse. The nurse asks whether the family has considered arranging for in-home assistive care, based primarily on which knowledge? 1. The patient may live for many more years. 2. This type of assistive care is warranted because PD is both progressive and degenerative. 3. It is becoming more difficult for the spouse to adequately meet the patient's physical needs. 4. This type of assistance can help preserve the physical and emotional well-being of the patient's spouse.

4

Persons with Parkinson disease have an altered gait characterized by: a. short shuffling steps. b. the trunk in a backward position. c. exaggerated swinging of the arms. d. lifting the legs in a high-stepping fashion.

a

A client diagnosed with Parkinson's disease is prescribed to take levodopa. The nurse should instruct the client about possible side effects which include: A) orthostatic hypotension and confusion. B) acute hypertension and glycosuria. C) diarrhea. D) bradycardia.

a

The nurse is caring for a client with Parkinson's disease. Which intervention does the nurse implement to prevent respiratory complications in the client? a. Keep an oral airway at the bedside. b. Ensure fluid intake of at least 3 L/day. c. Teach the client pursed-lip breathing techniques. d. Maintain the head of the bed at 30 degrees or greater.

d

The nurse is having a conversation with an older adult with Parkinson's disease. What would this patient most likely exhibit during the conversation? Select all that apply. 1. A low-pitched monotone voice 2. Bubbly, spirited discussion 3. Jumbled words that do not make sense 4. Angry, loud talk 5. Slurring and poor articulation of words

1, 5

The nurse is explaining Parkinson's disease to the student nurse. Which statement by the nurse is correct regarding the pathophysiology of the disease? a. "Regardless of the actual etiology, Parkinson's is caused by depletion of dopa-mine and excess of acetylcholine." b. "The pathophysiology of the disease is caused by the deterioration of the myelin sheath of the basal ganglia." c. "Excess dopamine and deficient acetyl-choline are the cause of Parkinson's dis-ease." d. "When there is decreased dopamine up-take at receptors in brain cells, Parkinson's disease results."

a

When doing a physical assessment of a client, the nurse should expect to find which symptom related to a diagnosis of Parkinson's disease? A) bradykinesia B) dry skin C) polyuria D) elevated blood pressure

a

The home health nurse assesses the patient with Parkinson's disease who has just been placed on carbidopa-levodopa. What side effects should the nurse be alert for when assessing this patient? (Select all that apply.) a. Urinary retention b. Rash c. Increased diaphoresis d. Orthostatic hypotension e. Hematuria

a, b, c, d

Important self-care measures a nurse can teach a client with Parkinson's disease in order to prevent contractures and improve mobility include which of the following? (Select all that apply.) a. Bend over with your head over your toes to get out of chairs. b. Exercise first thing in the morning. c. Keep a narrow-based gait. d. Look up when you walk, not down at the floor. e. Use a firm surface, like the floor, for exercising.

a, b, d

A nurse is reviewing a colleague's discharge instructions for a client with Parkinson's. Which of the following will the nurse make sure are included in the instructions? (Select all that apply.) a. Arrange for a bathroom/bedroom on the first floor. b. Instruct client NOT to wear crepe or rubber soled shoes as they may cause client to trip. c. Place throw rugs throughout the home for easier ambulation. d. Install handrails at steps, in hallways, and in the bathroom. e. Inform client that waxed floors are safe to walk on due to smoothness of surface. f. Encourage the client to use adaptive devices for independence in ADLs. g. Fluids should be mildly restricted to prevent incontinence. h. Take medications at scheduled times to maintain therapeutic dosing levels.

a, b, d, f, h

A client with Parkinson's needs to make which of the following changes at meal time for safety? a. Restrict fluids to prevent aspiration. b. Be monitored for choking due to dysphagia. c. Follow a high fat diet to ease swallowing. d. Eat semi-pureed food.

b

The client with Parkinson's disease has been taking a combination carbidopa-levodopa drug (Sinemet) for 3 years. Which of the following side effects should the nurse be alert for in this client as a result of this medication? A. Constipation B. Abnormal movements C. Malabsorption syndrome D. Increased resting heart rate

b

Which medication would be prescribed to control tremors and rigidity in a Parkinson's Disease client? a. dopadecarboxylase inhibitor c. cholinergic drugs b. anticholinergic drugs d. antiseizure

b

Which statement regarding the pathophysiology of Parkinson's disease is true? A. Alteration in neuronal signals from the basal ganglia cause dopamine levels to increase. B. Degeneration of the substantia nigra leads to a decrease in dopamine levels. C. Cerebellar levels of acetylcholine rise, inhibiting voluntary movement. D. The cerebral cortex fails to use available acetylcholine.

b

A patient who has been diagnosed with Parkinson's disease expresses hopelessness regarding the future. The nurse would consider which genetic technology when formulating a response? 1. Gene therapy 2. Real-time PCR 3. Stem cell therapy 4. Microarray analysis

c

To assist the client with Parkinson's disease to reduce tremor, the nurse suggests that the client a. clasp arms about self and squeeze. b. sleep on the non-tremorous side. c. tightly hold change in the pocket. d. visualize stilling the tremor.

c

Which condition is a result of deposits of proteins in the cytoplasm of neurons in the brain's cortex? a. Parkinson's Disease Which condition is a result of deposits of proteins in the cytoplasm of neurons in the brain's cortex? a. Parkinson's Disease c. Lewy Body Dementia b. Alzheimer's Disease d. Vascular Dementia

c

Which of the following interventions is most appropriate for the client with Parkinson's who is hospitalized with pneumonia? A. Implement universal precautions B. Implement seizure precautions C. Implement falls precautions D. Use a geri-chair to provide out-of-bed activity

c

The nurse is talking to the family of a client who has Parkinson's disease. Which statement indicates that the family has a good understanding of the changes in motor movement associated with this disease? a. "I can never tell what she's thinking. She hides behind a frozen face." b. "She drools all the time so I just can't take her out anywhere." c. "I think this disease makes her nervous. She perspires all the time." d. "She has trouble chewing so I will offer bite-sized portions."

d

Which nursing intervention will assist in preventing respiratory complications in the client with Parkinson's disease? A. Keeping an oral airway at the bedside. B. Ensuring a fluid intake of at least 3 L/day. C. Teaching the client pursed-lip breathing techniques. D. Maintaining the backrest elevation at greater than 30 degrees.

d

Which statement indicates that the family has a good understanding of the changes in motor movement associated with Parkinson's disease? A. "I can never tell what he's thinking—he hides behind a frozen face." B. "She drools all the time just so I can't take her out anywhere." C. "I think this disease makes him nervous—he perspires all the time." D. "I can offer smaller meals with bite-size portions and a liquid supplement."

d