MS2 quiz #8 Chapter 21&22: Neurologic System Introduction, Neurologic Disorders

8. What diagnostic test might be contraindicate for a patient who has a pacemaker? a. Computed tomography (CT) b. Electromyography (EMG) c. Magnetic resonance imaging (MRI) d. Electroencephalography (EEG)

ANS: Magnetic resonance imaging (MRI) Metal appliances may be affected by the magnetic field during MRI.

A long-term care resident is taking an anticholinergic agent. The nurse observes the resident to be disoriented and hallucinating. The priority nursing action is to: a. report development of alterations to the charge nurse. b. assess blood glucose. c. provide for resident's safety. d. medicate with antianxiety medication.

ANS Provide for resident's safety. Serious psychological side effects of anticholinergic agents include confusion, depression, nightmares, and hallucinations. The priority nursing action at onset of confusion and hallucinations is safety. Once the resident is safe, development of alterations may be reported.Blood glucose may be monitored once safety is established. If appropriate medications are ordered by the physician, they can be provided once the resident is calm and safe.

Which body function(s) is/are controlled by the autonomic nervous system? (Select all that apply.) a. Blood pressure b. Skeletal muscle contraction c. GI secretion d. Body temperature e. Urination

ANS: A, C, D, E Blood pressure, GI secretion, body temperature, and urinary bladder function are body functions controlled by the autonomic nervous system. The autonomic nervous system maintains control over most tissue function, with the exception of skeletal muscle.

7. What should the nurse assess for the when a patient is scheduled for an angiogram? a. Dizziness b. Allergy to shrimp c. Increased BP d. Irregular heartbeat

ANS: Allergy to shrimp Allergy to shrimp and other shellfish also indicates a probable allergy to contrast medium.

What is included in the nursing management of the patient with generalized tonic-clonic seizure activity? (Select all that apply.) a. Restraining the patient's arms to avoid further injury b. Placing padding around or under the patient's head c. Attempting to insert a tongue depressor into the patient's mouth d. Positioning the patient on the side once the relaxation stage is entered to allow oral secretions to drain e. Requesting additional assistance and/or necessary equipment in case the patient does not begin breathing spontaneously when the seizure is over

ANS: B, D, E Managing a patient during a seizure includes protecting the patient from further injury, (placing padding around or under the head to help prevent head injury), positioning the patient in the recovery position to facilitate respiratory effort, clearing the airway, and initiating ventilations should the patient lack spontaneous respirations after seizure. Restraining apatient who is having a seizure can cause, rather than prevent, injury. Inserting anything into the mouth of someone who is having a seizure can cause injury.

Which vitamin will reduce the therapeutic effects of levodopa? a. A b. B6 c. C d. D

ANS: B6 Pyridoxine (vitamin B6) will reduce the therapeutic effects of levodopa in oral doses of 5 to 10mg or more. Generally, diets typically have less than 1 mg of vitamin B6 and therefore are not restricted. The ingredients in multivitamins, however, must be assessed. Vitamins A, C, and D do not affect therapy with levodopa.

5. A patient is stuporous but reacts by withdrawing from painful stimuli. What term is most appropriate for this patient? a. Comatose b. Lethargic c. Semicomatose d. Somnolent

ANS: Semicomatose A stuporous patient who reacts to pain is semicomatose. The patient with no reaction to pain is comatose.

A(n) ______ hematoma forms in the space between the inner surface of the skull and the outermost meningeal covering of the brain.

epidural

Which are normal brain alterations associated with age? (Select all that apply.) a. Decrease in brain weight b. Pigmentation of brain with lipofuscin c. Present of amyloid d. Tiny clot formation e. Tangled nerve fibers

ANS: A, B, C, E All brain alterations listed are expected changes that affect the older adult's neurologic function except for tiny clot formations, which are a pathologic change.

Neurotransmitter(s) include: (Select all that apply.) a. gamma aminobutyric acid. b. acetylcholine. c. serotonin. d. glucose. e. histamine. f. epinephrine.

ANS: A, B, C, E, F The CNS is composed of systems of different types of neurons that secrete separate neurotransmitters. Gamma aminobutyric acid, acetylcholine, serotonin, histamine, and epinephrine are examples. Glucose is a sugar that is the body's main source of energy.

Parkinson's disease has which characteristic symptom(s)? (Select all that apply.) a. Muscle tremors b. Posture alterations c. Muscle flaccidity d. Tachycardia e. Slow body movement

ANS: A, B, E Symptoms of Parkinson's disease include muscle tremors, posture and equilibrium alterations, and slow body movement or bradykinesia. Muscle flaccidity is not a symptom of Parkinson's disease. Symptoms of Parkinson's disease do not include alterations in heart rate.

A patient with generalized convulsive disorder has a nursing diagnosis of "Deficient knowledge, related to lack of information about the side effects of phenytoin (Dilantin)." Which goal and outcome criteria would be most appropriate? a. Absence of gastrointestinal (GI) complaint; takes medication with food b. Stimulation of gingiva; brushes teeth vigorously to encourage gingival growth c. Maintenance of normal pattern of elimination; limits fluids and eats foods that reduce diarrhea d. Maintenance of normal sleep pattern; reduces stimuli and takes warm baths to induce drowsiness

ANS: Absence of gastrointestinal (GI) complaint; takes medication with food Dilantin is irritating to GI tissues. Dilantin causes gingival hyperplasia, constipation, and drowsiness.

What is a guideline for the nurse when administering phenytoin (Dilantin) intravenously? a. Deliver rapidly. b. Monitor for signs of tachycardia. c. Assess for hypertensive crisis. d. Administer without mixing with other medications.

ANS: Administer without mixing with other medications. Phenytoin should not be mixed in the same syringe with other medications or added to other intravenous (IV) solutions because a precipitate will form. Phenytoin should be administered slowly at a rate of 25 to 50 mg/min. Patients should be monitored with an ECG closely for bradycardia. Patients should be monitored for hypotension.

Which term describes the collective symptoms of blurred vision; constipation; urinary retention; and dry nose, mouth, and throat? A. Dehydration B. Toxic effects C. Anticholinergic effects D. Cholinergic action

ANS: Anticholinergic effects This combination of symptoms is commonly referred to as anticholinergic effects, which are common adverse effects of many medications.Remember that cholinergic effects are opposite in many ways - SLUDGE - diarrhea instead of constipation, urinary incontinence instead of urinary retention, salivation and lacrimation instead of dry nose, mouth, throat

Which three symptoms are characteristic of Cushing triad associated with increased ICP? a. Hypotension, tachycardia, and narrowing pulse pressure b. Hypertension, tachycardia, and headache c. Widening pulse pressure, headache, and seizure d. Bradycardia, hypertension, and widening pulse pressure

ANS: Bradycardia, hypertension, and widening pulse pressure Bradycardia, increasing BP, and widening pulse pressure are all signs of increased ICP.

Before the initiation of anticholinergic medications, it is important for the nurse to screen patients for which condition? a. Hypertension b. Infectious diseases c. Diabetes d. Closed-angle glaucoma

ANS: Closed-angle glaucoma The inhibition of cholinergic activity (anticholinergic effects) causes pupil dilation, which increases intraocular pressure in patients with glaucoma. In patients with closed-angle glaucoma, anticholinergic medications can precipitate an acute attack. Anticholinergic agents may produce increased heart rate but not hypertension. Anticholinergic agents do not affect infections or diabetes.

What action should the nurse implement when a patient falls to the floor in a generalized seizure? a. Cradle the head to prevent injury. b. Insert an object between the teeth to prevent the patient from biting the tongue. c. Manually restrain the limbs. d. Keep the patient on his or her back to prevent aspiration.

ANS: Cradle the head to prevent injury Cradling the head and turning it to the side prevents injury and aspiration; restraint of limbs and insertion of an object into a patient's mouth often result in injury.

Patients taking phenytoin (Dilantin) for control of seizures must be aware of the risk for which adverse effect(s)? (Select all that apply.) a. Blood dyscrasias b. Hyperglycemia c. Urinary retention d. Gingival hyperplasia e. Insomnia f. Sedation

ANS: A, B, D, F Phenytoin may cause blood dyscrasias, gingival hyperplasia, and sedation and may elevate blood glucose levels, especially if higher doses are used. Urinary retention and insomnia are not adverse effects of phenytoin.

A nurse is evaluating the effectiveness of teaching for a patient with multiple sclerosis (MS). Which statement by the patient indicates that accurate patient learning has taken place? a. "Now that I am taking steroids, I will be able to work like I used to." b. "I'm making a list of things that are important and things I will simply have to let go." c. "I will make a plan to allow for long rest periods at least four times a day." d. "I am working on balancing time among rest, work, and family time."

ANS: "I am working on balancing time among rest, work, and family time."Balancing time between various activities indicates that the patient with MS understands the need to conserve energy, not just to give up things or attempt to perform at a preillness level.

The nurse is caring for a patient taking a cholinergic agent. When auscultating lung sounds, the nurse notes inspiratory and expiratory wheezing bilaterally. The best action for the nurse to take would be to: a. provide the next dose of the cholinergic agent immediately. b. assess heart rate and blood pressure. c. reposition the patient. d. withhold the next dose and notify the physician.

ANS: Withhold the next dose and notify the physician. Serious respiratory adverse effects of cholinergic agents include bronchospasm and wheezing. If these symptoms present, the next dose of the cholinergic agent should be withheld until the patient is evaluated by a healthcare provider.

When a patient taking a monoamine oxidase B inhibitor receives his dietary tray, the nurse knows to remove the: a. cheese. b. eggs. c. bread. d. coffee.

ANS: cheese Patients taking monoamine oxidase B inhibitors should avoid food and beverages with a high tyramine content, such as cheeses. Eggs, bread, and coffee do not have a high tyramine content.

Stress triggers the sympathetic system to ___. a. increase the secretion of epinephrine b. decrease the secretion of norepinephrine c. decrease heart rate d. dilate peripheral blood vessels

ANS: increase the secretion of epinephrine

How can the nurse help reduce ICP in caring for the patient after a craniotomy? a. Keeping the patient flat in bed b. Elevating the head of the bed 30 degrees c. Closely monitoring the IV rate d. Turning the patient to the right side

ANS: Elevating the head of the bed 30 degrees

The nurse is teaching a patient with Parkinson's disease about levodopa. Which statement by the nurse is accurate regarding drug administration? a. "Take this medication in between meals." b. "Take this medication at bedtime to prevent dizziness." c. "Take this medication when your tremors get worse." d. "Take this medication with food or antacids to reduce GI upset."

ANS: "Take this medication with food or antacids to reduce GI upset."Levodopa causes nausea, vomiting, and anorexia. Therefore, administration should be in divided doses with food or antacids to decrease gastrointestinal (GI) irritation. Levodopa should be taken with food. Levodopa must be taken on a regular schedule as prescribed to provide therapeutic results.

A patient with Parkinson's disease asks the nurse why anticholinergics are used in the treatment. Which response by the nurse is most accurate? a. "These drugs help you urinate." b. "These drugs will decrease your eye pressure." c. "These drugs inhibit the action of acetylcholine." d. "These drugs will assist in lowering your heart rate."

ANS: "These drugs inhibit the action of acetylcholine." Anticholinergic agents inhibit the action of acetylcholine in the parasympathetic nervoussystem. These drugs occupy receptor sites at the parasympathetic nerve endings, preventing the action of acetylcholine. Inhibition of acetylcholine facilitates stimulation of the dopaminergic receptors, which relieves the symptoms associated with Parkinson's disease. Anticholinergic agents cause urinary retention, increase intraocular pressure, and increase the heart rate.

A patient with a history of seizures had experienced a tonic-clonic seizure in the last half hour and is now very drowsy, but arousable. The family asks if this is a concern. What is the nurse's best response? A. "This is a normal occurrence after a seizure. It's called the 'postictal state.'" B. "This is the atonic stage of a seizure." C. "This is not a normal part of a seizure. I'll notify the physician." D. "The medication she was given to stop her seizure shouldn't make her this drowsy."

ANS: "This is a normal occurrence after a seizure. It's called the 'postictal state.'" After a tonic-clonic seizure, the person is exhausted and occasionally flaccid and may sleep for several hours. This is a predictable part of a seizure related to the time after the rapid firing of electrical activity in the brain. The victim usually has no recall of the event. The nurse must monitor the patient carefully for further seizure activity and position the patient to prevent possible aspiration.

What action should the nurse implement when a patient falls to the floor in a generalized seizure? a. Cradle the head to prevent injury. b. Insert an object between the teeth to prevent the patient from biting the tongue. c. Manually restrain the limbs. d. Keep the patient on his or her back to prevent aspiration.

ANS: Cradle the head to prevent injury. Cradling the head and turning it to the side prevents injury and aspiration; restraint of limbs and insertion of an object into a patient's mouth often result in injury.

A patient who has recently experienced a heart attack is prescribed a beta-adrenergic blocking agent. Which symptom os this therapy would be of concern to the nurse? A. Decrease in heart rate from 88/min to 46/min B. Decrease in blood pressure from 146 mm Hg systolic to 110 mm Hg systolic C. Decrease in temperature from 37.6º to 37.2º C D. Decrease in respirations from 26/min to 20/min

ANS: Decrease in heart rate from 88/min to 46/min Beta-adrenergic blocking agents are commonly used to decrease heart rate, blood pressure, and oxygen demand of the heart. A heart rate decrease from 88 to 46/min is a significant drop below what is expected and warrants a full assessment.

What is the therapeutic outcome of antiparkinson medication therapy? A. Cure the disease B. Prevent the symptoms of the disease C. Decrease the symptoms of the disease D. Stop the progression of the disease

ANS: Decrease the symptoms of the disease There is no known cure for Parkinson's disease. Medication therapy will decrease but not prevent the symptoms of the disease. High doses of drugs may increase the very symptoms that are being treated. The goal of treatment is to relieve symptoms and restore dopaminergic activity and neurotransmitter function as close to normal as possible.

An older adult patient is experiencing extreme stress related to an admission to the hospital. What should the nurse expect the patient to demonstrate? a. Decreased heart rate b. Decreased blood pressure (BP) c. Irregular respiration d. Dilation of the pupils

ANS: Dilation of the pupils Stress stimulates the fight-or-flight reaction with the release of epinephrine and norepinephrine, which causes increased heart rate and BP, reduced peristalsis, and pupil dilation.

Which describes the Babinski reflex? a. Downward curl of the toes b. Big toe bending upward c. Spreading out of the toes d. Pain in the big toe

ANS: Downward curl of the toes Normal cortical function causes the toes to curl downward. Abnormal findings would be the toes turning up and spreading.

What should the nurse implement before giving an enteral feeding to a patient? a. Palpate the abdomen to check for residual feeding. b. Warm the feeding. c. Elevate the head of the bed 30 degrees. d. Ask the patient to tip his head forward.

ANS: Elevate the head of the bed 30 degrees. The head of the bed should be elevated 30 degrees to prevent aspiration.

Hydantoins are a common anticonvulsant used to control partial and generalized tonic-clonic seizures. Which assessment finding in a patient receiving a hydantoin does the nurse report to the health provider? a. Gingival hyperplasia b. Drowsiness and fatigue c. Elevated blood glucose d. Drug blood levels within therapeutic range

ANS: Elevated blood glucose Hydantoins have an increased risk of common adverse effects such as drowsiness and gingival hyperplasia. The patient should be taught how to manage these symptoms. It is important for the patient on hydantoins to have blood levels of the drug drawn to determine if the current dosing is adequate. Serious adverse effects are hyperglycemia, blood dyscrasias, skin reactions, or elevated liver enzymes.

Which adverse effect of benzodiazepines is considered serious? A. Drowsiness B. Dizziness C. Blurred vision D. Elevated liver enzymes

ANS: Elevated liver enzymes Drowsiness, dizziness, and blurred vision are common adverse effects noted from benzodiazepines. The appearance of any liver dysfunction, blood dyscrasias, or marked behavioral disturbances is serious and should be reported to the health care provider immediately.

A nurse is caring for a patient with meningitis who has a positive Brudzinski sign. Which assessment led to this conclusion? a. Flexed hips when the neck is flexed by the nurse b. Inability to extend the flexed leg fully because of hamstring pain c. Resisting efforts of the nurse to flex his or her neck d. Flexing the big toe upward and fan out the other toes

ANS: Flexed hips when the neck is flexed by the nurse Inflamed meninges will stimulate hip flexion to reduce meningeal discomfort.

A nurse is careful about limb position in caring for an unconscious patient who sustained a head injury 10 days ago. What is the nurse trying to prevent? a. Flexion deformities b. Atrophy c. Paralysis d. Pathologic fracture

ANS: Flexion deformities An unconscious patient should be positioned in anatomic alignment to prevent flexion deformities. Passive range of motion and frequent position changes are essential to maintain the limbs in a functional position.

Which condition is associated with hydantoin therapy? a. Postictal state b. Atonia c. Seizure threshold reduction d. Gingival hyperplasia

ANS: Gingival hyperplasia Encouraging good oral hygiene practices is indicated when a patient is on hydantoin therapy because its use contributes to gingival hyperplasia. Postictal state is a characteristic of generalized tonic-clonic seizures. Atonia is not associated with hydantoin therapy. Hydantoin raises the seizure threshold.

The nurse is preparing discharge instructions for a patient with a history of diabetes who has just been diagnosed with seizure disorder. The patient has been prescribed hydantoin therapy.What will the patient most likely experiencing? a. Hunger b. Hyperglycemia c. Diarrhea d. Pupil dilation

ANS: Hyperglycemia Hydantoins may elevate blood sugar levels. Hunger, diarrhea, and pupil dilation are adverse effects of hydantoin therapy. Constipation and nystagmus are potential adverse effects.

What is the physiologic cause of tremors in patients with Parkinson's Disease? A. Increase in the amount of acetylcholine in the brain B. Increase in the amount of dopamine produced in the substantia nigra C. Overgrowth of the substantia nigra in the brain D. Lack of oxygen to the brainduring respiratory distress

ANS: Increase in the amount of acetylcholine in the brain The symptoms associated with parkinsonism are caused by a deterioration of the dopaminergic neurons in the substantia nigra, resulting in a depletion of dopamine in the autonomic ganglia, basal ganglia, and spinal cord causing progressive neurologic deficits. These areas of the brain are responsible for maintaining posture and muscle tone and regulating voluntary smooth muscle activity as well as other nonmotor activities.

Which nursing assessment would indicate a need for suctioning a patient with Guillain-Barré who is experiencing impaired breathing patterns because of neuromuscular failure? a. Decreased pulse rate and respiration of 20 breaths/min b. Increased pulse rate and adventitious breath sounds c. Increased pulse rate and respiration of 16 breaths/min d. Decreased pulse and abdominal breathing

ANS: Increased pulse rate and adventitious breath sounds Increased pulse rate, adventitious breath sounds, and abdominal breathing indicate an impaired breathing pattern.

Which assessment on a patient on mannitol therapy for cerebral edema indicates the medication is effective in decreasing ICP? a. Increased BP b. Increased urinary output c. Decreased pulse d. Widening pulse pressure

ANS: Increased urinary output Mannitol is a hyperosmolar diuretic that draws fluid from brain tissue into the bloodstream, which is then excreted by the kidneys. Decreasing pulse and widening pulse pressure indicate increased ICP.

A patient with a severe head injury begins to assume a posture of flexed upper extremities, with plantarflexed lower extremities. What do these assessments indicate? a. Increasing intracranial pressure (ICP) with decorticate posturing b. Decreasing ICP with decerebrate posturing c. Decreasing ICP with decorticate posturing d. Increasing ICP with decerebrate posturing

ANS: Increasing intracranial pressure (ICP) with decorticate posturing Increasing pressure on the tissue above the midbrain results in abnormal flexion (decorticate posturing).

Why is a patient with amyotrophic lateral sclerosis (ALS) uniquely prone to depression? a. Nutritional intake is poor. b. Intellectual capacity is not affected. c. Mobility is limited. d. Communication is altered.

ANS: Intellectual capacity is not affected. Because of their unimpaired intellect, patients with ALS are able to assess their deterioration, which increases their risk for depression. Altered mobility, nutrition, and communication are common to many disorders.

What is the most reliable indicator of neurologic status? a. Blood pressure b. Pulse rate c. Temperature d. Level of consciousness

ANS: Level of consciousness The ability to respond readily and correctly to person, place, and time is good evidence of intact sensorium.

What should a nurse instruct a patient after a lumbar puncture to prevent a headache? a. Lie flat. b. Lie on left side. c. Stay in semi-Fowler position. d. Ambulate in the room with assistance.

ANS: Lie flat Lying flat for a prescribed period will allow the loss of cerebrospinal fluid during the procedure to replenish.

Which condition would indicate to the nurse that a patient has phenytoin (Dilantin) toxicity? a. Oculogyric crisis b. Nystagmus c. Strabismus d. Amblyopia

ANS: Nystagmus Nystagmus (involuntary rhythmic, uncontrollable movements of one or both eyes) may be a sign of phenytoin toxicity. Oculogyric crisis is an adverse effect of some antipsychotic medications. Strabismus is a visual disorder in which the eyes are misaligned and point in different directions. Amblyopia is a loss of visual acuity in the nondominant eye caused by lack of use of the eye in early childhood.

A patient has been prescribed an anticholinergic drug for irritable bowel syndrome (IBS). For which adverse effect must the nurse teach the patient to be aware when beginning this drug?A. Rhinitis (runny nose) B. Drowsiness C. Diarrhea D. Orthostatic hypotension

ANS: Orthostatic hypotension The patient must be made aware of orthostatic hypotension with anticholinergic drug therapy, which may occur when getting up too quickly from a lying position. This may be accompanied by weakness and dizziness. The patient should be instructed to rise slowly and sit down if feeling faint.

A nurse encounters a patient having a seizure. Which action is correct? A. Placing the patient's arms in restraints B. Placing a padded towel under the patient's head C. Placing the patient in a sitting position D. Placing a padded tongue blade between the patient's teeth

ANS: Placing a padded towel under the patient's head Placing a padded towel under the patient's head protects the patient from injury. Placing restraints, sitting the patient up, or placing a tongue blade in the mouth would actually increase the risk for injury.

Which nursing intervention is best for patients with Parkinson's disease? A. Provide six small meals per day rather than three large ones B. Provide for all of the patient's basic needs like dressing, feeding and bathing C. Schedule all activities in the morning after breakfast and bathing D. Provide environmental stimulation with music, television and activities

ANS: Provide six small meals per day rather than three large ones The patient with Parkinson's disease often has difficulty chewing and swallowing because of muscle weakness and fatigue. Frequent small meals also allow the patient to have a more balanced diet. Swallowing techniques must be taught to prevent aspiration.

Stimulates flight or flight reaction with release of epinephrine and norepinephrine a. Increased HR b. Increased BP c. Reduced peristalsis d. Pupil dilation

ANS: Pupil dilation

Although the mechanism of seizure activity is not well-understood, what is the major action of anticonvulsants? A. Lowering the seizure threshold B. Increasing the effect of gamma-aminobutyric acid (GABA) C. Raising the seizure threshold D. Increasing the excitability of brain cell firing

ANS: Raising the seizure threshold Hydantoins have an increased risk of common adverse effects such as drowsiness and gingival hyperplasia. The patient should be taught how to manage these symptoms. It is important for the patient on hydantoins to have blood levels of the drug drawn to determine if the current dosing is adequate. Serious adverse effects are hyperglycemia, blood dyscrasias, skin reactions, or elevated liver enzymes.

Why are beta blockers used cautiously in patients with respiratory conditions? a. They mask the signs and symptoms of acute hypoglycemia. b. They cause extensive vasodilation and cardiac overload. c. They may produce severe bronchoconstriction. d. They increase hypertensive episodes.

ANS: They may produce severe bronchoconstriction. Nonselective beta blockers, such as Inderal, and larger doses of selective beta antagonists will readily affect the beta-2 receptors of the bronchi, causing bronchoconstriction. Therefore, beta blockers must be used with extreme caution in patients with respiratory conditions such as bronchitis, emphysema, asthma, or allergic rhinitis. Beta blockers affect blood glucose byinducing the hypoglycemic effects of insulin. Vasodilation relieves cardiac overload. Beta blockers induce hypotensive effects.

Which intervention should be added to the nursing care plan for supporting nutritional intake in a patient with Parkinson disease? a. Offer large meals with a variety of finger foods. b. Thicken liquids to make them easier to swallow. c. Puree all foods and drink through a straw. d. Offer a diet high in carbohydrates and fat and low in protein.

ANS: Thicken liquids to make them easier to swallow. Thickened feedings are easier to swallow. Several small, protein-rich meals are preferable to large ones. A pureed diet is unappealing.

Which medication is used to control seizures or prevent migraine headaches?a. Topiramate (Topamax)b. Zonisamide (Zonegran)c. Valproic acid (Depakene)d. Tiagabine (Gabitril)

ANS: Topiramate (Topamax)Topiramate has been approved for adults in the prevention (but not treatment) of migraine headaches. Zonisamide, valproic acid, and tiagabine do not affect migraine headaches.

Which cholinergic symptoms of Parkinson's disease are reduced with anticholinergic drugs? a. Cognitive impairments b. Rigidity c. Tremors and drooling d. Postural abnormalities

ANS: Tremors and droolingAnticholinergic drugs will reduce the severity of tremors and drooling in patients with Parkinson's disease. Anticholinergics are most useful when used in combination with levodopa. Anticholinergic drugs do not affect cognitive impairments. Anticholinergics havelittle effect on rigidity or on postural abnormalities.

For which condition may carbamazepine (Tegretol) be used? a. Tardive dyskinesia b. Psychotic episodes c. Trigeminal neuralgia pain d. Sedation

ANS: Trigeminal neuralgia pain Carbamazepine has been used successfully to treat pain associated with trigeminal neuralgia and for bipolar disorders when lithium therapy has not been optimal. Carbamazepine does not have antidepressant, antipsychotic, or sedative effects.

What is the drug of choice when treating a generalized tonic-clonic seizure? a. Diazepam (Valium) b. Haloperidol (Haldol) c. Valproic acid (Depakene) d. Risperidone (Risperdal)

ANS: Valproic acid (Depakene) Anticonvulsant therapy should start with the use of a single agent selected from a group of first-line agents based on the type of seizure. Valproic acid is indicated for generalized tonic-clonic seizures. Diazepam is not the drug of choice for treatment of tonic-clonic seizures. Haloperidol is an antipsychotic medication. Risperidone is an antipsychotic agent.