Parkinsons disease & Multiple sclerosis
A patient with Parkinson Disease is experiencing weight loss due to difficulty chewing and swallowing. Which meal option below is the best for this patient?* A. Scrambled eggs with a side of cottage cheese B. Grilled cheese with apple slices C. Baked chicken with bacon slices D. Tacos with refried beans
A
A patient with multiple sclerosis has issues with completely emptying the bladder. The physician orders the patient to take ___________, which will help with bladder emptying.* A. Bethanechol B. Oxybutynin C. Avonex D. Amantadine
A
A physician orders a patient to take Benztropine (Cogentin). The patient has never taken this medication before and is due to take the first dose at 1000. What statement by the patient requires you to hold the dose and notify the physician?* A. "I forgot to tell the doctor I take eye drops for my glaucoma." B. "I had a PET scan last week." C. "I take aspirin once day." D. "My hands are experiencing tremors at rest."
A
While providing discharge teaching to a patient prescribed Ropinirole (Requip), you make it priority to teach the patient about what side effect?* A. Drowsiness B. Dry mouth C. Coughing D. Dark sweat or saliva
A
You're caring for a patient with Parkinson's Disease that has tremors. Select the option that is INCORRECT about tremors experienced in this disease:* A. The tremors are most likely to occur with purposeful movements. B. A common term used to describe the tremors in the hands and fingers is called "pill-rolling". C. Tremors are one of the most common signs and symptoms in Parkinson's Disease. D. Tremors in this disease can occur in the hands, fingers, arms, legs and even the lips and tongue.
A
A patient is suspected of having multiple sclerosis. The neurologist orders various test. The patient's MRI results are back and show lesions on the cerebellum and optic nerve. What signs and symptoms below would correlate with this MRI finding in a patient with multiple sclerosis?* A. Blurry vision B. Pain when moving eyes C. Dysarthria D. Balance and coordination issues E. "Pill rolling" of fingers and hands G. Heat intolerance H. Dark spots in vision I. Ptosis
ABCDH
10. A spouse of a husband who has Parkinson's Disease explains to you that her husband experiences episodes while walking where he freezes and can't move. She asks what can be done to help with these types of episodes to prevent injury. Select all the options that are correct:* A. Have the husband try to change direction of movement by moving in the opposite direction when the freeze ups occur. B. Use a cane with a laser point while walking. C. Have the husband try to push through the freeze ups. D. Encourage the husband to consciously lift the legs while walking (as with marching).
ABD
Which finding below represents a positive Romberg Sign in a patient with multiple sclerosis?*A. The patient report dark spots in the visual fields during the confrontation visual field test.B. When the patient closes the eyes and stands with their feet together they start to lose their balance and sway back and forth.C. The patient's sign and symptoms increase when expose to hot temperatures.D. The patient reports an electric shock feeling when the head and neck are moved downward.
B
While assessing a patient with Parkinson's Disease, you note the patient's arms slightly jerk as you passively move them toward the patient's body. This is known as:* A. Lead Pipe Rigidity B. Cogwheel Rigidity C. Pronate Rigidity D. Flexor RigidityA patient with
B
You're performing a head-to-toe assessment on a patient with multiple sclerosis. When you ask the patient to move the head and neck downward the patient reports an "electric shock" sensation that travels down the body. You would report your finding to the doctor that the patient is experiencing:*A. Romberg's SignB. Lhermitte's SignC. Uhthoff's SignD. Homan's Sign
B
Select all the TRUE statements about the pathophysiology of multiple sclerosis:* A. "The dendrites on the neuron are overstimulated leading to the destruction of the axon." B. "The myelin sheath, which is made up of Schwann cells, is damaged along the axon." C. "This disease affects the insulating structure found on the neuron in the central nervous system." D. "The dopaminergic neurons in the part of the brain called substantia nigra have started to die."
BC
You're providing free education to a local community group about the signs and symptoms of Parkinson's Disease. Select all the signs and symptoms a patient could experience with this disease:* A. Increased Salivation B. Loss of smell C. Constipation D. Tremors with purposeful movement E. Shuffling of gait F. Freezing of extremities G. Euphoria H. Coordination issues
BCEFH
During your discharge teaching to a patient with multiple sclerosis, you educate the patient on how to avoid increasing symptoms and relapses. You tell the patient to avoid:* A. Cold temperatures B. Infection C. Overexertion D. Salt F. Stress
BCF
You're developing a plan of care for a patient with multiple sclerosis who presents with Uhthoff's Sign. What interventions will you include in the patient's plan of care? Select all that apply:* A. Avoid movements of the head and neck downward B. Keep room temperature cool C. Encourage patient to use warm packs and heating pads for symptoms D. Educate the patient on three ways to avoid overheating during exercise
BD
You're providing diet education to a patient with Parkinson's Disease. Which statement below demonstrates the patient understood your teaching? Select all that apply:* A. "I will limit foods high in fiber like fruits and vegetables in my diet." B. "I will be sure to drink 2 Liter of fluid per day." C. "It is very common for me to experience diarrhea with this disease." D. "I will avoid taking Carbidopa/Levodopa with a protein rich meal."
BD
A patient is taking Rasagiline "Azilect" for treatment of Parkinson's Disease. What foods do the patient want to limit in their diet? Select all that apply:* A. Liver B. Aged Cheese C. Sweetbread D. Beer E. Fermented foods F. Shellfish
BDE
12. You're patient with Parkinson's Disease has been taking Carbidopa/Levodopa for several years. The patient reports that his signs and symptoms actually become worse before the next dose of medication is due. As the nurse, you know what medication can be prescribed with this medication to help decrease this for happening?* A. Anticholinergic (Benztropine) B. Dopamine agonists (Ropinirole) C. COMT Inhibitor (Entacapone) D: Beta blockers (Metoprolol)
C
A patient is prescribed to take Carbidopa/Levodopa (Sinemet). As the nurse you know that which statement is incorrect about this medication:* A. It can take up to 3 weeks for the patient to notice a decrease in signs and symptoms when beginning treatment with this medication. B. Body fluids can turn a dark color and stain clothes. C. This medication is most commonly prescribed with a vitamin B6 supplement. D. Carbidopa helps to prevent Levodopa from being broken down in the blood before it enters the brain. Hence, levodopa is able to enter the brain.
C
A patient is receiving Interferon Beta for treatment of multiple sclerosis. As the nurse you will stress the importance of?* A. Physical exercise to improve fatigue B. Low fat diet C. Hand hygiene and avoiding infection D. Reporting ideation of suicide
C
A patient with Parkinson's Disease has slow movements that affects their swallowing, facial expressions, and ability to coordinate movements. As the nurse you will document the patient has:* A. Akinesia B. "Freeze up" tremors C. Bradykinesia D. Pill-rolling
C
As the nurse you know that Parkinson's Disease tends to affect the _____________ of the midbrain, which leads to the depletion of the neurotransmitter ________________.* A. red nucleus, acetylcholine B. leminisci, norepinephrine C. substantia nigra, dopamine D. tectum nigra, dopamine
C
Which medications below can help treat muscle spasms in a patient with multiple sclerosis? Select all that apply:* A. Propranolol B. Isoniazid C. Baclofen D. Diazepam E. Modafinil
CD
As the home health nurse you are helping a patient with Parkinson's Disease get dressed. What item gathered by the patient to wear should NOT be worn?* A. Velcro pants B. Pull over sweatshirt C. Non-slip socks D. Rubber sole shoes
D
True or False: Parkinson's Disease most commonly affects patients in young adulthood, and there is currently no cure for the disease.*
False
Your patient is scheduled for a lumbar puncture to help diagnose multiple sclerosis. The patient wants clarification about what will be found in the cerebrospinal fluid during the lumbar puncture to confirm the diagnosis of MS. You explain that ____________ will be present in the fluid if MS is present.* A. high amounts of IgM B. oligoclonal bands C. low amounts of WBC D. oblong red blood cells and glucose
b
True or False: Multiple Sclerosis tends to affect men more than women and occurs during the ages of 50-70 years.*
false
True or False: Patients with multiple sclerosis have different signs and symptoms because this disease can affect various areas of the peripheral nervous system.*
false