PrepU: Parkinsons

A patient with Parkinson's disease is experiencing an on-off syndrome. What does the nurse recognize that the patient's clinical symptoms will be? a. The patient will have a period when medication with levodopa will be unnecessary. b. The patient will have periods of near immobility, followed by a sudden return of effectiveness of the medication. c. The patient will have a slow, shuffling gait and then will be able to move at a faster pace. d. The patient will have unilateral resting tremors and then will have a period of no tremors present.

b. The patient will have periods of near immobility, followed by a sudden return of effectiveness of the medication.

A new ancillary staff member is assisting the nurse with a client diagnosed with Parkinson's disease. The client needs assistance with eating but doesn't require thickened liquids to aid swallowing. Which instruction should the nurse give the ancillary staff member about eating assistance? a. Clients with Parkinson's disease shouldn't have liquids; remove them from the dinner tray before serving food to the client. b. There are no special precautions for the client with Parkinson's disease. c. Make sure the client is sitting with the head of bed elevated to 90 degrees. d. Assist the client into a comfortable position and stay alert for coughing, which signifies aspiration.

c. Make sure the client is sitting with the head of bed elevated to 90 degrees.

A client has just been diagnosed with Parkinson's disease. The nurse is teaching the client and family about dietary issues related to this diagnosis. Which of the following are risks for this client? Select all that apply. a. Choking b. Dysphagia c. Fluid overload d. Constipation e. Anorexia

a. Choking b. Dysphagia d. Constipation

Nursing students are reviewing information about Parkinson's disease in preparation for class the next day. The students demonstrate understanding of the material when they identify which of the following as a cardinal sign of this disorder? Select all that apply. a. Postural instability b. Intellectual decline c. Tremor d. Bradykinesia e. Rigidity

a. Postural instability c. Tremor d. Bradykinesia e. Rigidity

Indications for use of anticholinergic drugs in the treatment for Parkinsonism include to: a. Decrease salivation, spasticity, and tremors. b. Decrease headaches. c. Decrease motor movement. d. Improve blurred vision.

a. Decrease salivation, spasticity, and tremors.

A female client is prescribed centrally acting anticholinergics for her Parkinson's disease. Six weeks later, her daughter asks the health care provider to hospitalize the client for a psychiatric evaluation. The nurse anticipates that the provider will respond in what way to the daughter's request? a. Evaluate the client for adverse reactions from the centrally acting anticholinergics b. Immediately discontinue the centrally acting anticholinergic medication c. Increase the centrally active anticholinergics to decrease the client's symptoms d. Admit the client to the hospital for a psychological evaluation

a. Evaluate the client for adverse reactions from the centrally acting anticholinergics

A male client's physician orders levodopa for the treatment of the client's Parkinson's disease. The client asks the nurse whether the levodopa will cure his condition. Which is a correct statement about the effects of levodopa? a. It does not alter the underlying disease process, but it may improve a client's quality of life. b. It will control the symptoms for 10 to 12 years. c. It is the treatment of last resort and may control his symptoms. d. It will cure the Parkinson's disease.

a. It does not alter the underlying disease process, but it may improve a client's quality of life.

A client who diagnosed with Parkinson's disease is being treated with levodopa/carbidopa. Which disorder will result in the discontinuation of this drug based on a disease-related contraindication? a. Narrow-angle glaucoma b. Transient ischemic attacks (TIA) c. Human papillomavirus d. Human immune deficiency virus

a. Narrow-angle glaucoma

The three major features of Parkinson's include: a. Rigidity, bradykinesia, and tremors. b. Urinary retention, stooped posture, and constipation. c. Slow gait, worsening eyesight, and slowed thought process. d. Sasked facies, bradycardia, and hypertension.

a. Rigidity, bradykinesia, and tremors.

A client taking carbidopa-levodopa for the treatment of Parkinson's disease reports blurred vision and the nurse observes that the client has worsening ataxia. Which nursing diagnosis should the nurse prioritize? a. Risk for injury b. Ineffective role performance c. Impaired verbal communication d. Disturbed body image

a. Risk for injury

A client with Parkinson's disease began treatment with dopaminergics two weeks ago and has now presented for a follow-up assessment. What finding best suggests to the nurse that the treatment is having a therapeutic effect? a. The client is able to walk more briskly and stably than two weeks ago b. The client is oriented to person, place and time c. The client denies shortness of breath and adventitious lung sounds are absent on auscultation d. The client describes an increase in appetite compared with two weeks ago

a. The client is able to walk more briskly and stably than two weeks ago

A client with Parkinson's disease asks the nurse what their treatment is supposed to do since the disease is progressive. What would be the nurse's best response? a. "Treatment really doesn't matter; the disease is going to progress anyway." b. "Treatment aims at keeping you independent as long as possible." c. "Treatment aims at keeping you emotionally healthy by making you think you are doing something to fight this disease." d. "Treatment for Parkinson's is only palliative; it keeps you comfortable."

b. "Treatment aims at keeping you independent as long as possible."

A nurse is assessing a client with Parkinson's disease. The nurse determines that the client's drug therapy is effective when the client exhibits what? a. Improved short term memory b. Decreased tremors c. Improved level of intellectual functioning d. Decreased aggression

b. Decrease tremors

The home care nurse is caring for an 80-year-old patient who is receiving carbidopa-levodopa, a dopaminergic drug used to treat Parkinson's disease. The nurse knows that this drug may place the patient at increased risk for: a. Excessive sedation. b. Falls. c. Infection. d. Uncontrolled bleeding.

b. Falls

A nurse is educating a client who has Parkinson's disease and family regarding possible adverse effects of carbidopa-levodopa. The nurse emphasizes which should be a closely monitored effect? a. Appetite or thirst. b. Involuntary movements. c. Mobility. d. Perspiration.

b. Involuntary movements.

A 55-year-old female client presents at the walk-in clinic complaining of feeling like a mask is on her face. While doing the initial assessment, the nurse notes the demonstration of a pill-rolling movement in the right hand and a stooped posture. Physical examination shows bradykinesia and a shuffling gait. What would the nurse suspect is the causative factor for these symptoms? a. Myasthenia gravis b. Parkinson's disease c. Multiple sclerosis d. Huntington's disease

b. Parkinson's disease

A female client has been prescribed ropinirole (Requip). She states, "I don't know why they are giving me this medicine. I don't have restless leg syndrome." What is the nurse's best response in teaching this client with newly diagnosed Parkinson's disease about ropinirole (Requip)? a. "Ropinirole is used for restless leg syndrome and migraines, not parkinsonism." b. "Your health care provider must have written the prescription wrong. I will call her." c. "You are right about ropinirole, but it is also used in early Parkinson's disease." d. "You are mistaken; ropinirole is not used for restless leg syndrome."

c. "You are right about ropinirole, but it is also used in early Parkinson's disease."

A nurse is providing care to a client with Parkinson's disease. The nurse understands the client's signs and symptoms are related to a depletion of which of the following? a. Serotonin b. Norepinephrine c. Dopamine d. Acetylcholine

c. Dopamine

The most effective drug to treat major symptoms associated with Parkinson's is: a. Apomorphine. b. Amantadine. c. Levodopa. d. MAO inhibitors.

c. Levodopa

Which topic is most important for the nurse to include in the teaching plan for a client newly diagnosed with Parkinson's disease? a. Enhancement of the immune system b. Establishing balanced nutrition c. Maintaining a safe environment d. Involvement with diversion activities

c. Maintaining a safe environment

The nurse teaches the client with which disorder that the disease is due to decreased levels of dopamine in the basal ganglia of the brain? a. Multiple sclerosis b. Huntington disease c. Parkinson disease d. Creutzfeldt-Jakob disease

c. Parkinson disease

A nurse is caring for a patient who has received carbidopa/levodopa. After administration of the first dose of the drug, the patient has developed gastrointestinal disturbances. Which nursing intervention should the nurse perform when caring for this patient? a. Administer the next drug dose with milk. b. Withhold the next dose of the drug. c. Observe alterations in blood pressure. d. Administer the next drug dose with meals.

d. Administer the next drug dose with meals.

A nurse is caring for 70-year-old patient who is undergoing anticholinergic drug therapy. The nurse should assess for which condition when caring for this elderly patient? a. Suicidal tendencies b. Choreiform movements c. Psychotic episodes d. Confusion and disorientation

d. Confusion and disorientation

A client is admitted to the hospital with pneumonia. He has a history of Parkinson disease, which his family says is worsening. Which assessment should the nurse expect? a. Tremors in the fingers that increase with purposeful movement b. Pleasant and smiling demeanor c. Muscle flaccidity d. Impaired speech

d. Impaired speech

A 60-year-old client has developed a tremor of the right hand with a pill-rolling motion. Upon interviewing, the client states having sustained several head injuries. This information supports which possible diagnosis? a. Degenerative joint disease b. Amyotrophic lateral sclerosis c. Seizure disorder d. Parkinson's disease

d. Parkinson's disease

The nurse is providing client education to a client newly diagnosed with Parkinson disease. The nurse most accurately describes the disease progression as: a. Parkinson's disease, while chronic, will likely improve over time. b. Parkinson's has no known effective treatment. c. Parkinson's is an acute disorder that can be surgically corrected. d. Parkinson's is a chronic condition and treatment aims to manage symptoms.

d. Parkinson's is a chronic condition and treatment aims to manage symptoms.

A client diagnosed with Parkinson's disease has been prescribed rasagiline. When educating this client on this medication, which herbal supplement should be identified as having the potential to produce hyperpyrexia and death? a. Dextromethorphan b. Ginger c. Garlic d. St. John's wort

d. St. John's wort

A nurse is assessing a client with Parkinson's disease. Which of the following would the nurse expect to find? a. Slowing of activity b. Continuous tremors c. Gait with the body leaning backward d. Muscle flaccidity

a. Slowing of activity

A patient with Parkinson's disease asks the nurse what can be done to prevent problems with bowel elimination. What would be an intervention that would assist this patient with a regular stool pattern? a. Adopt a high-fiber diet. b. Take psyllium (Metamucil) daily. c. Adopt a diet with moderate fiber intake. d. Take a laxative whenever bloating is experienced.

c. Adopt a diet with moderate fiber intake.

A nurse has been invited to speak to a support group for Parkinson's disease clients and families. Which statement addresses the chronic nature of the disease and the relevant drug therapies? a. "Drugs do not cure these disorders; they instead enhance quality of life." b. "Drugs used to treat these disorders always pose a risk of severe liver and kidney dysfunction." c. "Drug therapy can consist of one or more drugs to eliminate the symptoms of these diseases." d. "Persons of all cultures are treated similarly and respond in similar ways to treatment."

a. "Drugs do not cure these disorders; they instead enhance quality of life."

Which anticholinergic agent is used to control tremor and rigidity in Parkinson disease? a. Benztropine Mesylate b. Amantadine c. Bromocriptine mesylate d. Levodopa

a. Benztropine Mesylate

After teaching an in-service program about nervous system conditions, the nurse determines that the teaching was successful when the group identifies which condition or disease as a group of symptoms involving motor movement characterized by tremors, rigidity, and bradykinesia? a. Parkinsonism b. Anxiety c. Seizure disorder d. Myasthenia gravis

a. Parkinsonism

The home health nurse is caring for a client with Parkinson's disease. The nurse understands that the purpose of adding selegiline with carbidopa-levodopa to the medication regime should result in which purpose? a. Slows the progression of the disease b. Prevents side effects from carbidopa-levodopa c. Relieves symptoms of dyskinesia d. Replaces dopamine

a. Slows the progression of the disease (Not true, you can't slow the progression of the disease)

A 52-year-old male client is being treated for Parkinson's disease. The nurse is aware that Parkinson's disease results in several physical manifestations. What occurs in the neurons that causes these symptoms? a. There is an imbalance between dopamine and acetylcholine. b. There is an increased level of GABA at the striatum. c. There is a decrease in stimulation of the nigrostriatal neural tracts. d. There is an increase in dopamine in the terminal nerve endings.

a. There is an imbalance between dopamine and acetylcholine.

A home care nurse makes a visit to a client with Parkinson's disease who is being cared for by his spouse. During the visit, the spouse says, "I'm just so tired. I have to do just about everything for him." Which response by the nurse would be most appropriate? a. "Are you upset about how your husband is doing?" b. "It must be difficult for you to see your husband like this." c. "You sound a bit overwhelmed. Tell me more about what's happening." d. "You're doing a great job. Just keep it up."

c. "You sound a bit overwhelmed. Tell me more about what's happening."

Common side effects of anticholinergics include: a. Blurred vision, decreased liver enzymes, increased B/P, and papillary constriction. b. Decreased GI absorption, nausea, heartburn, and hypotension. c. Dry mouth, urinary retention, constipation, and increased pulse rate. d. Skin rashes, decreased urinary output, constipation, and increased WBCs.

c. Dry mouth, urinary retention, constipation, and increased pulse rate.

A client with Parkinson's disease has been receiving levodopa as treatment for the past 7 years. The client comes to the facility for an evaluation and the nurse observes facial grimacing, head bobbing, and smacking movements. The nurse interprets these findings as which of the following? a. Dysphonia b. Micrographia c. Dyskinesia d. Bradykinesia

c. Dyskinesia

The nurse is performing an assessment for a patient in the clinic with Parkinson's disease. The nurse determines that the patient's voice has changed since the last visit and is now more difficult to understand. How should the nurse document this finding? a. Hypokinesia b. Dysphagia c. Dysphonia d. Micrographia

c. Dysphonia

The nurse identifies a nursing diagnosis of imbalanced nutrition, less than body requirements related to difficulty in chewing and swallowing for a client with Parkinson's disease. Which of the following would be most appropriate for the nurse to integrate into the client's plan of care? a. Arrange for specialized utensils for the client to use when eating. b. Encourage the use of liquids that are thin in consistency. c. Encourage the client to massage the facial and neck muscles before eating. d. Raise the head of the client's bed about 30 degrees during meals.

c. Encourage the client to massage the facial and neck muscles before eating.

Bradykinesia occurring in Parkinson disease places the Parkinson's client most at risk for: a. Weight loss b. Incontinence c. Falls and injury d. Emotional dysfunction

c. Falls and injury

Which nursing diagnosis takes the highest priority for a client with parkinsonian crisis? a. Risk for injury b. Imbalanced nutrition: Less than body requirements c. Ineffective airway clearance d. Impaired urinary elimination

c. Ineffective airway clearance

A client diagnosed with Parkinson disease is displaying the following manifestations: tremor, rigidity, and slowness of movement. The nurse would interpret these as: a. Signs of clinical improvement b. Signs of clinical deterioration c. Manifestations of another disease process d. Normal manifestations of Parkinson disease

d. Normal manifestations of Parkinson disease

A client with Parkinson's disease is prescribed amantadine hydrochloride 100 mg twice a day. The pharmacy supplies amantadine syrup, because the client has a history of difficulty swallowing tablets. The label reads 50 mg/5 mL. How many milliliters would the nurse administer to the client for each dose? Enter the correct number ONLY.

10

A client is receiving levodopa as treatment for Parkinson disease. The nurse would instruct the client to avoid foods high in which vitamin to prevent a reduction in the effect of levodopa? a. Cyanocobalamin (vitamin B12) b. Phylloquinone (vitamin K1) c. Ascorbic acid (vitamin C) d. Pyridoxine (vitamin B6)

d. Pyridoxine (vitamin B6)