NUR 202 EXAM 3 QUESTIONS AND ACCURATE ANSWERS | COMPREHENSIVE STUDY GUIDE,
NCLEX-STYLE PRACTICE REVIEW 2026/2027
Parkinson's Disease - ANS ✔✔A slow progressive neurological movement disorder; *idiopathic
is the most common form*; characterized by *decreased levels of dopamine* and increased
excitatory neurotransmitters leading to an imbalance that *affects voluntary movement*
*The majority of damage is done prior to symptoms*
Cardinal Symptoms of Parkinson's Disease - ANS ✔✔- Tremor
- Rigidity
- Bradykinesia
- Postural Instability
Clinical Manifestations of Parkinson's Disease - ANS ✔✔- *Slow, unilateral resting tremor*
present at DX, disappears with purposeful movement (pill-rolling so slow rhythmic movement of
head)
- Rigidity (shoulder pain)
- Autonomic sis (constipation, urinary retention)
- Psychiatric changes (AH/VH, dementia in 70%)
- Dysphagia
- Vision changes
- Shuffled, short-stepped gait
Diagnosis of Parkinson's Disease - ANS ✔✔Based on history and *presence of 2 of the 4 cardinal
symptoms*
Patient will likely be unable to recall when symptoms started
,Diagnosis confirmed with a positive levodopa trial
Medical Management of Parkinson's Disease - ANS ✔✔*No treatment prevents the progression
of the disease* goal is to control symptoms and maintain functional independence
- *Pharmacological:* anti-viral & anti-parkinsonian medications
- *Deep Brain Stimulation:* to block anti choline rigid release
- *Surgical Management:* temporary fix for severe tremor/rigidity or levodopa-induced
dyskinesia
Parkinson's Disease: Nursing Interventions - ANS ✔✔- Regular exercise
- Walking programs
- Postural exercise
- Warm baths
- Enhance self-care
- Improve bowel elimination (decreased use of laxatives, bowel schedule)
- Daily weights
- Nutritional/meal supplements (Ensure)
- Monitor Albumin level
- Encourage use of assistive devices for feeding, walking, toileting
- Speech therapy
- Support coping abilities (r/t depression/withdrawal)
- Involve home & community based supports
- Promote independence
,Multiple Sclerosis - ANS ✔✔A progressive immune-related *demyelination* disease of the CNS
characterized by relapsing and remitting cycles of symptoms; new symptoms often exacerbate
old sxs
Cause remains unknown
Clinical Manifestations of MS: Relapsing Course - ANS ✔✔AKA Remitting Course
*85%*
- Recovery is usually complete
- Residual deficits may occur and accumulate
Clinical Manifestations of MS: Primary Progressive Course - ANS ✔✔*15%*
- Disabling symptoms steadily increase with rate plateaus
- May result in quadra paresis, cognitive dysfunction, visual loss, & brain stem syndromes
Clinical Manifestations of MS: Progressive Relapsing Course - ANS ✔✔*5%*
- Continuous disabling progression between exacerbations
Gerontologic Considerations r/t MS - ANS ✔✔- Shorter life expectancy by 5-7 years
- Alterations in medication absorption, distribution, metabolism & excretion
- Adverse & toxic effects of medications
- Osteoporosis
- Decreased mobility
, Medical Management of MS - ANS ✔✔*No cure of MS*
Goal of treatment:
- Delay progression of the disease
- Manage chronic symptoms
- Treat acute exacerbation
Pharmacologic Therapy for MS - ANS ✔✔- Interferon β-1a and interferon β-1b
- Glatiramer acetate (Copaxone) SC
- Mitoxantrone (Novantrone) IV
- Natalizumab IV
- Methylprednisolone IV
- *Baclofen* (most common/med of choice for spasticity)
Nursing Diagnoses r/t MS - ANS ✔✔- Impaired physical mobility
- Risk for injury
- Impaired bowel & bladder function
- Impaired verbal communication
- Disturbed thought process
- Ineffective coping
- Impaired home maintenance
- Potential sexual dysfunction
Guillian-Barre Syndrome (GBS) - ANS ✔✔Autoimmune d/o with acute attack of peripheral nerve
myelin.
NCLEX-STYLE PRACTICE REVIEW 2026/2027
Parkinson's Disease - ANS ✔✔A slow progressive neurological movement disorder; *idiopathic
is the most common form*; characterized by *decreased levels of dopamine* and increased
excitatory neurotransmitters leading to an imbalance that *affects voluntary movement*
*The majority of damage is done prior to symptoms*
Cardinal Symptoms of Parkinson's Disease - ANS ✔✔- Tremor
- Rigidity
- Bradykinesia
- Postural Instability
Clinical Manifestations of Parkinson's Disease - ANS ✔✔- *Slow, unilateral resting tremor*
present at DX, disappears with purposeful movement (pill-rolling so slow rhythmic movement of
head)
- Rigidity (shoulder pain)
- Autonomic sis (constipation, urinary retention)
- Psychiatric changes (AH/VH, dementia in 70%)
- Dysphagia
- Vision changes
- Shuffled, short-stepped gait
Diagnosis of Parkinson's Disease - ANS ✔✔Based on history and *presence of 2 of the 4 cardinal
symptoms*
Patient will likely be unable to recall when symptoms started
,Diagnosis confirmed with a positive levodopa trial
Medical Management of Parkinson's Disease - ANS ✔✔*No treatment prevents the progression
of the disease* goal is to control symptoms and maintain functional independence
- *Pharmacological:* anti-viral & anti-parkinsonian medications
- *Deep Brain Stimulation:* to block anti choline rigid release
- *Surgical Management:* temporary fix for severe tremor/rigidity or levodopa-induced
dyskinesia
Parkinson's Disease: Nursing Interventions - ANS ✔✔- Regular exercise
- Walking programs
- Postural exercise
- Warm baths
- Enhance self-care
- Improve bowel elimination (decreased use of laxatives, bowel schedule)
- Daily weights
- Nutritional/meal supplements (Ensure)
- Monitor Albumin level
- Encourage use of assistive devices for feeding, walking, toileting
- Speech therapy
- Support coping abilities (r/t depression/withdrawal)
- Involve home & community based supports
- Promote independence
,Multiple Sclerosis - ANS ✔✔A progressive immune-related *demyelination* disease of the CNS
characterized by relapsing and remitting cycles of symptoms; new symptoms often exacerbate
old sxs
Cause remains unknown
Clinical Manifestations of MS: Relapsing Course - ANS ✔✔AKA Remitting Course
*85%*
- Recovery is usually complete
- Residual deficits may occur and accumulate
Clinical Manifestations of MS: Primary Progressive Course - ANS ✔✔*15%*
- Disabling symptoms steadily increase with rate plateaus
- May result in quadra paresis, cognitive dysfunction, visual loss, & brain stem syndromes
Clinical Manifestations of MS: Progressive Relapsing Course - ANS ✔✔*5%*
- Continuous disabling progression between exacerbations
Gerontologic Considerations r/t MS - ANS ✔✔- Shorter life expectancy by 5-7 years
- Alterations in medication absorption, distribution, metabolism & excretion
- Adverse & toxic effects of medications
- Osteoporosis
- Decreased mobility
, Medical Management of MS - ANS ✔✔*No cure of MS*
Goal of treatment:
- Delay progression of the disease
- Manage chronic symptoms
- Treat acute exacerbation
Pharmacologic Therapy for MS - ANS ✔✔- Interferon β-1a and interferon β-1b
- Glatiramer acetate (Copaxone) SC
- Mitoxantrone (Novantrone) IV
- Natalizumab IV
- Methylprednisolone IV
- *Baclofen* (most common/med of choice for spasticity)
Nursing Diagnoses r/t MS - ANS ✔✔- Impaired physical mobility
- Risk for injury
- Impaired bowel & bladder function
- Impaired verbal communication
- Disturbed thought process
- Ineffective coping
- Impaired home maintenance
- Potential sexual dysfunction
Guillian-Barre Syndrome (GBS) - ANS ✔✔Autoimmune d/o with acute attack of peripheral nerve
myelin.
