NCLEX-RN Pharmacology Neurological
System Part 1 Exam Questions with
Detailed Rationales |
20 Original NGN Practice MCQs |
Nursing Pharmacology Study Guide
Question 1
Clinical Scenario
A 68-year-old man with newly diagnosed Parkinson disease is
prescribed carbidopa/levodopa. His medical history includes
hypertension and osteoarthritis. During the first week of
therapy, he reports feeling dizzy when standing and notices that
his tremor has improved slightly. His blood pressure is 138/82
mm Hg while sitting and 108/68 mm Hg when standing. The
nurse reviews his medications and home safety measures.
Question Stem
Which nursing intervention is the priority to reduce this
patient's risk for injury?
,Options
A. Encourage the patient to increase protein intake with each
dose.
B. Teach the patient to rise slowly from sitting or lying positions.
C. Advise the patient to discontinue the medication if dizziness
occurs.
D. Recommend taking the medication only at bedtime.
Correct Answer
Correct Answer: B. Teach the patient to rise slowly from sitting
or lying positions.
Detailed Rationale
Carbidopa/levodopa remains the most effective medication for
improving motor symptoms of Parkinson disease by increasing
dopamine availability in the brain. Orthostatic hypotension is a
common adverse effect, particularly during treatment initiation
and dose adjustments. Teaching the patient to change positions
slowly, sit briefly before standing, and use assistance if needed
helps prevent falls and injuries while allowing continued
therapy. Home safety modifications such as removing loose rugs
and ensuring adequate lighting are also beneficial.
Option A is incorrect because high-protein meals may reduce
levodopa absorption due to competition with amino acids for
,transport across the intestinal wall and blood-brain barrier.
Protein intake should often be distributed evenly or separated
from medication if symptoms fluctuate.
Option C is incorrect because dizziness should be reported
rather than prompting abrupt discontinuation. Suddenly
stopping dopaminergic therapy may worsen Parkinson
symptoms or contribute to serious complications.
Option D is incorrect because limiting doses to bedtime would
not provide adequate daytime symptom control. Medication
timing should match symptom patterns while minimizing
adverse effects.
The nurse should reinforce hydration, monitor blood pressure,
assess gait stability, and educate the patient about reporting
persistent dizziness or falls.
Learning Objectives
After completing this question, the learner should be able to:
• Recognize orthostatic hypotension associated with
carbidopa/levodopa.
• Prioritize interventions that reduce fall risk.
• Teach patients safe position changes during dopaminergic
therapy.
Medication Safety Focus
, Patient education—Fall prevention during dopaminergic
therapy.
Question 2
Clinical Scenario
A 27-year-old woman with epilepsy has been taking phenytoin
for two years. During a routine dental visit, the dentist notes
enlarged, inflamed gums. The patient states she brushes
occasionally but rarely flosses. Laboratory studies show a
therapeutic phenytoin level, and she has remained seizure-free.
Question Stem
Which nursing teaching is most appropriate?
Options
A. Stop taking phenytoin until the gums return to normal.
B. Increase dietary calcium intake to reverse the gum changes.
C. Perform meticulous oral hygiene and schedule regular dental
examinations.
D. Take phenytoin only when seizure symptoms occur.
Correct Answer
Correct Answer: C. Perform meticulous oral hygiene and
schedule regular dental examinations.
System Part 1 Exam Questions with
Detailed Rationales |
20 Original NGN Practice MCQs |
Nursing Pharmacology Study Guide
Question 1
Clinical Scenario
A 68-year-old man with newly diagnosed Parkinson disease is
prescribed carbidopa/levodopa. His medical history includes
hypertension and osteoarthritis. During the first week of
therapy, he reports feeling dizzy when standing and notices that
his tremor has improved slightly. His blood pressure is 138/82
mm Hg while sitting and 108/68 mm Hg when standing. The
nurse reviews his medications and home safety measures.
Question Stem
Which nursing intervention is the priority to reduce this
patient's risk for injury?
,Options
A. Encourage the patient to increase protein intake with each
dose.
B. Teach the patient to rise slowly from sitting or lying positions.
C. Advise the patient to discontinue the medication if dizziness
occurs.
D. Recommend taking the medication only at bedtime.
Correct Answer
Correct Answer: B. Teach the patient to rise slowly from sitting
or lying positions.
Detailed Rationale
Carbidopa/levodopa remains the most effective medication for
improving motor symptoms of Parkinson disease by increasing
dopamine availability in the brain. Orthostatic hypotension is a
common adverse effect, particularly during treatment initiation
and dose adjustments. Teaching the patient to change positions
slowly, sit briefly before standing, and use assistance if needed
helps prevent falls and injuries while allowing continued
therapy. Home safety modifications such as removing loose rugs
and ensuring adequate lighting are also beneficial.
Option A is incorrect because high-protein meals may reduce
levodopa absorption due to competition with amino acids for
,transport across the intestinal wall and blood-brain barrier.
Protein intake should often be distributed evenly or separated
from medication if symptoms fluctuate.
Option C is incorrect because dizziness should be reported
rather than prompting abrupt discontinuation. Suddenly
stopping dopaminergic therapy may worsen Parkinson
symptoms or contribute to serious complications.
Option D is incorrect because limiting doses to bedtime would
not provide adequate daytime symptom control. Medication
timing should match symptom patterns while minimizing
adverse effects.
The nurse should reinforce hydration, monitor blood pressure,
assess gait stability, and educate the patient about reporting
persistent dizziness or falls.
Learning Objectives
After completing this question, the learner should be able to:
• Recognize orthostatic hypotension associated with
carbidopa/levodopa.
• Prioritize interventions that reduce fall risk.
• Teach patients safe position changes during dopaminergic
therapy.
Medication Safety Focus
, Patient education—Fall prevention during dopaminergic
therapy.
Question 2
Clinical Scenario
A 27-year-old woman with epilepsy has been taking phenytoin
for two years. During a routine dental visit, the dentist notes
enlarged, inflamed gums. The patient states she brushes
occasionally but rarely flosses. Laboratory studies show a
therapeutic phenytoin level, and she has remained seizure-free.
Question Stem
Which nursing teaching is most appropriate?
Options
A. Stop taking phenytoin until the gums return to normal.
B. Increase dietary calcium intake to reverse the gum changes.
C. Perform meticulous oral hygiene and schedule regular dental
examinations.
D. Take phenytoin only when seizure symptoms occur.
Correct Answer
Correct Answer: C. Perform meticulous oral hygiene and
schedule regular dental examinations.
