NCLEX-RN Pharmacology Neurological
System Part 1 Exam Questions &
Answers
20 Original NGN Practice MCQs with
Rationales
ATI Pharmacology Review
Nursing School 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 discharge teaching, he
tells the nurse, "I usually take all my medications with a protein
shake every morning." His blood pressure is 128/76 mm Hg,
heart rate is 72/min, and he ambulates independently with a
mild resting tremor.
Question Stem
,Which instruction should the nurse provide to maximize the
therapeutic effectiveness of carbidopa/levodopa?
A. Take the medication with a high-protein meal to improve
absorption.
B. Stop taking the medication if involuntary movements
develop.
C. Avoid taking the medication with large amounts of dietary
protein because protein may reduce drug absorption.
D. Double the next dose if symptoms return before the next
scheduled dose.
Correct Answer
C. Avoid taking the medication with large amounts of dietary
protein because protein may reduce drug absorption.
Detailed Rationale
Carbidopa/levodopa is the cornerstone therapy for Parkinson
disease. Levodopa crosses the blood-brain barrier and is
converted to dopamine, while carbidopa inhibits peripheral
metabolism, increasing levodopa availability and reducing
nausea. Dietary protein competes with levodopa for transport
across the intestinal wall and blood-brain barrier, potentially
reducing medication effectiveness. Patients should be taught to
distribute protein intake evenly throughout the day or avoid
,taking the medication with protein-heavy meals if symptom
control becomes inconsistent.
Option A is incorrect because high-protein meals decrease
rather than improve levodopa absorption. Option B is incorrect
because involuntary movements (dyskinesias) may indicate
excessive dopaminergic stimulation and should be reported to
the provider for dose adjustment rather than abrupt
discontinuation. Option D is unsafe because doubling doses
increases the risk of hypotension, hallucinations, dyskinesias,
and other adverse effects. Nurses should also teach patients to
change positions slowly due to orthostatic hypotension,
monitor for hallucinations in older adults, and emphasize that
symptom improvement may take days to weeks.
Learning Objectives
After completing this question, the learner should be able to:
• Explain how dietary protein affects levodopa absorption.
• Provide patient teaching for safe administration of
carbidopa/levodopa.
• Recognize common adverse effects requiring provider
notification.
Medication Safety Focus: Patient education
, Question 2
Clinical Scenario
A 74-year-old woman with Parkinson disease has been taking
carbidopa/levodopa for three years. During assessment, the
nurse notes repetitive twisting movements of her arms and face
while she is awake. The client reports that her tremor has
improved but these movements are becoming bothersome.
Vital signs are stable.
Question Stem
Which nursing interpretation is most appropriate?
A. The client is experiencing dyskinesias associated with
dopaminergic therapy.
B. The client is developing an acute stroke.
C. The medication is no longer effective and should be
discontinued immediately.
D. The client is experiencing an allergic reaction.
Correct Answer
A. The client is experiencing dyskinesias associated with
dopaminergic therapy.
Detailed Rationale
System Part 1 Exam Questions &
Answers
20 Original NGN Practice MCQs with
Rationales
ATI Pharmacology Review
Nursing School 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 discharge teaching, he
tells the nurse, "I usually take all my medications with a protein
shake every morning." His blood pressure is 128/76 mm Hg,
heart rate is 72/min, and he ambulates independently with a
mild resting tremor.
Question Stem
,Which instruction should the nurse provide to maximize the
therapeutic effectiveness of carbidopa/levodopa?
A. Take the medication with a high-protein meal to improve
absorption.
B. Stop taking the medication if involuntary movements
develop.
C. Avoid taking the medication with large amounts of dietary
protein because protein may reduce drug absorption.
D. Double the next dose if symptoms return before the next
scheduled dose.
Correct Answer
C. Avoid taking the medication with large amounts of dietary
protein because protein may reduce drug absorption.
Detailed Rationale
Carbidopa/levodopa is the cornerstone therapy for Parkinson
disease. Levodopa crosses the blood-brain barrier and is
converted to dopamine, while carbidopa inhibits peripheral
metabolism, increasing levodopa availability and reducing
nausea. Dietary protein competes with levodopa for transport
across the intestinal wall and blood-brain barrier, potentially
reducing medication effectiveness. Patients should be taught to
distribute protein intake evenly throughout the day or avoid
,taking the medication with protein-heavy meals if symptom
control becomes inconsistent.
Option A is incorrect because high-protein meals decrease
rather than improve levodopa absorption. Option B is incorrect
because involuntary movements (dyskinesias) may indicate
excessive dopaminergic stimulation and should be reported to
the provider for dose adjustment rather than abrupt
discontinuation. Option D is unsafe because doubling doses
increases the risk of hypotension, hallucinations, dyskinesias,
and other adverse effects. Nurses should also teach patients to
change positions slowly due to orthostatic hypotension,
monitor for hallucinations in older adults, and emphasize that
symptom improvement may take days to weeks.
Learning Objectives
After completing this question, the learner should be able to:
• Explain how dietary protein affects levodopa absorption.
• Provide patient teaching for safe administration of
carbidopa/levodopa.
• Recognize common adverse effects requiring provider
notification.
Medication Safety Focus: Patient education
, Question 2
Clinical Scenario
A 74-year-old woman with Parkinson disease has been taking
carbidopa/levodopa for three years. During assessment, the
nurse notes repetitive twisting movements of her arms and face
while she is awake. The client reports that her tremor has
improved but these movements are becoming bothersome.
Vital signs are stable.
Question Stem
Which nursing interpretation is most appropriate?
A. The client is experiencing dyskinesias associated with
dopaminergic therapy.
B. The client is developing an acute stroke.
C. The medication is no longer effective and should be
discontinued immediately.
D. The client is experiencing an allergic reaction.
Correct Answer
A. The client is experiencing dyskinesias associated with
dopaminergic therapy.
Detailed Rationale
