,NUR170/NUR 170 Exam 2 |
Medical-Surgical Nursing | Galen College |
1. A nurse is caring for a client with Parkinson's disease. The nurse understands that this condition is
caused by an imbalance of which neurotransmitters?
A) Increased dopamine and decreased acetylcholine
B) Decreased dopamine and increased acetylcholine
C) Increased serotonin and decreased norepinephrine
D) Decreased serotonin and increased norepinephrine
Correct Answer: Decreased dopamine and increased acetylcholine
Rationale: Parkinson's disease is caused by degeneration of the substantia nigra, resulting in
decreased dopamine and a relative excess of acetylcholine. This imbalance produces the characteristic
movement symptoms. The other options do not describe the neurotransmitter imbalance seen in
Parkinson's disease.
2. A client with Parkinson's disease is prescribed levodopa-carbidopa. The nurse understands that
carbidopa is added for which purpose?
A) To increase the amount of levodopa that reaches the brain
B) To decrease the risk of dyskinesia
C) To increase dopamine receptor sensitivity
D) To prevent the peripheral breakdown of levodopa
Correct Answer: To prevent the peripheral breakdown of levodopa
Rationale: Carbidopa is a decarboxylase inhibitor that prevents the peripheral breakdown of
levodopa, allowing more levodopa to cross the blood-brain barrier and reducing peripheral side
effects. It does not increase receptor sensitivity, and dyskinesia remains a potential side effect.
,3. A nurse is assessing a client with Parkinson's disease. Which finding is most consistent with this
condition?
A) Hyperactive reflexes and spasticity
B) Tremor at rest and bradykinesia
C) Choreiform movements and hypotonia
D) Ataxia and nystagmus
Correct Answer: Tremor at rest and bradykinesia
Rationale: Parkinson's disease is characterized by resting tremor, bradykinesia (slow movement),
rigidity, and postural instability. Hyperactive reflexes and spasticity suggest upper motor neuron
lesions. Choreiform movements are seen in Huntington's disease. Ataxia and nystagmus suggest
cerebellar dysfunction.
4. A client with Parkinson's disease is experiencing difficulty swallowing and drooling. Which nursing
intervention is most appropriate?
A) Place the client in a supine position during meals
B) Encourage the client to drink thin liquids quickly
C) Thicken liquids and position the client upright during meals
D) Restrict oral intake and provide enteral nutrition
Correct Answer: Thicken liquids and position the client upright during meals
Rationale: Thickened liquids reduce the risk of aspiration, and upright positioning facilitates
swallowing and protects the airway. Supine positioning increases aspiration risk. Thin liquids are more
difficult to control. Enteral nutrition is not the first intervention.
5. A client taking levodopa-carbidopa for Parkinson's disease develops involuntary, excessive
movements. The nurse recognizes this as which side effect?
A) Tardive dyskinesia
B) Dystonia
C) Dyskinesia
, D) Akathisia
Correct Answer: Dyskinesia
Rationale: Dyskinesia (involuntary, excessive movements) is a common side effect of levodopa
therapy, often related to long-term use or peak-dose effects. Tardive dyskinesia is associated with
antipsychotics. Dystonia involves sustained muscle spasms. Akathisia is restlessness.
6. A nurse is planning care for a client with Parkinson's disease who experiences dyskinesia. Which
nutritional consideration is most important?
A) Restrict caloric intake to prevent weight gain
B) Increase caloric intake to compensate for increased energy expenditure
C) Limit protein intake to reduce medication interactions
D) Provide a low-fiber diet to prevent diarrhea
Correct Answer: Increase caloric intake to compensate for increased energy expenditure
Rationale: Dyskinesia causes excessive movement, leading to increased energy expenditure and
potential weight loss. Clients may require increased caloric intake to maintain weight. Protein
restriction may be needed for levodopa absorption but is not the primary concern with dyskinesia.
7. A client with Parkinson's disease has difficulty communicating due to speech changes. Which
intervention should the nurse implement?
A) Speak loudly and slowly to the client
B) Provide an alphabet board or communication board
C) Avoid communicating with the client to reduce frustration
D) Ask the client to repeat words until they are understood
Correct Answer: Provide an alphabet board or communication board
Medical-Surgical Nursing | Galen College |
1. A nurse is caring for a client with Parkinson's disease. The nurse understands that this condition is
caused by an imbalance of which neurotransmitters?
A) Increased dopamine and decreased acetylcholine
B) Decreased dopamine and increased acetylcholine
C) Increased serotonin and decreased norepinephrine
D) Decreased serotonin and increased norepinephrine
Correct Answer: Decreased dopamine and increased acetylcholine
Rationale: Parkinson's disease is caused by degeneration of the substantia nigra, resulting in
decreased dopamine and a relative excess of acetylcholine. This imbalance produces the characteristic
movement symptoms. The other options do not describe the neurotransmitter imbalance seen in
Parkinson's disease.
2. A client with Parkinson's disease is prescribed levodopa-carbidopa. The nurse understands that
carbidopa is added for which purpose?
A) To increase the amount of levodopa that reaches the brain
B) To decrease the risk of dyskinesia
C) To increase dopamine receptor sensitivity
D) To prevent the peripheral breakdown of levodopa
Correct Answer: To prevent the peripheral breakdown of levodopa
Rationale: Carbidopa is a decarboxylase inhibitor that prevents the peripheral breakdown of
levodopa, allowing more levodopa to cross the blood-brain barrier and reducing peripheral side
effects. It does not increase receptor sensitivity, and dyskinesia remains a potential side effect.
,3. A nurse is assessing a client with Parkinson's disease. Which finding is most consistent with this
condition?
A) Hyperactive reflexes and spasticity
B) Tremor at rest and bradykinesia
C) Choreiform movements and hypotonia
D) Ataxia and nystagmus
Correct Answer: Tremor at rest and bradykinesia
Rationale: Parkinson's disease is characterized by resting tremor, bradykinesia (slow movement),
rigidity, and postural instability. Hyperactive reflexes and spasticity suggest upper motor neuron
lesions. Choreiform movements are seen in Huntington's disease. Ataxia and nystagmus suggest
cerebellar dysfunction.
4. A client with Parkinson's disease is experiencing difficulty swallowing and drooling. Which nursing
intervention is most appropriate?
A) Place the client in a supine position during meals
B) Encourage the client to drink thin liquids quickly
C) Thicken liquids and position the client upright during meals
D) Restrict oral intake and provide enteral nutrition
Correct Answer: Thicken liquids and position the client upright during meals
Rationale: Thickened liquids reduce the risk of aspiration, and upright positioning facilitates
swallowing and protects the airway. Supine positioning increases aspiration risk. Thin liquids are more
difficult to control. Enteral nutrition is not the first intervention.
5. A client taking levodopa-carbidopa for Parkinson's disease develops involuntary, excessive
movements. The nurse recognizes this as which side effect?
A) Tardive dyskinesia
B) Dystonia
C) Dyskinesia
, D) Akathisia
Correct Answer: Dyskinesia
Rationale: Dyskinesia (involuntary, excessive movements) is a common side effect of levodopa
therapy, often related to long-term use or peak-dose effects. Tardive dyskinesia is associated with
antipsychotics. Dystonia involves sustained muscle spasms. Akathisia is restlessness.
6. A nurse is planning care for a client with Parkinson's disease who experiences dyskinesia. Which
nutritional consideration is most important?
A) Restrict caloric intake to prevent weight gain
B) Increase caloric intake to compensate for increased energy expenditure
C) Limit protein intake to reduce medication interactions
D) Provide a low-fiber diet to prevent diarrhea
Correct Answer: Increase caloric intake to compensate for increased energy expenditure
Rationale: Dyskinesia causes excessive movement, leading to increased energy expenditure and
potential weight loss. Clients may require increased caloric intake to maintain weight. Protein
restriction may be needed for levodopa absorption but is not the primary concern with dyskinesia.
7. A client with Parkinson's disease has difficulty communicating due to speech changes. Which
intervention should the nurse implement?
A) Speak loudly and slowly to the client
B) Provide an alphabet board or communication board
C) Avoid communicating with the client to reduce frustration
D) Ask the client to repeat words until they are understood
Correct Answer: Provide an alphabet board or communication board
