Chapter 15: Drugs for Neurodegenerative Diseases
MULTIPLE CHOICE
1. An older patient exhibits a shuffling gait, lack of facial expression, and tremors at rest.
The nurse will expect the provider to order which medication for this patient? a. Carbidopa-
levodopa (Sinemet)
b. Donepezil (Aricept)
c. Rivastigmine (Exelon)
d. Tacrine (Cognex)
ANS: A
This patient is exhibiting signs of Parkinsons disease and should be treated with carbidopa-
levodopa. The other drugs are used to treat Alzheimers disease.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 317
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pathophysiology
2. A nursing student asks the nurse to differentiate the pathology of Alzheimers disease from
that of Parkinsons disease. Which description is correct?
a. Alzheimers disease involves a possible excess of acetylcholine and neuritic plaques.
b. Alzheimers disease is caused by decreased amounts of dopamine and degeneration of
cholinergic neurons.
c. Parkinsons disease is characterized by an imbalance of dopamine and acetylcholine.
d. Parkinsons disease involves increased dopamine production and decreased acetylcholine.
ANS: C
Parkinsons disease (PD) is characterized by an imbalance of dopamine (DA) and acetylcholine
(ACh) caused by an unexplained degeneration of the dopaminergic neurons allowing the
excitatory response of acetylcholine to exceed the inhibitory response of dopamine. Alzheimers
disease (AD) may result from decreased ACh, degeneration of cholinergic neurons, and
neuritic plaques. Dopamine does not appear to play a role in Alzheimers disease.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 315
TOP: NURSING PROCESS: N/A MSC: NCLEX: Physiological Integrity: Pathophysiology
3. The spouse of a patient newly diagnosed with mild, unilateral symptoms of Parkinsons
disease (PD) asks the nurse what, besides medication, can be done to manage the disease. The
nurse will a. counsel the spouse that parkinsonism is a normal part of the aging process in some
people.
b. recommend exercise, nutritional counseling, and group support to help manage the disease.
c. tell the spouse that the disease will not progress if mild symptoms are treated early.
d. tell the spouse that medication therapy can be curative if drugs are begun in time.
ANS: B
, PD is a progressive disorder. Nonpharmacologic measures can lessen symptoms and help
patients and families cope with the disorder. Although the aging process may contribute to
the development of PD, it is not necessarily a normal part of aging. Treatment may slow the
progression but does not arrest or cure the disease.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 315
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pathophysiology
4. A patient who has Parkinsons disease is being treated with the anticholinergic
medication benztropine (Cogentin). The nurse will tell the patient that this drug will have
which effect? a. Helping the patient to walk faster
b. Improving mental function
c. Minimizing symptoms of bradykinesia
d. Reducing some of the tremors
ANS: D
Benztropine is given to reduce rigidity and some of the tremors. It does not enhance walking
or reduce bradykinesia or improve mental function.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 317
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. The nurse is preparing to administer a first dose of benztropine (Cogentin) to a patient
diagnosed with parkinsonism. The nurse would notify the patients provider if the patient had
a history of which condition? a. Asthma
b. Glaucoma
c. Hypertension
d. Irritable bowel disease
ANS: B
Patients with a history of glaucoma should not take anticholinergic medications.
Anticholinergics are not contraindicated in patients who have asthma, hypertension, or irritable
bowel disease.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 317
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. The nurse is caring for a patient who is receiving trihexyphenidyl (Artane) to treat
parkinsonism. The patient reports having a dry mouth, and the nurse notes a urine output of
300 mL in the past 8 hours. Which action will the nurse perform? a. Encourage increased oral
fluids.
b. Obtain an order for intravenous fluids.
c. Report the urine output to the provider.
d. Request an order for renal function tests.
MULTIPLE CHOICE
1. An older patient exhibits a shuffling gait, lack of facial expression, and tremors at rest.
The nurse will expect the provider to order which medication for this patient? a. Carbidopa-
levodopa (Sinemet)
b. Donepezil (Aricept)
c. Rivastigmine (Exelon)
d. Tacrine (Cognex)
ANS: A
This patient is exhibiting signs of Parkinsons disease and should be treated with carbidopa-
levodopa. The other drugs are used to treat Alzheimers disease.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 317
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pathophysiology
2. A nursing student asks the nurse to differentiate the pathology of Alzheimers disease from
that of Parkinsons disease. Which description is correct?
a. Alzheimers disease involves a possible excess of acetylcholine and neuritic plaques.
b. Alzheimers disease is caused by decreased amounts of dopamine and degeneration of
cholinergic neurons.
c. Parkinsons disease is characterized by an imbalance of dopamine and acetylcholine.
d. Parkinsons disease involves increased dopamine production and decreased acetylcholine.
ANS: C
Parkinsons disease (PD) is characterized by an imbalance of dopamine (DA) and acetylcholine
(ACh) caused by an unexplained degeneration of the dopaminergic neurons allowing the
excitatory response of acetylcholine to exceed the inhibitory response of dopamine. Alzheimers
disease (AD) may result from decreased ACh, degeneration of cholinergic neurons, and
neuritic plaques. Dopamine does not appear to play a role in Alzheimers disease.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 315
TOP: NURSING PROCESS: N/A MSC: NCLEX: Physiological Integrity: Pathophysiology
3. The spouse of a patient newly diagnosed with mild, unilateral symptoms of Parkinsons
disease (PD) asks the nurse what, besides medication, can be done to manage the disease. The
nurse will a. counsel the spouse that parkinsonism is a normal part of the aging process in some
people.
b. recommend exercise, nutritional counseling, and group support to help manage the disease.
c. tell the spouse that the disease will not progress if mild symptoms are treated early.
d. tell the spouse that medication therapy can be curative if drugs are begun in time.
ANS: B
, PD is a progressive disorder. Nonpharmacologic measures can lessen symptoms and help
patients and families cope with the disorder. Although the aging process may contribute to
the development of PD, it is not necessarily a normal part of aging. Treatment may slow the
progression but does not arrest or cure the disease.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 315
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pathophysiology
4. A patient who has Parkinsons disease is being treated with the anticholinergic
medication benztropine (Cogentin). The nurse will tell the patient that this drug will have
which effect? a. Helping the patient to walk faster
b. Improving mental function
c. Minimizing symptoms of bradykinesia
d. Reducing some of the tremors
ANS: D
Benztropine is given to reduce rigidity and some of the tremors. It does not enhance walking
or reduce bradykinesia or improve mental function.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 317
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. The nurse is preparing to administer a first dose of benztropine (Cogentin) to a patient
diagnosed with parkinsonism. The nurse would notify the patients provider if the patient had
a history of which condition? a. Asthma
b. Glaucoma
c. Hypertension
d. Irritable bowel disease
ANS: B
Patients with a history of glaucoma should not take anticholinergic medications.
Anticholinergics are not contraindicated in patients who have asthma, hypertension, or irritable
bowel disease.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 317
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. The nurse is caring for a patient who is receiving trihexyphenidyl (Artane) to treat
parkinsonism. The patient reports having a dry mouth, and the nurse notes a urine output of
300 mL in the past 8 hours. Which action will the nurse perform? a. Encourage increased oral
fluids.
b. Obtain an order for intravenous fluids.
c. Report the urine output to the provider.
d. Request an order for renal function tests.
