Chapter 13: Antiparkinsonian Drugs
Steele: Keltner’s Psychiatric Nursing,
MULTIPLE CHOICE
1. A psychiatric nurse should base care of patients diagnosed with Parkinson disease and patients
demonstrating extrapyramidal side effects (EPSEs) caused by antipsychotic drug therapy on what
premise concerning symptoms?
a. Both conditions share similar symptoms.
b. Both sets of symptoms result from deficits in dopamine synthesis.
c. Both sets of symptoms result from acetylcholine and dopamine imbalance.
d. All associated symptoms are produced by neurodegeneration of the substantia nigra.
ANS: C
In both problems, acetylcholine and dopamine are not in balance. In Parkinson disease, this
results from neurodegeneration of the substantia nigra, and in the case of EPSEs, the cause is
blockade of dopamine receptors in the basal ganglia. The other options are not valid premises.
DIF: Cognitive level: Applying TOP: Nursing process: Planning
MSC: Client Needs: Physiologic Integrity
, 2. A patient who is receiving an antipsychotic drug is restless, paces, and cannot sit still when
watching television. The nurse should use which term to document these findings?
a. Dystonia
b. Akathisia
c. Dyskinesia
d. Bradykinesia
ANS: B
A patient with akathisia describes feeling restless, jittery, and unable to sit, and has restless legs
that feel better only if the patient is moving. Dystonia refers to sustained, twisted muscle
contractions. Dyskinesia refers to jerky motions. Bradykinesia refers to slow movement.
DIF: Cognitive level: Understanding TOP: Nursing process: Implementation
MSC: Client Needs: Physiologic Integrity
3. A patient who is receiving an antipsychotic drug is restless, paces, and cannot sit still when
watching television. The patient says, ―I couldn‘t sleep last night because I needed to pace.‖
What is the expected nursing intervention?
a. Administration of a prescribed anticholinergic drug
b. Discontinuation of the administration of the antipsychotic drug
c. Administration of a prescribed dopaminergic medication.
d. Administration of a prescribed bedtime antihistamine to promote sleep.
ANS: A
The patient‘s motor symptoms can be assessed as akathisia. Anticholinergic medication provides
relief for some patients. The nurse should report the patient‘s symptoms to the health care
provider and anticipate the order to begin anticholinergic therapy. The other options do not
provide acceptable alternatives.
DIF: Cognitive level: Applying TOP: Nursing process: Implementation
MSC: Client Needs: Physiologic Integrity
Steele: Keltner’s Psychiatric Nursing,
MULTIPLE CHOICE
1. A psychiatric nurse should base care of patients diagnosed with Parkinson disease and patients
demonstrating extrapyramidal side effects (EPSEs) caused by antipsychotic drug therapy on what
premise concerning symptoms?
a. Both conditions share similar symptoms.
b. Both sets of symptoms result from deficits in dopamine synthesis.
c. Both sets of symptoms result from acetylcholine and dopamine imbalance.
d. All associated symptoms are produced by neurodegeneration of the substantia nigra.
ANS: C
In both problems, acetylcholine and dopamine are not in balance. In Parkinson disease, this
results from neurodegeneration of the substantia nigra, and in the case of EPSEs, the cause is
blockade of dopamine receptors in the basal ganglia. The other options are not valid premises.
DIF: Cognitive level: Applying TOP: Nursing process: Planning
MSC: Client Needs: Physiologic Integrity
, 2. A patient who is receiving an antipsychotic drug is restless, paces, and cannot sit still when
watching television. The nurse should use which term to document these findings?
a. Dystonia
b. Akathisia
c. Dyskinesia
d. Bradykinesia
ANS: B
A patient with akathisia describes feeling restless, jittery, and unable to sit, and has restless legs
that feel better only if the patient is moving. Dystonia refers to sustained, twisted muscle
contractions. Dyskinesia refers to jerky motions. Bradykinesia refers to slow movement.
DIF: Cognitive level: Understanding TOP: Nursing process: Implementation
MSC: Client Needs: Physiologic Integrity
3. A patient who is receiving an antipsychotic drug is restless, paces, and cannot sit still when
watching television. The patient says, ―I couldn‘t sleep last night because I needed to pace.‖
What is the expected nursing intervention?
a. Administration of a prescribed anticholinergic drug
b. Discontinuation of the administration of the antipsychotic drug
c. Administration of a prescribed dopaminergic medication.
d. Administration of a prescribed bedtime antihistamine to promote sleep.
ANS: A
The patient‘s motor symptoms can be assessed as akathisia. Anticholinergic medication provides
relief for some patients. The nurse should report the patient‘s symptoms to the health care
provider and anticipate the order to begin anticholinergic therapy. The other options do not
provide acceptable alternatives.
DIF: Cognitive level: Applying TOP: Nursing process: Implementation
MSC: Client Needs: Physiologic Integrity
