NCLEX-RN Pharmacology Neurological
System Part 1 Exam Questions &
Answers
20 Original ATI & NGN-Style Practice
MCQs with Detailed Rationales
Nursing Pharmacology Study Guide
Question 1
Clinical Scenario
A 68-year-old man is admitted with newly diagnosed Parkinson
disease. His medical history includes hypertension and benign
prostatic hyperplasia (BPH). The provider prescribes
carbidopa/levodopa. Before administering the first dose, the
nurse reviews the patient's medications, which include
lisinopril, tamsulosin, and a daily multivitamin containing iron.
Vital signs:
• BP: 128/76 mm Hg
• HR: 72 beats/min
, • RR: 18 breaths/min
• SpO₂: 98% on room air
Question Stem
Which nursing instruction is most appropriate when teaching
the patient about taking carbidopa/levodopa?
A. Take the medication with the iron-containing multivitamin
each morning.
B. Stop the medication immediately if tremors persist after the
first dose.
C. Avoid taking the medication at the same time as iron
supplements.
D. Restrict all dietary protein while taking the medication.
Correct Answer
C. Avoid taking the medication at the same time as iron
supplements.
Detailed Rationale
Carbidopa/levodopa is the cornerstone treatment for Parkinson
disease. Levodopa crosses the blood-brain barrier and is
converted to dopamine, while carbidopa inhibits peripheral
metabolism of levodopa, increasing its availability in the central
nervous system and reducing nausea. Iron supplements can
bind levodopa in the gastrointestinal tract, decreasing
,absorption and reducing therapeutic effectiveness. Patients
should separate iron-containing supplements from levodopa by
several hours whenever possible.
Option A is incorrect because simultaneous administration with
iron decreases levodopa absorption.
Option B is incorrect because symptom improvement often
requires several days or weeks. Abrupt discontinuation may
precipitate severe rigidity or a syndrome resembling neuroleptic
malignant syndrome.
Option D is incorrect because patients do not need to eliminate
protein. Instead, they should maintain a balanced diet and, if
motor fluctuations occur, consider distributing protein intake
later in the day under provider guidance since large protein
meals may compete with levodopa absorption.
The nurse should also educate the patient about orthostatic
hypotension, dizziness, dyskinesias, nausea, and harmless
darkening of urine or sweat. Monitoring symptom improvement
and medication timing helps maximize therapeutic benefit.
Learning Objectives
After completing this question, the learner should be able to:
• Explain the mechanism of action of carbidopa/levodopa.
• Identify medications and supplements that interfere with
levodopa absorption.
, • Provide essential patient education regarding medication
administration.
• Recognize common adverse effects requiring monitoring.
Medication Safety Focus
Drug interaction
Question 2
Clinical Scenario
A 74-year-old woman with Parkinson disease has been taking
carbidopa/levodopa for several years. During morning
assessment, the nurse notes repetitive involuntary twisting
movements of the arms and face shortly after medication
administration. The patient states, "My tremor is better, but
these movements are getting worse."
Question Stem
Which nursing action is most appropriate?
A. Instruct the patient to skip the next scheduled dose.
B. Notify the provider because the patient may be experiencing
levodopa-induced dyskinesia.
C. Administer an additional dose of carbidopa/levodopa.
System Part 1 Exam Questions &
Answers
20 Original ATI & NGN-Style Practice
MCQs with Detailed Rationales
Nursing Pharmacology Study Guide
Question 1
Clinical Scenario
A 68-year-old man is admitted with newly diagnosed Parkinson
disease. His medical history includes hypertension and benign
prostatic hyperplasia (BPH). The provider prescribes
carbidopa/levodopa. Before administering the first dose, the
nurse reviews the patient's medications, which include
lisinopril, tamsulosin, and a daily multivitamin containing iron.
Vital signs:
• BP: 128/76 mm Hg
• HR: 72 beats/min
, • RR: 18 breaths/min
• SpO₂: 98% on room air
Question Stem
Which nursing instruction is most appropriate when teaching
the patient about taking carbidopa/levodopa?
A. Take the medication with the iron-containing multivitamin
each morning.
B. Stop the medication immediately if tremors persist after the
first dose.
C. Avoid taking the medication at the same time as iron
supplements.
D. Restrict all dietary protein while taking the medication.
Correct Answer
C. Avoid taking the medication at the same time as iron
supplements.
Detailed Rationale
Carbidopa/levodopa is the cornerstone treatment for Parkinson
disease. Levodopa crosses the blood-brain barrier and is
converted to dopamine, while carbidopa inhibits peripheral
metabolism of levodopa, increasing its availability in the central
nervous system and reducing nausea. Iron supplements can
bind levodopa in the gastrointestinal tract, decreasing
,absorption and reducing therapeutic effectiveness. Patients
should separate iron-containing supplements from levodopa by
several hours whenever possible.
Option A is incorrect because simultaneous administration with
iron decreases levodopa absorption.
Option B is incorrect because symptom improvement often
requires several days or weeks. Abrupt discontinuation may
precipitate severe rigidity or a syndrome resembling neuroleptic
malignant syndrome.
Option D is incorrect because patients do not need to eliminate
protein. Instead, they should maintain a balanced diet and, if
motor fluctuations occur, consider distributing protein intake
later in the day under provider guidance since large protein
meals may compete with levodopa absorption.
The nurse should also educate the patient about orthostatic
hypotension, dizziness, dyskinesias, nausea, and harmless
darkening of urine or sweat. Monitoring symptom improvement
and medication timing helps maximize therapeutic benefit.
Learning Objectives
After completing this question, the learner should be able to:
• Explain the mechanism of action of carbidopa/levodopa.
• Identify medications and supplements that interfere with
levodopa absorption.
, • Provide essential patient education regarding medication
administration.
• Recognize common adverse effects requiring monitoring.
Medication Safety Focus
Drug interaction
Question 2
Clinical Scenario
A 74-year-old woman with Parkinson disease has been taking
carbidopa/levodopa for several years. During morning
assessment, the nurse notes repetitive involuntary twisting
movements of the arms and face shortly after medication
administration. The patient states, "My tremor is better, but
these movements are getting worse."
Question Stem
Which nursing action is most appropriate?
A. Instruct the patient to skip the next scheduled dose.
B. Notify the provider because the patient may be experiencing
levodopa-induced dyskinesia.
C. Administer an additional dose of carbidopa/levodopa.
