ondros NUR 212 Exam 2 Medical-Surgical
H
Nursing Official Practice Exam Actual Exam
2026/2027 with Detailed Rationales | Complete
Exam-Style Questions | Pass Guaranteed – A+
Graded
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SECTION 1: PARKINSON’S DISEASE & NEUROLOGICAL DISORDERS Q1 – Q10
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Question 1 of 50
A 68-year-old patient with Parkinson’s disease is being discharged with a new
prescription for levodopa/carbidopa. The nurse is providing dietary education to
optimize the medication's effectiveness. What instruction should the nurse include in
the discharge teaching?
. Consume high-protein meals during the day and restrict protein to the evening meal.
A
✓ CORRECT
B. Increase intake of vitamin B6 supplements to enhance the levodopa absorption.
C. Take the medication with a full glass of milk to prevent gastrointestinal upset.
D. Maintain a low-fiber diet to prevent diarrhea associated with the medication.
orrect Answer: A
C
Rationale: Levodopa absorption competes with dietary amino acids in the gut, so
separating high-protein meals from medication administration helps maximize drug
efficacy. Increasing vitamin B6 is incorrect because high doses of B6 accelerate the
peripheral breakdown of levodopa, reducing the amount crossing the blood-brain barrier.
,A practical exam tip is to remember the "protein competition" concept when reviewing
Parkinson's pharmacotherapy.
Question 2 of 50
A 72-year-old patient with advanced Parkinson’s disease experiences sudden "off"
episodes characterized by severe freezing and immobility. The provider prescribes
apomorphine subcutaneously. What is the priority nursing assessment before
administering this medication?
. Assess the patient's blood glucose levels for hypoglycemia.
A
B. Monitor the patient for orthostatic hypotension and syncope. ✓ CORRECT
C. Evaluate the patient's deep tendon reflexes for hyperreflexia.
D. Check the patient's white blood cell count for agranulocytosis.
orrect Answer: B
C
Rationale: Apomorphine is a dopamine agonist that causes significant vasodilation,
putting the patient at high risk for severe orthostatic hypotension and syncope.
Assessing deep tendon reflexes is incorrect because Parkinson’s disease typically
presents with rigidity and bradykinesia, not hyperreflexia. Always ensure the patient is
lying down during the initial administration of apomorphine to prevent fall injuries.
Question 3 of 50
A 65-year-old patient is admitted with Parkinson’s disease, and the nurse is performing
a baseline neurological assessment using the TRAP criteria. Select all that apply: Which
of the following findings would the nurse expect to document as part of this classic
triad?
, . Intention tremor that worsens with voluntary movement
A
B. Cogwheel rigidity in the upper extremities
C. Akinesia characterized by a masked facial expression
D. Postural instability leading to a festinating gait ✓ CORRECT
E. Flaccid muscle tone throughout the body
orrect Answer: B, C, D
C
Rationale: The TRAP criteria for Parkinson’s disease include Tremor (usually a resting
pill-rolling tremor), Rigidity (often described as cogwheel), Akinesia/bradykinesia
(manifesting as a masked face and slow movements), and Postural instability. An
intention tremor is incorrect because this is characteristic of cerebellar disorders, not
the resting tremor of Parkinson’s. Remembering the acronym TRAP will help quickly
identify classic assessment findings on exam questions.
Question 4 of 50
A 75-year-old patient with Parkinson’s disease experiences severe freezing episodes
when trying to initiate walking through doorways. The patient asks the nurse for
strategies to overcome this. What is the best nonpharmacological intervention to
suggest?
. Pull the patient forward by the belt to help break the freeze.
A
B. Instruct the patient to take larger, faster steps to push through the doorway.
C. Suggest the patient rock side-to-side or step over a visual line on the floor. ✓
CORRECT
D. Recommend the patient use a wheelchair to navigate through all doorways.
orrect Answer: C
C
Rationale: Rocking side-to-side or using a visual cue like a laser line can help bypass the
disrupted internal cueing system in Parkinson’s, allowing the patient to initiate
, movement. Pulling the patient forward is incorrect because it compromises balance and
significantly increases the risk of falls. Visual or auditory cueing strategies are highly
effective nursing interventions for freezing gait.
Question 5 of 50
A 70-year-old patient who has been taking levodopa/carbidopa for 5 years reports
experiencing sudden, uncontrollable jerking movements of the arms and legs. The nurse
recognizes this as a common complication of long-term therapy. How should the nurse
document this finding?
. Neuroleptic malignant syndrome
A
B. Acute dystonic reaction
C. Levodopa-induced dyskinesia ✓ CORRECT
D. Wearing-off phenomenon
orrect Answer: C
C
Rationale: Levodopa-induced dyskinesia presents as involuntary, jerky, writhing
movements and is a common adverse effect of long-term levodopa therapy indicating
the medication dose may need adjustment. The wearing-off phenomenon is incorrect
because it refers to the medication losing effectiveness before the next dose is due,
causing a return of Parkinsonian symptoms. Recognizing the difference between
dyskinesia and dystonia is crucial for accurate neurological assessments.
Question 6 of 50
H
Nursing Official Practice Exam Actual Exam
2026/2027 with Detailed Rationales | Complete
Exam-Style Questions | Pass Guaranteed – A+
Graded
═════════════════════════════════════
═
SECTION 1: PARKINSON’S DISEASE & NEUROLOGICAL DISORDERS Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 68-year-old patient with Parkinson’s disease is being discharged with a new
prescription for levodopa/carbidopa. The nurse is providing dietary education to
optimize the medication's effectiveness. What instruction should the nurse include in
the discharge teaching?
. Consume high-protein meals during the day and restrict protein to the evening meal.
A
✓ CORRECT
B. Increase intake of vitamin B6 supplements to enhance the levodopa absorption.
C. Take the medication with a full glass of milk to prevent gastrointestinal upset.
D. Maintain a low-fiber diet to prevent diarrhea associated with the medication.
orrect Answer: A
C
Rationale: Levodopa absorption competes with dietary amino acids in the gut, so
separating high-protein meals from medication administration helps maximize drug
efficacy. Increasing vitamin B6 is incorrect because high doses of B6 accelerate the
peripheral breakdown of levodopa, reducing the amount crossing the blood-brain barrier.
,A practical exam tip is to remember the "protein competition" concept when reviewing
Parkinson's pharmacotherapy.
Question 2 of 50
A 72-year-old patient with advanced Parkinson’s disease experiences sudden "off"
episodes characterized by severe freezing and immobility. The provider prescribes
apomorphine subcutaneously. What is the priority nursing assessment before
administering this medication?
. Assess the patient's blood glucose levels for hypoglycemia.
A
B. Monitor the patient for orthostatic hypotension and syncope. ✓ CORRECT
C. Evaluate the patient's deep tendon reflexes for hyperreflexia.
D. Check the patient's white blood cell count for agranulocytosis.
orrect Answer: B
C
Rationale: Apomorphine is a dopamine agonist that causes significant vasodilation,
putting the patient at high risk for severe orthostatic hypotension and syncope.
Assessing deep tendon reflexes is incorrect because Parkinson’s disease typically
presents with rigidity and bradykinesia, not hyperreflexia. Always ensure the patient is
lying down during the initial administration of apomorphine to prevent fall injuries.
Question 3 of 50
A 65-year-old patient is admitted with Parkinson’s disease, and the nurse is performing
a baseline neurological assessment using the TRAP criteria. Select all that apply: Which
of the following findings would the nurse expect to document as part of this classic
triad?
, . Intention tremor that worsens with voluntary movement
A
B. Cogwheel rigidity in the upper extremities
C. Akinesia characterized by a masked facial expression
D. Postural instability leading to a festinating gait ✓ CORRECT
E. Flaccid muscle tone throughout the body
orrect Answer: B, C, D
C
Rationale: The TRAP criteria for Parkinson’s disease include Tremor (usually a resting
pill-rolling tremor), Rigidity (often described as cogwheel), Akinesia/bradykinesia
(manifesting as a masked face and slow movements), and Postural instability. An
intention tremor is incorrect because this is characteristic of cerebellar disorders, not
the resting tremor of Parkinson’s. Remembering the acronym TRAP will help quickly
identify classic assessment findings on exam questions.
Question 4 of 50
A 75-year-old patient with Parkinson’s disease experiences severe freezing episodes
when trying to initiate walking through doorways. The patient asks the nurse for
strategies to overcome this. What is the best nonpharmacological intervention to
suggest?
. Pull the patient forward by the belt to help break the freeze.
A
B. Instruct the patient to take larger, faster steps to push through the doorway.
C. Suggest the patient rock side-to-side or step over a visual line on the floor. ✓
CORRECT
D. Recommend the patient use a wheelchair to navigate through all doorways.
orrect Answer: C
C
Rationale: Rocking side-to-side or using a visual cue like a laser line can help bypass the
disrupted internal cueing system in Parkinson’s, allowing the patient to initiate
, movement. Pulling the patient forward is incorrect because it compromises balance and
significantly increases the risk of falls. Visual or auditory cueing strategies are highly
effective nursing interventions for freezing gait.
Question 5 of 50
A 70-year-old patient who has been taking levodopa/carbidopa for 5 years reports
experiencing sudden, uncontrollable jerking movements of the arms and legs. The nurse
recognizes this as a common complication of long-term therapy. How should the nurse
document this finding?
. Neuroleptic malignant syndrome
A
B. Acute dystonic reaction
C. Levodopa-induced dyskinesia ✓ CORRECT
D. Wearing-off phenomenon
orrect Answer: C
C
Rationale: Levodopa-induced dyskinesia presents as involuntary, jerky, writhing
movements and is a common adverse effect of long-term levodopa therapy indicating
the medication dose may need adjustment. The wearing-off phenomenon is incorrect
because it refers to the medication losing effectiveness before the next dose is due,
causing a return of Parkinsonian symptoms. Recognizing the difference between
dyskinesia and dystonia is crucial for accurate neurological assessments.
Question 6 of 50
