PAIN MANAGEMENT EXAM SCRIPT TESTED
QUESTIONS AND SOLUTIONS 100 PERCENT
CORRECT
◉ Parkinson's Disease. Answer: Chemical imbalance (low dopamine
and high acetylcholine)
◉ Symptoms of Parkinson's Disease. Answer: slow slurred
monotonous speech, blank face, rigidity and tremor of extremities and
head
forward tilt to posture, reduced arm swinging, short shuffling gait
◉ Anti-Parkinson Drugs. Answer: Cannot reverse neuronal damage.
Only treats symptoms
2 broad classes of drugs: Dopaminergic agents and anticholinergic
agents
(anticholinergic = antimuscarinic = parasympathetic)
◉ Levadopa. Answer: Most effective in PD when combined with
carbidopa
,Dopamine restoration (increases dopamine levels in the brain that are
depleted in Parkinson disease)
◉ Minimizing "wear off" of levadopa. Answer: shorten dose interval
give a drug that prolongs levadopa's half life (COMT-1)
give a direct dopamine agonist
◉ Adverse effects of Levodopa. Answer: Nausea, vomiting
Dyskinesia (paradoxical effect) - head bobbing, tics, grimace, chorea
movement
◉ Managing adverse effects of Levodopa. Answer: Presence of
dyskinesia will need a decrease in L dopa, give amentadine, or
surgery and electrical stimulation
◉ Dyskenesia. Answer: impaired movement
◉ More adverse effects of Levodopa. Answer: postural hypoTN
(increase Na and water, alpha agonist)
Dysrhythmias
visual hallucinations, nightmaires, paranoid ideation (FGAs decrease
psychotic symptoms but increase PD, SGAs are preferred -->
clozapine and quetapine)
Dark sweat and urine color
,◉ Food-drug interactions of Levodopa. Answer: Meals high in
protein interfere with absorption from the intestine and across the
BBB
◉ Drug-drug interaction of Levodopa. Answer: Levodopa + MAOI =
HTN crisis
◉ Carbidopa-levodopa (Sinemet) is prescribed for a client with
Parkinson's disease. The nurse monitors the client for which side
effects of the medication? Select all that apply.
Vomiting
Anorexia
Slow heart rate
Changes in mood
Peripheral edema. Answer: Vomiting
Anorexia
Changes in mood
◉ A 76-year-old patient is being treated with carbidopa/levodopa
(Sinemet) for Parkinson's disease. Which information is most
important for the nurse to report to the health care provider?
Shuffling gait
Tremor at rest
, Cogwheel rigidity of limbs
Uncontrolled head movement. Answer: Uncontrolled head movement
◉ What should the nurse include when teaching a client with severe
Parkinson disease about carbidopa-levodopa (Sinemet)?
Multivitamins should be taken daily
Alcohol consumption should be in moderation
The medication should be taken with meals
A high-protein diet should be followed. Answer: The medication
should be taken with meals (reduces nausea and vomiting)
◉ Monoamine Oxidase A. Answer: Inactivates NE and S-HT
Inhibitors: antidepressants: PANAMA
PAmate
NArdil
MArplan
◉ MAO B. Answer: Inactivates DA
Inhibitors: anti-Parkinson (giline)
Selegiline
Rasagiline
◉ MAOI. Answer:
QUESTIONS AND SOLUTIONS 100 PERCENT
CORRECT
◉ Parkinson's Disease. Answer: Chemical imbalance (low dopamine
and high acetylcholine)
◉ Symptoms of Parkinson's Disease. Answer: slow slurred
monotonous speech, blank face, rigidity and tremor of extremities and
head
forward tilt to posture, reduced arm swinging, short shuffling gait
◉ Anti-Parkinson Drugs. Answer: Cannot reverse neuronal damage.
Only treats symptoms
2 broad classes of drugs: Dopaminergic agents and anticholinergic
agents
(anticholinergic = antimuscarinic = parasympathetic)
◉ Levadopa. Answer: Most effective in PD when combined with
carbidopa
,Dopamine restoration (increases dopamine levels in the brain that are
depleted in Parkinson disease)
◉ Minimizing "wear off" of levadopa. Answer: shorten dose interval
give a drug that prolongs levadopa's half life (COMT-1)
give a direct dopamine agonist
◉ Adverse effects of Levodopa. Answer: Nausea, vomiting
Dyskinesia (paradoxical effect) - head bobbing, tics, grimace, chorea
movement
◉ Managing adverse effects of Levodopa. Answer: Presence of
dyskinesia will need a decrease in L dopa, give amentadine, or
surgery and electrical stimulation
◉ Dyskenesia. Answer: impaired movement
◉ More adverse effects of Levodopa. Answer: postural hypoTN
(increase Na and water, alpha agonist)
Dysrhythmias
visual hallucinations, nightmaires, paranoid ideation (FGAs decrease
psychotic symptoms but increase PD, SGAs are preferred -->
clozapine and quetapine)
Dark sweat and urine color
,◉ Food-drug interactions of Levodopa. Answer: Meals high in
protein interfere with absorption from the intestine and across the
BBB
◉ Drug-drug interaction of Levodopa. Answer: Levodopa + MAOI =
HTN crisis
◉ Carbidopa-levodopa (Sinemet) is prescribed for a client with
Parkinson's disease. The nurse monitors the client for which side
effects of the medication? Select all that apply.
Vomiting
Anorexia
Slow heart rate
Changes in mood
Peripheral edema. Answer: Vomiting
Anorexia
Changes in mood
◉ A 76-year-old patient is being treated with carbidopa/levodopa
(Sinemet) for Parkinson's disease. Which information is most
important for the nurse to report to the health care provider?
Shuffling gait
Tremor at rest
, Cogwheel rigidity of limbs
Uncontrolled head movement. Answer: Uncontrolled head movement
◉ What should the nurse include when teaching a client with severe
Parkinson disease about carbidopa-levodopa (Sinemet)?
Multivitamins should be taken daily
Alcohol consumption should be in moderation
The medication should be taken with meals
A high-protein diet should be followed. Answer: The medication
should be taken with meals (reduces nausea and vomiting)
◉ Monoamine Oxidase A. Answer: Inactivates NE and S-HT
Inhibitors: antidepressants: PANAMA
PAmate
NArdil
MArplan
◉ MAO B. Answer: Inactivates DA
Inhibitors: anti-Parkinson (giline)
Selegiline
Rasagiline
◉ MAOI. Answer:
