Galen College NU 185 Exam 1 (pdf) | 2026/2027 | Med-Surg II Q&A |
Medical-Surgical Nursing
1. A nurse is assessing a client diagnosed with Parkinson's disease. Which
finding should the nurse report to the healthcare provider immediately?
A) Pill-rolling tremor in the right hand
B) Cogwheel rigidity in both upper extremities
C) Shuffling gait with a stooped posture
D) Episodes of freezing while ambulating, increasing in frequency
Correct Answer: Episodes of freezing while ambulating, increasing in
frequency
Rationale: Freezing episodes that increase in frequency may indicate
worsening mobility and a higher fall risk. This change requires prompt
intervention to ensure patient safety. Pill-rolling tremor, cogwheel rigidity,
and shuffling gait are expected findings in Parkinson's disease and do not
require immediate reporting unless they represent a significant change from
baseline.
2. Which clinical manifestation is most characteristic of Parkinson's disease?
A) Muscle flaccidity
B) Hyperactive reflexes
C) Pill-rolling tremor
D) Sudden onset of muscle weakness
Correct Answer: Pill-rolling tremor
Rationale: A resting "pill-rolling" tremor is a hallmark symptom of Parkinson's
disease, particularly affecting the hands. This tremor is most noticeable
,when the hands are at rest. Muscle flaccidity, hyperactive reflexes, and
sudden weakness are not characteristic of Parkinson's disease.
3. Which nursing diagnosis is most appropriate for a client in the early stages
of Parkinson's disease?
A) Risk for infection related to immobility
B) Risk for disturbed body image related to facial changes and motor
symptoms
C) Impaired memory related to neurodegeneration
D) Ineffective airway clearance related to excessive mucus production
Correct Answer: Risk for disturbed body image related to facial changes and
motor symptoms
Rationale: In the early stages, clients may begin to notice facial changes
(mask-like expression), tremors, and shuffling gait, all of which can affect
body image and self-esteem. This is a priority psychosocial concern. Risk for
infection, impaired memory, and ineffective airway clearance are not the
most appropriate early-stage nursing diagnoses.
4. A nurse is developing a plan of care for a client with Parkinson's disease.
Which intervention is most important to reduce the risk of injury?
A) Encourage the client to rest frequently
B) Provide thickened liquids to prevent aspiration
C) Use a gait belt and provide fall prevention education
D) Administer antiparkinsonian medications on a schedule
Correct Answer: Use a gait belt and provide fall prevention education
,Rationale: Clients with Parkinson's disease are at high risk for falls due to
shuffling gait, freezing episodes, and postural instability. Using a gait belt
and providing fall prevention education are priority interventions to reduce
injury risk. While medication administration and aspiration precautions are
important, fall prevention is the most direct intervention for reducing injury.
5. A client with Parkinson's disease is prescribed levodopa-carbidopa. The
nurse should monitor for which potential adverse effect?
A) Hypotension and bradycardia
B) Dyskinesias and orthostatic hypotension
C) Hyperglycemia and weight gain
D) Sedation and respiratory depression
Correct Answer: Dyskinesias and orthostatic hypotension
Rationale: Levodopa-carbidopa can cause dyskinesias (involuntary
movements) and orthostatic hypotension as common adverse effects. Blood
pressure should be monitored, and the client should be instructed to rise
slowly from sitting or lying positions. The other options are not characteristic
adverse effects of this medication.
6. A client with Parkinson's disease is experiencing "on-off" phenomena. The
nurse understands that this refers to:
A) Fluctuations in medication effectiveness
B) Alternating periods of sleep and wakefulness
C) Changes in mood from depression to euphoria
D) Variations in blood pressure throughout the day
Correct Answer: Fluctuations in medication effectiveness
, Rationale: The "on-off" phenomenon refers to fluctuations in the
effectiveness of levodopa therapy, where the client experiences alternating
periods of good symptom control ("on") and periods of increased symptoms
("off"). This is a common complication of long-term levodopa therapy.
7. The nurse is assessing a client who had a stroke. Which finding is most
consistent with left-sided (dominant hemisphere) stroke?
A) Left-sided neglect and impulsivity
B) Aphasia and right-sided weakness
C) Difficulty with spatial awareness
D) Denial of deficits and poor judgment
Correct Answer: Aphasia and right-sided weakness
Rationale: Left-sided (dominant hemisphere) stroke typically causes aphasia
(language impairment) and right-sided weakness or paralysis. Left-sided
neglect, impulsivity, difficulty with spatial awareness, and denial of deficits
are more characteristic of right-sided (non-dominant hemisphere) stroke.
8. A client who had a stroke 24 hours ago is now experiencing increasing
confusion and lethargy. The nurse should suspect:
A) Normal post-stroke recovery
B) Medication side effects
C) Increased intracranial pressure or cerebral edema
D) A urinary tract infection
Correct Answer: Increased intracranial pressure or cerebral edema
Rationale: Increasing confusion and lethargy after a stroke may indicate
cerebral edema or increased intracranial pressure, which are serious
Medical-Surgical Nursing
1. A nurse is assessing a client diagnosed with Parkinson's disease. Which
finding should the nurse report to the healthcare provider immediately?
A) Pill-rolling tremor in the right hand
B) Cogwheel rigidity in both upper extremities
C) Shuffling gait with a stooped posture
D) Episodes of freezing while ambulating, increasing in frequency
Correct Answer: Episodes of freezing while ambulating, increasing in
frequency
Rationale: Freezing episodes that increase in frequency may indicate
worsening mobility and a higher fall risk. This change requires prompt
intervention to ensure patient safety. Pill-rolling tremor, cogwheel rigidity,
and shuffling gait are expected findings in Parkinson's disease and do not
require immediate reporting unless they represent a significant change from
baseline.
2. Which clinical manifestation is most characteristic of Parkinson's disease?
A) Muscle flaccidity
B) Hyperactive reflexes
C) Pill-rolling tremor
D) Sudden onset of muscle weakness
Correct Answer: Pill-rolling tremor
Rationale: A resting "pill-rolling" tremor is a hallmark symptom of Parkinson's
disease, particularly affecting the hands. This tremor is most noticeable
,when the hands are at rest. Muscle flaccidity, hyperactive reflexes, and
sudden weakness are not characteristic of Parkinson's disease.
3. Which nursing diagnosis is most appropriate for a client in the early stages
of Parkinson's disease?
A) Risk for infection related to immobility
B) Risk for disturbed body image related to facial changes and motor
symptoms
C) Impaired memory related to neurodegeneration
D) Ineffective airway clearance related to excessive mucus production
Correct Answer: Risk for disturbed body image related to facial changes and
motor symptoms
Rationale: In the early stages, clients may begin to notice facial changes
(mask-like expression), tremors, and shuffling gait, all of which can affect
body image and self-esteem. This is a priority psychosocial concern. Risk for
infection, impaired memory, and ineffective airway clearance are not the
most appropriate early-stage nursing diagnoses.
4. A nurse is developing a plan of care for a client with Parkinson's disease.
Which intervention is most important to reduce the risk of injury?
A) Encourage the client to rest frequently
B) Provide thickened liquids to prevent aspiration
C) Use a gait belt and provide fall prevention education
D) Administer antiparkinsonian medications on a schedule
Correct Answer: Use a gait belt and provide fall prevention education
,Rationale: Clients with Parkinson's disease are at high risk for falls due to
shuffling gait, freezing episodes, and postural instability. Using a gait belt
and providing fall prevention education are priority interventions to reduce
injury risk. While medication administration and aspiration precautions are
important, fall prevention is the most direct intervention for reducing injury.
5. A client with Parkinson's disease is prescribed levodopa-carbidopa. The
nurse should monitor for which potential adverse effect?
A) Hypotension and bradycardia
B) Dyskinesias and orthostatic hypotension
C) Hyperglycemia and weight gain
D) Sedation and respiratory depression
Correct Answer: Dyskinesias and orthostatic hypotension
Rationale: Levodopa-carbidopa can cause dyskinesias (involuntary
movements) and orthostatic hypotension as common adverse effects. Blood
pressure should be monitored, and the client should be instructed to rise
slowly from sitting or lying positions. The other options are not characteristic
adverse effects of this medication.
6. A client with Parkinson's disease is experiencing "on-off" phenomena. The
nurse understands that this refers to:
A) Fluctuations in medication effectiveness
B) Alternating periods of sleep and wakefulness
C) Changes in mood from depression to euphoria
D) Variations in blood pressure throughout the day
Correct Answer: Fluctuations in medication effectiveness
, Rationale: The "on-off" phenomenon refers to fluctuations in the
effectiveness of levodopa therapy, where the client experiences alternating
periods of good symptom control ("on") and periods of increased symptoms
("off"). This is a common complication of long-term levodopa therapy.
7. The nurse is assessing a client who had a stroke. Which finding is most
consistent with left-sided (dominant hemisphere) stroke?
A) Left-sided neglect and impulsivity
B) Aphasia and right-sided weakness
C) Difficulty with spatial awareness
D) Denial of deficits and poor judgment
Correct Answer: Aphasia and right-sided weakness
Rationale: Left-sided (dominant hemisphere) stroke typically causes aphasia
(language impairment) and right-sided weakness or paralysis. Left-sided
neglect, impulsivity, difficulty with spatial awareness, and denial of deficits
are more characteristic of right-sided (non-dominant hemisphere) stroke.
8. A client who had a stroke 24 hours ago is now experiencing increasing
confusion and lethargy. The nurse should suspect:
A) Normal post-stroke recovery
B) Medication side effects
C) Increased intracranial pressure or cerebral edema
D) A urinary tract infection
Correct Answer: Increased intracranial pressure or cerebral edema
Rationale: Increasing confusion and lethargy after a stroke may indicate
cerebral edema or increased intracranial pressure, which are serious
