Neurological System Pharmacology
NCLEX-RN Practice Questions with
Rationales
20 Original NGN Exam-Style MCQs |
Nursing Pharmacology Study Guide
Question 1
Clinical Scenario
A 68-year-old client with Parkinson disease is prescribed
carbidopa/levodopa. During morning rounds, the nurse notes
increasing hand tremors and rigidity. The client states, "My
medication does not seem to work anymore."
Question Stem
Which instruction should the nurse provide?
A. Take the medication with a high-protein breakfast.
B. Stop the medication when symptoms improve.
C. Take doses at the same times each day and avoid large
protein intake with doses.
D. Double the next dose if tremors worsen.
,Correct Answer
C. Take doses at the same times each day and avoid large
protein intake with doses.
Detailed Rationale
Levodopa competes with dietary amino acids for transport
across the intestinal wall and blood-brain barrier. Large protein
meals may decrease drug absorption and reduce therapeutic
effectiveness. Taking medication consistently promotes stable
dopamine levels and symptom control.
Option A is incorrect because high-protein meals may reduce
effectiveness. Option B is unsafe because abrupt
discontinuation can precipitate severe rigidity and neuroleptic
malignant syndrome-like symptoms. Option D increases risk for
dyskinesias and adverse effects.
Nurses should monitor for orthostatic hypotension,
hallucinations, dyskinesias, and fluctuations in symptom control
("on-off phenomenon"). Patients should also be informed that
urine and sweat may darken.
Learning Objectives
• Explain the mechanism and administration considerations
of levodopa.
• Identify factors affecting levodopa absorption.
, • Educate patients regarding medication adherence.
Medication Safety Focus
Patient education
Question 2
Clinical Scenario
A 72-year-old client newly diagnosed with Alzheimer disease is
prescribed donepezil.
Question Stem
Which finding requires immediate notification of the provider?
A. Mild insomnia
B. Heart rate of 48/min
C. Decreased appetite
D. Muscle cramps
Correct Answer
B. Heart rate of 48/min
Detailed Rationale
Donepezil is an acetylcholinesterase inhibitor that increases
acetylcholine levels. Increased parasympathetic activity may
cause bradycardia and heart block. A heart rate of 48/min
requires prompt evaluation.
NCLEX-RN Practice Questions with
Rationales
20 Original NGN Exam-Style MCQs |
Nursing Pharmacology Study Guide
Question 1
Clinical Scenario
A 68-year-old client with Parkinson disease is prescribed
carbidopa/levodopa. During morning rounds, the nurse notes
increasing hand tremors and rigidity. The client states, "My
medication does not seem to work anymore."
Question Stem
Which instruction should the nurse provide?
A. Take the medication with a high-protein breakfast.
B. Stop the medication when symptoms improve.
C. Take doses at the same times each day and avoid large
protein intake with doses.
D. Double the next dose if tremors worsen.
,Correct Answer
C. Take doses at the same times each day and avoid large
protein intake with doses.
Detailed Rationale
Levodopa competes with dietary amino acids for transport
across the intestinal wall and blood-brain barrier. Large protein
meals may decrease drug absorption and reduce therapeutic
effectiveness. Taking medication consistently promotes stable
dopamine levels and symptom control.
Option A is incorrect because high-protein meals may reduce
effectiveness. Option B is unsafe because abrupt
discontinuation can precipitate severe rigidity and neuroleptic
malignant syndrome-like symptoms. Option D increases risk for
dyskinesias and adverse effects.
Nurses should monitor for orthostatic hypotension,
hallucinations, dyskinesias, and fluctuations in symptom control
("on-off phenomenon"). Patients should also be informed that
urine and sweat may darken.
Learning Objectives
• Explain the mechanism and administration considerations
of levodopa.
• Identify factors affecting levodopa absorption.
, • Educate patients regarding medication adherence.
Medication Safety Focus
Patient education
Question 2
Clinical Scenario
A 72-year-old client newly diagnosed with Alzheimer disease is
prescribed donepezil.
Question Stem
Which finding requires immediate notification of the provider?
A. Mild insomnia
B. Heart rate of 48/min
C. Decreased appetite
D. Muscle cramps
Correct Answer
B. Heart rate of 48/min
Detailed Rationale
Donepezil is an acetylcholinesterase inhibitor that increases
acetylcholine levels. Increased parasympathetic activity may
cause bradycardia and heart block. A heart rate of 48/min
requires prompt evaluation.
