NCLEX-RN Pharmacology Neurological
System Part 1
20 Original NGN-Style Practice
Questions with Rationales
Nursing Exam Prep
Question 1
Clinical Scenario
A 68-year-old man with newly diagnosed Parkinson disease is
prescribed carbidopa/levodopa. His medical history includes
hypertension and chronic constipation. Current vital signs are
BP 132/78 mm Hg, HR 74/min, RR 18/min. During discharge
teaching, the nurse discusses medication administration and
expected effects.
Question Stem
Which statement by the client indicates correct understanding
of the medication?
A. "I'll stop taking the medication once my tremors improve."
,B. "I'll take the medication with a high-protein meal every
morning."
C. "I'll change positions slowly because this medication may
make me dizzy."
D. "If my urine becomes darker, I'll stop the medication
immediately."
Correct Answer
Correct Answer: C. "I'll change positions slowly because this
medication may make me dizzy."
Detailed Rationale
Carbidopa/levodopa is the most effective medication for
improving the motor symptoms of Parkinson disease by
increasing dopamine availability in the central nervous system.
Orthostatic hypotension is a common adverse effect, especially
during initiation and dosage adjustments, increasing the risk of
falls. Teaching patients to rise slowly from lying or sitting
positions is an essential nursing intervention to reduce injury
risk.
Option A is incorrect because Parkinson disease requires long-
term management, and medications should not be
discontinued abruptly without provider guidance, as sudden
withdrawal may cause severe symptom worsening.
,Option B is incorrect because high-protein meals may interfere
with levodopa absorption due to competition with amino acids.
Many patients achieve better symptom control by spacing
protein intake away from medication doses if instructed by the
healthcare provider.
Option D is incorrect because darkening of urine or sweat may
occur with levodopa and is generally harmless. Patients should
be informed of this benign effect to avoid unnecessary
medication discontinuation.
Nurses should monitor symptom improvement, dyskinesias,
orthostatic hypotension, and medication adherence while
reinforcing fall-prevention strategies.
Learning Objectives
After completing this question, the learner should be able to:
• Identify essential patient teaching for carbidopa/levodopa.
• Recognize common adverse effects requiring safety
precautions.
• Explain factors affecting levodopa absorption.
• Promote medication adherence in Parkinson disease.
Medication Safety Focus
Patient Education
, Question 2
Clinical Scenario
A 29-year-old woman with generalized tonic-clonic seizures has
been taking phenytoin for six months. During her follow-up
visit, the nurse observes swollen, bleeding gums. Laboratory
values show a therapeutic serum phenytoin level. The client
reports taking the medication as prescribed.
Question Stem
Which nursing intervention is the priority?
A. Recommend discontinuing phenytoin immediately.
B. Teach meticulous oral hygiene and schedule regular dental
care.
C. Encourage increased dietary sodium intake.
D. Restrict fluid intake to reduce gum swelling.
Correct Answer
Correct Answer: B. Teach meticulous oral hygiene and
schedule regular dental care.
Detailed Rationale
Gingival hyperplasia is a well-known adverse effect of long-term
phenytoin therapy. Because the serum drug level is therapeutic
and there are no signs of toxicity, the priority nursing
System Part 1
20 Original NGN-Style Practice
Questions with Rationales
Nursing Exam Prep
Question 1
Clinical Scenario
A 68-year-old man with newly diagnosed Parkinson disease is
prescribed carbidopa/levodopa. His medical history includes
hypertension and chronic constipation. Current vital signs are
BP 132/78 mm Hg, HR 74/min, RR 18/min. During discharge
teaching, the nurse discusses medication administration and
expected effects.
Question Stem
Which statement by the client indicates correct understanding
of the medication?
A. "I'll stop taking the medication once my tremors improve."
,B. "I'll take the medication with a high-protein meal every
morning."
C. "I'll change positions slowly because this medication may
make me dizzy."
D. "If my urine becomes darker, I'll stop the medication
immediately."
Correct Answer
Correct Answer: C. "I'll change positions slowly because this
medication may make me dizzy."
Detailed Rationale
Carbidopa/levodopa is the most effective medication for
improving the motor symptoms of Parkinson disease by
increasing dopamine availability in the central nervous system.
Orthostatic hypotension is a common adverse effect, especially
during initiation and dosage adjustments, increasing the risk of
falls. Teaching patients to rise slowly from lying or sitting
positions is an essential nursing intervention to reduce injury
risk.
Option A is incorrect because Parkinson disease requires long-
term management, and medications should not be
discontinued abruptly without provider guidance, as sudden
withdrawal may cause severe symptom worsening.
,Option B is incorrect because high-protein meals may interfere
with levodopa absorption due to competition with amino acids.
Many patients achieve better symptom control by spacing
protein intake away from medication doses if instructed by the
healthcare provider.
Option D is incorrect because darkening of urine or sweat may
occur with levodopa and is generally harmless. Patients should
be informed of this benign effect to avoid unnecessary
medication discontinuation.
Nurses should monitor symptom improvement, dyskinesias,
orthostatic hypotension, and medication adherence while
reinforcing fall-prevention strategies.
Learning Objectives
After completing this question, the learner should be able to:
• Identify essential patient teaching for carbidopa/levodopa.
• Recognize common adverse effects requiring safety
precautions.
• Explain factors affecting levodopa absorption.
• Promote medication adherence in Parkinson disease.
Medication Safety Focus
Patient Education
, Question 2
Clinical Scenario
A 29-year-old woman with generalized tonic-clonic seizures has
been taking phenytoin for six months. During her follow-up
visit, the nurse observes swollen, bleeding gums. Laboratory
values show a therapeutic serum phenytoin level. The client
reports taking the medication as prescribed.
Question Stem
Which nursing intervention is the priority?
A. Recommend discontinuing phenytoin immediately.
B. Teach meticulous oral hygiene and schedule regular dental
care.
C. Encourage increased dietary sodium intake.
D. Restrict fluid intake to reduce gum swelling.
Correct Answer
Correct Answer: B. Teach meticulous oral hygiene and
schedule regular dental care.
Detailed Rationale
Gingival hyperplasia is a well-known adverse effect of long-term
phenytoin therapy. Because the serum drug level is therapeutic
and there are no signs of toxicity, the priority nursing
