Med Surge II: Exam 4
1. Which assessment finding Upper extremity tremors.
corresponds with the first
stage of Parkinson's dis- --Parkinson's disease (PD) is characterized by five progressive
ease (PD)? stages:
1st stage: Pt presents with unexplained unilateral weakness and
1. Upper extremity upper extremity tremors.
tremors 2nd stage: Slowness of movement & shuffling gait.
2. Muscle rigidity Later stages: Postural instability & increased risk for fall, and muscle
3. Shuffling gait rigidity is more pronounced.
4. Postural instability
P. 804 (Ch. 36)
2. Which finding is used to Presence of tremors and muscular rigidity.
diagnose the presence of
Parkinson's disease (PD)? --There is no specific diagnostic studies for PD.
1. Electroencephalogram --Presence of two or more cardinal symptoms with asymmetrical
(EEG) presentation is considered in the diagnosis of PD.
2. Magnetic resonance
--Diagnosis is made by: Considering progressive decline in motor
imaging (MRI)
function, accompanied by tremors and rigidity.
3. Cerebrospinal fluid (CSF)
testing
**EEG: Diagnosis seizures, tumors, inflammations, and brain injury.
4. Presence of tremors and
muscular rigidity **MRI: Detects masses, cysts, and irregularities in the vessels or
bone of the head.
**Cerebrospinal fluid (CSF): Obtained by lumbar puncture is used
to diagnose headaches, encephalitis, and meningitis.
P. 804 (Ch. 36)
3. Anticholinergics are used Memory impairment.
to reduce tremors and
, Med Surge II: Exam 4
drooling associated with --Side effects of anticholinergics: Confusion & Memory impairment.
Parkinson's disease (PD).
Which side effect of this --Anticholinergics also cause: Urinary retention, and constipation.
drug contraindicates it for
**Side effects of Dopamine-receptor agonists (first-line treatment
older patients?
for PD): N/V, impulse control (gambling and hypersexuality).
1. Memory impairment
P. 804 (Ch. 36)
2. Urinary frequency
3. Nausea and vomiting
4. Disorders of impulse
control
4. Which surgical procedure Stereotactic pallidotomy.
is used to treat the pa-
tient with Parkinson's dis- --Involves the opening of the pallidum within the corpus striatum.
ease (PD)?
--A cylindrical rod or electrode is implanted, allowing the targeted
1. Vagal nerve stimulator area to receive mild electrical stimulation to reduce tremors and the
(VNS) rigidity associated with PD.
2. Stereotactic pallidoto-
**Vagal nerve stimulator (VNS): Used to stimulate vagus nerve (10th
my
cranial nerve) to effectively control seizure activity.
3. Deep brain stimulation
4. Partial corpus callosec-
**Deep brain stimulation: Used to treat uncontrolled seizure activity
tomy
--> Electrodes are placed in deep brain structures and programmed
to activate when a seizure activity is sensed.
P. 805 (Ch. 36).
5. Which describes the role To evaluate the patient's ability to swallow.
of the speech therapist in
terms of care provided for --A swallowing evaluation is completed & suggestions would be
a patient with Parkinson's made to promote safe oral intake.
, Med Surge II: Exam 4
disease? **Occupational therapist: Maximizes independence activities in
daily living (ADLs) and promotes home safety.
1. To maximize indepen-
dence in activities of daily **Physical therapists: Provide exercises and activities that maximize
living (ADLs) strength, flexibility, and movement.
2. To evaluate the patient's
ability to swallow P. 806 (Ch. 36).
3. To provide exercises that
increase strength
4. To promote home safety
6. Which interventions 1, 2, 4, 5
should the nurse imple-
ment for the patient with -Elevate head of bed when eating and drinking. (Due to increased
Parkinson's disease (PD)? risk of aspiration due to swallowing impairment).
Select all that apply.
-Arrange speech therapy for the patient. (Speech therapy will help
1. Elevate head of bed improve the patient's breathing, swallowing, and speech, and iden-
when eating and drinking. tify if assistive devices are needed to assist with communication).
2. Arrange speech therapy
-Teach the patient to call the healthcare provider for medical com-
for the patient.
pliance. (The pt should contact the provider if the effectiveness of
3. Teach the patient to take
medications seems to be declining and dosage adjustments are
long steps while walking.
needed).
4. Teach the patient to call
the healthcare provider for
-Discuss and evaluate the patient's ability to drive. (Due to tremors
medical compliance.
and muscle rigidity, and medications causing sleep deprivation, the
5. Discuss and evaluate the
nurse should discuss if the patient is at risk for driving).
patient's ability to drive.
**The nurse should teach the patient to take short, deliberative
steps, with the feet spread to decrease the risk of falls.
P. 806 (Ch. 36)
, Med Surge II: Exam 4
7. The home healthcare Speak calmly using positive statements.
nurse is caring for
an elderly patient with --As the patient develops memory loss, the patient may require
Alzheimer's disease (AD). frequent reminders to complete an activity. The nurse and other
Which intervention should caregivers should use a calm approach and tone to decrease esca-
the nurse implement for lation of the patient's agitation.
the patient?
**The patient should be provided finger foods.
1. Provide the patient with
**The patient should be busy during the day to encourage sleeping
semi-soft diet.
better at night due to sleep disturbances.
2. Encourage the patient to
take an afternoon nap.
**The patient should follow a regular routine every day.
3. Provide the patient with
a different schedule every P. 809 (Ch. 36)
day.
4. Speak calmly using posi-
tive statements.
8. Which confirms the diag- Examination of the brain following death.
nosis of Alzheimer's dis-
ease (AD)? --Neurofibrillary tangles and beta-amyloid plaques can be ob-
served microscopically.
1. Neuropsychiatric test-
ing **Neuropsychiatric testing: Used to rule out depression and delir-
2. Written and oral testing ium.
3. Examination of the brain
**Written and oral testing: Assesses the patient's cognitive func-
following death
tions, such as mental status, language ability, functional ability,
4. Examination of cere-
memory, and concentration.
brospinal fluid
**Examine cerebrospinal fluid: Tested to diagnose meningitis &
encephalitis.
1. Which assessment finding Upper extremity tremors.
corresponds with the first
stage of Parkinson's dis- --Parkinson's disease (PD) is characterized by five progressive
ease (PD)? stages:
1st stage: Pt presents with unexplained unilateral weakness and
1. Upper extremity upper extremity tremors.
tremors 2nd stage: Slowness of movement & shuffling gait.
2. Muscle rigidity Later stages: Postural instability & increased risk for fall, and muscle
3. Shuffling gait rigidity is more pronounced.
4. Postural instability
P. 804 (Ch. 36)
2. Which finding is used to Presence of tremors and muscular rigidity.
diagnose the presence of
Parkinson's disease (PD)? --There is no specific diagnostic studies for PD.
1. Electroencephalogram --Presence of two or more cardinal symptoms with asymmetrical
(EEG) presentation is considered in the diagnosis of PD.
2. Magnetic resonance
--Diagnosis is made by: Considering progressive decline in motor
imaging (MRI)
function, accompanied by tremors and rigidity.
3. Cerebrospinal fluid (CSF)
testing
**EEG: Diagnosis seizures, tumors, inflammations, and brain injury.
4. Presence of tremors and
muscular rigidity **MRI: Detects masses, cysts, and irregularities in the vessels or
bone of the head.
**Cerebrospinal fluid (CSF): Obtained by lumbar puncture is used
to diagnose headaches, encephalitis, and meningitis.
P. 804 (Ch. 36)
3. Anticholinergics are used Memory impairment.
to reduce tremors and
, Med Surge II: Exam 4
drooling associated with --Side effects of anticholinergics: Confusion & Memory impairment.
Parkinson's disease (PD).
Which side effect of this --Anticholinergics also cause: Urinary retention, and constipation.
drug contraindicates it for
**Side effects of Dopamine-receptor agonists (first-line treatment
older patients?
for PD): N/V, impulse control (gambling and hypersexuality).
1. Memory impairment
P. 804 (Ch. 36)
2. Urinary frequency
3. Nausea and vomiting
4. Disorders of impulse
control
4. Which surgical procedure Stereotactic pallidotomy.
is used to treat the pa-
tient with Parkinson's dis- --Involves the opening of the pallidum within the corpus striatum.
ease (PD)?
--A cylindrical rod or electrode is implanted, allowing the targeted
1. Vagal nerve stimulator area to receive mild electrical stimulation to reduce tremors and the
(VNS) rigidity associated with PD.
2. Stereotactic pallidoto-
**Vagal nerve stimulator (VNS): Used to stimulate vagus nerve (10th
my
cranial nerve) to effectively control seizure activity.
3. Deep brain stimulation
4. Partial corpus callosec-
**Deep brain stimulation: Used to treat uncontrolled seizure activity
tomy
--> Electrodes are placed in deep brain structures and programmed
to activate when a seizure activity is sensed.
P. 805 (Ch. 36).
5. Which describes the role To evaluate the patient's ability to swallow.
of the speech therapist in
terms of care provided for --A swallowing evaluation is completed & suggestions would be
a patient with Parkinson's made to promote safe oral intake.
, Med Surge II: Exam 4
disease? **Occupational therapist: Maximizes independence activities in
daily living (ADLs) and promotes home safety.
1. To maximize indepen-
dence in activities of daily **Physical therapists: Provide exercises and activities that maximize
living (ADLs) strength, flexibility, and movement.
2. To evaluate the patient's
ability to swallow P. 806 (Ch. 36).
3. To provide exercises that
increase strength
4. To promote home safety
6. Which interventions 1, 2, 4, 5
should the nurse imple-
ment for the patient with -Elevate head of bed when eating and drinking. (Due to increased
Parkinson's disease (PD)? risk of aspiration due to swallowing impairment).
Select all that apply.
-Arrange speech therapy for the patient. (Speech therapy will help
1. Elevate head of bed improve the patient's breathing, swallowing, and speech, and iden-
when eating and drinking. tify if assistive devices are needed to assist with communication).
2. Arrange speech therapy
-Teach the patient to call the healthcare provider for medical com-
for the patient.
pliance. (The pt should contact the provider if the effectiveness of
3. Teach the patient to take
medications seems to be declining and dosage adjustments are
long steps while walking.
needed).
4. Teach the patient to call
the healthcare provider for
-Discuss and evaluate the patient's ability to drive. (Due to tremors
medical compliance.
and muscle rigidity, and medications causing sleep deprivation, the
5. Discuss and evaluate the
nurse should discuss if the patient is at risk for driving).
patient's ability to drive.
**The nurse should teach the patient to take short, deliberative
steps, with the feet spread to decrease the risk of falls.
P. 806 (Ch. 36)
, Med Surge II: Exam 4
7. The home healthcare Speak calmly using positive statements.
nurse is caring for
an elderly patient with --As the patient develops memory loss, the patient may require
Alzheimer's disease (AD). frequent reminders to complete an activity. The nurse and other
Which intervention should caregivers should use a calm approach and tone to decrease esca-
the nurse implement for lation of the patient's agitation.
the patient?
**The patient should be provided finger foods.
1. Provide the patient with
**The patient should be busy during the day to encourage sleeping
semi-soft diet.
better at night due to sleep disturbances.
2. Encourage the patient to
take an afternoon nap.
**The patient should follow a regular routine every day.
3. Provide the patient with
a different schedule every P. 809 (Ch. 36)
day.
4. Speak calmly using posi-
tive statements.
8. Which confirms the diag- Examination of the brain following death.
nosis of Alzheimer's dis-
ease (AD)? --Neurofibrillary tangles and beta-amyloid plaques can be ob-
served microscopically.
1. Neuropsychiatric test-
ing **Neuropsychiatric testing: Used to rule out depression and delir-
2. Written and oral testing ium.
3. Examination of the brain
**Written and oral testing: Assesses the patient's cognitive func-
following death
tions, such as mental status, language ability, functional ability,
4. Examination of cere-
memory, and concentration.
brospinal fluid
**Examine cerebrospinal fluid: Tested to diagnose meningitis &
encephalitis.
