HESI Case Studies--Medical/Surgical-
Parkinson's (Leo White) Practice Test
Questions and Answers 2025-2026 latest
update.
1. Which statement explains the mechanisms of action of Sinemet in the treatment
of Parkinson's disease?
A. Sinemet counteracts the neurotransmitter acetylcholine and restores the natural
balance of neurotransmitters in the CNS.
B. Sinemet inhibits dopamine breakdown, leading to increased amounts of
dopamine available in the CNS.
C. Sinemet causes a release of dopamine from neuronal storage sites and blocks re-
uptake of dopamine.
D. Sinemet is converted to dopamine and provides an exogenous form of dopamine
replacement. - n
Ans✔
D. Sinemet is converted to dopamine and provides an exogenous form of dopamine
replacement
Rationale: Sinemet, a combination of levodopa and carbidopa, provides an
exogenous source of dopamine to the CNS. Levodopa crosses the blood-brain
barrier and is converted to dopamine. Carbidopa does not cross the blood-brain
barrier. Its role is to prevent the breakdown of levodopa in the periphery, allowing
more levodopa to cross the blood-brain barrier. This in turn allows lower doses of
levodopa to be used and reduces the risk of side effects such as nausea and
vomiting.
Qs
Nancy calls the healthcare provider's office and reports to the nurse that Leo has
started seeing and talking to people that have been dead for many years. In
,addition, he has developed jerky movements of his head and has begun smacking
his lips.
2. How should the nurse respond?
A. Suggest that Nancy contact a psychiatrist as soon as possible.
B. Advise Nancy to administer an extra dose of levodopa.
C. Explain that this is normal behavior as the disease progresses.
D. Instruct Nancy to bring Leo to the healthcare provider's office now. - n
Ans✔
D. Instruct Nancy to bring Leo to the healthcare provider's office now
Rationale: Hallucinations, delusions, and tardive dyskinesia are adverse effects of
long-term levodopa therapy. Therefore, Leo needs to be assessed by the healthcare
provider.
Qs
Nancy brings Leo to the healthcare provider's office. After assessing Leo, the
healthcare provider informs Nancy that Leo is going to get progressively worse.
Nancy starts crying and tells the healthcare provider she just can't keep caring for
Leo by herself. The healthcare provider writes a referral for home health care.
During the initial visit with the home health nurse, Nancy expresses frustration,
stating that it is getting harder for her to understand what Leo is saying, although
he can still communicate if she gives him enough time. In addition, the nurse
observes that Leo has a shuffling gait and has difficulty getting out of the chair.
3. In planning care, which nursing diagnosis is the priority?
A. Ineffective coping related to depression and dysfunction due to disease process.
, B. Impaired verbal communication related to limited ability to move facial muscles.
C. Impaired physical mobility related to - n
Ans✔
C. Impaired physical mobility related to muscle rigidity and motor weakness
Rationale: Impaired physical mobility is a priority since it impacts every aspect of
Leo's ability to function safely, and it places him at risk for numerous complications
of immobility.
Qs
Leo tells the nurse that he is starting to have difficulty eating and chokes when
swallowing food.
4. How should the nurse respond?
A. Instruct Leo to chew more slowly to help prevent choking.
B. Encourage Nancy to provide a soft diet with mainly thick liquids.
C. Advise Leo to sit in a semi-Fowler's position when eating meals.
D. Explain the importance of drinking water prior to all meals. - n
Ans✔
B. Encourage Nancy to provide a soft diet with mainly thick liquids
Rationale: Swallowing disorders can be due to poor head control, tongue tremor, or
difficulty shaping food in the mouth. A soft diet with thickened liquids is easier to
swallow.
Parkinson's (Leo White) Practice Test
Questions and Answers 2025-2026 latest
update.
1. Which statement explains the mechanisms of action of Sinemet in the treatment
of Parkinson's disease?
A. Sinemet counteracts the neurotransmitter acetylcholine and restores the natural
balance of neurotransmitters in the CNS.
B. Sinemet inhibits dopamine breakdown, leading to increased amounts of
dopamine available in the CNS.
C. Sinemet causes a release of dopamine from neuronal storage sites and blocks re-
uptake of dopamine.
D. Sinemet is converted to dopamine and provides an exogenous form of dopamine
replacement. - n
Ans✔
D. Sinemet is converted to dopamine and provides an exogenous form of dopamine
replacement
Rationale: Sinemet, a combination of levodopa and carbidopa, provides an
exogenous source of dopamine to the CNS. Levodopa crosses the blood-brain
barrier and is converted to dopamine. Carbidopa does not cross the blood-brain
barrier. Its role is to prevent the breakdown of levodopa in the periphery, allowing
more levodopa to cross the blood-brain barrier. This in turn allows lower doses of
levodopa to be used and reduces the risk of side effects such as nausea and
vomiting.
Qs
Nancy calls the healthcare provider's office and reports to the nurse that Leo has
started seeing and talking to people that have been dead for many years. In
,addition, he has developed jerky movements of his head and has begun smacking
his lips.
2. How should the nurse respond?
A. Suggest that Nancy contact a psychiatrist as soon as possible.
B. Advise Nancy to administer an extra dose of levodopa.
C. Explain that this is normal behavior as the disease progresses.
D. Instruct Nancy to bring Leo to the healthcare provider's office now. - n
Ans✔
D. Instruct Nancy to bring Leo to the healthcare provider's office now
Rationale: Hallucinations, delusions, and tardive dyskinesia are adverse effects of
long-term levodopa therapy. Therefore, Leo needs to be assessed by the healthcare
provider.
Qs
Nancy brings Leo to the healthcare provider's office. After assessing Leo, the
healthcare provider informs Nancy that Leo is going to get progressively worse.
Nancy starts crying and tells the healthcare provider she just can't keep caring for
Leo by herself. The healthcare provider writes a referral for home health care.
During the initial visit with the home health nurse, Nancy expresses frustration,
stating that it is getting harder for her to understand what Leo is saying, although
he can still communicate if she gives him enough time. In addition, the nurse
observes that Leo has a shuffling gait and has difficulty getting out of the chair.
3. In planning care, which nursing diagnosis is the priority?
A. Ineffective coping related to depression and dysfunction due to disease process.
, B. Impaired verbal communication related to limited ability to move facial muscles.
C. Impaired physical mobility related to - n
Ans✔
C. Impaired physical mobility related to muscle rigidity and motor weakness
Rationale: Impaired physical mobility is a priority since it impacts every aspect of
Leo's ability to function safely, and it places him at risk for numerous complications
of immobility.
Qs
Leo tells the nurse that he is starting to have difficulty eating and chokes when
swallowing food.
4. How should the nurse respond?
A. Instruct Leo to chew more slowly to help prevent choking.
B. Encourage Nancy to provide a soft diet with mainly thick liquids.
C. Advise Leo to sit in a semi-Fowler's position when eating meals.
D. Explain the importance of drinking water prior to all meals. - n
Ans✔
B. Encourage Nancy to provide a soft diet with mainly thick liquids
Rationale: Swallowing disorders can be due to poor head control, tongue tremor, or
difficulty shaping food in the mouth. A soft diet with thickened liquids is easier to
swallow.
