Chapter 30-Parkinsons

Question 1

When assessing a client’s knowledge about Parkinson’s disease, the nurse recognizes more teaching is needed when the client comments:

Answer 1

“I inherited Parkinson’s from my parents.”

**the correct answer is: At the present time, heredity is not considered a predisposing factor.

Question 2

Home care client teaching for clients receiving levodopa should include which of the following?

Answer 2

Use caution and rise slowly from a bed or chair.

Question 3

When developing a care plan for a client with Parkinson’s disease, the nurse would identify which of the following nursing diagnoses as the highest priority?

Answer 3

risk for injury and falls related to lack of coordination in movements

Question 4

A client receiving carbidopa/levodopa would be monitored for:

Answer 4

nausea, vomiting, and orthostatic hypotension.

Question 5

The nurse understands that apomorphine HCl is sometimes used for clients with Parkinson’s disease:

Answer 5

as a rapid “rescue” from a “frozen” state.

It is very effective in treating a frozen state caused by undermedication.

Question 6

When teaching a client prescribed tolcapone, the nurse should instruct the client that the client:

Answer 6

will need to have liver function tests monitored every 2 weeks for the first year of therapy.
Because of the risk for liver failure, this action is necessary.

Question 7

The client with Parkinson’s disease who is prescribed carbidopa to be used in combination with levodopa asks the nurse why this has been prescribed. The nurse’s best response would be:

Answer 7

“The carbidopa prevents levodopa breakdown, so you’ll need less levodopa.”

This is the action of carbidopa in the combination product.

Question 8

Carbidopa can best be classified as a(n):

Answer 8

decarboxylase inhibitor.

Question 9

After being diagnosed with Parkinson’s disease, which of the following responses made to the nurse by the client would indicate a basic understanding of Parkinson’s disease?

Answer 9

“I have too much acetylcholine in my brain.”

Question 10

When teaching clients taking levodopa alone, the nurse should instruct them not to take vitamin supplements containing:

Answer 10

pyridoxine (B6)- Pyridoxine facilitates the breakdown of levodopa, decreasing its effects.

Question 11

In administering oral medications to a client with Parkinson’s disease, the nurse:

Answer 11

is careful not to rush the client.-Because difficulty swallowing is a manifestation of Parkinson’s disease, rushing the client would increase the risk of choking and aspiration.

Question 12

The therapeutic effectiveness of antiparkinson drugs can be assessed through observations regarding:

Answer 12

the ability to ambulate, speak, and provide self-care.

Question 13

When a client is to begin taking carbidopa/levodopa after having been on levodopa alone, the nurse should advise the client to:

Answer 13

discontinue levodopa at least 8 hours before carbidopa/levodopa therapy begins.

Question 14

A client asks the nurse if his medications for Parkinson’s disease will cure his disease. The nurse’s best response would be:

Answer 14

“No, at this time there is no cure for the disease, but these medications can manage the symptoms.”

Question 15

A client is prescribed carbidopa/levodopa in the form of Sinemet 10/100. The nurse explains to the client that this indicates what dosage of this medication?

Answer 15

10 mg of carbidopa and 100 mg of levodopa

Question 16

A client is prescribed a monoamine oxidase inhibitor for the treatment of his Parkinson’s disease. The nurse anticipates that this drug is:

Answer 16

-Selegiline inhibits monoamine oxidase.

Question 17

A client is prescribed benztropine mesylate for treatment of her Parkinson’s symptoms. The nurse understands this agent is:

Answer 17

an anticholinergic agent.-Benztropine mesylate is an anticholinergic agent.

Question 18

The nurse should offer the client taking benztropine mesylate which suggestion to cope with the adverse effects of this agent?

Answer 18

“Sucking on sugar-free hard candy and increasing your fluid intake will help decrease the dry mouth associated with this drug.
This drug is an anticholinergic that causes dry mouth. These suggestions will decrease this adverse effect.

Question 19

Newer treatments for Parkinson’s disease include the use of antioxidants such as:

Answer 19

vitamin E-Research is testing the use of low-protein diets and vitamin E for treatment.

Question 20

The nurse understands that most adverse effects associated with levodopa are related to:

Answer 20

the large doses required for therapy-The large doses necessary for effective treatment cause the adverse effects.

Question 21

When assessing a client diagnosed with Parkinson’s disease for evidence of inadequate drug management of the disease, the nurse anticipates the client will exhibit which of the following manifestations?

Answer 21

shuffling unsteady gait- A shuffling gait and lack of coordination leading to an unsteady gait are common manifestations of Parkinson’s and would indicate inadequate management.

Question 22

A client is prescribed apomorphine. The nurse prepares to administer this medication via what route?

Answer 22

Subcutaneous -administration provides effects within 4 to 8 minutes.

Question 23

When preparing to administer apomorphine, the nurse collects appropriate equipment consisting of:

Answer 23

a 25-gauge 5/8-inch needle on a 1 mL syringe.-is administered SC. This is appropriate equipment.

Question 24

When caring for the client with Parkinson’s disease, the nurse’s assessment of the client is influenced by an understanding that these clients:

Answer 24

usually develop additional health problems.

Some of the health problems are disease-related, some drug-therapy-related.

Question 25

Many clients with Parkinson’s disease experience negative feelings about how they appear, because of the manifestations of this disease. An appropriate goal for these clients would be:

Answer 25

client will verbalize positive feelings about body image.

The manifestations frequently cause a disturbed body image, and this is the best goal for this problem.

Question 26

Which of the following statements is NOT true concerning the use of Parlodel as part of a treatment regimen for Parkinson’s disease?

Answer 26

It is useful, but the maintenance dose of levodopa must be increased even in combination products.
-Parlodel may allow for a reduction in the maintenance dose of levodopa even in the combination products.

Question 27

The instructor questions the nurse recruit about the new prescription order for her client. The medication is ropinirole HCl, and the nurse recruit would be correct making all of the following statements EXCEPT:

Answer 27

Ropinirole HCl should be discontinued immediately if adverse effects are noted.”

Question 28

The nurse working with clients diagnosed with Parkinson’s disease should do which of the following? Select all that apply.

Answer 28

b. Encourage clients to provide as much self-care as possible.
c. Encourage clients to remain active.
d. Instruct clients to drink at least 8 glasses of water a day.
e. Encourage clients not to rush when taking their oral medications

Question 29

A client receiving trihexyphenidyl HCl should be monitored for which of the following? Select all that apply.

Answer 29

urinary retention and constipation-These are adverse effects of anticholinergic agents.

Question 30

A client is prescribed bromocriptine mesylate and should be monitored for which of the following? Select all that apply.

Answer 30

hallucinations
psychiatric symptoms
abnormal movements
Bromocriptine can cause hallucinations and psychiatric changes, and abnormal movements.