Lecture 2 olympics

Question 1

a patient who is newly diagnosed with Parkinson disease is prescribed levodopa. The patient asks the nurse about drugs to prevent disease progression. What will the nurse tell this patient.

Answer 1

“While some drugs show promise, there are no studies that have proven a neuroprotective effect”

Question 2

A hospitalized patient with parkinson disease who is receiving apomorphine to treat “off” episodes develops nausea and vomiting. The nurse will discuss the use of which medication with the patient’s provider?

Answer 2

Trimethobenzamide

Question 3

What point should be included when teaching a patient about the use of apomorphine for treatment of Parkinson’s disease

Answer 3

-Apomorphine does not have any opioid activity
-A multidose injector pen is commonly used to administer apomorphine.
- You may experience nausea and vomiting, which can be treated with trimethobenzamide
-you may experience sleep attacks or episodes of daytime sleepiness

Question 4

A patient has taken levodopa for parkinson. disease for 2 weeks but reports no improvement in the symptoms. Which response by the nurse is correct?

Answer 4

“It may take several months for a response to occur’

Question 5

What is the pharmacologic action of entacapone, a potent catechol O methyl transferase (COMT) inhibitor?

Answer 5

Reduces the destruction of dopamine in peripheral tissues

Question 6

A patient with Parkinson disease is taking levodopa/carbidopa and reports occasional periods of loss of drug effect lasting from minutes to several hours. The nurse questions the patient further and discovers that these episodes occur at different times related to the medication administration.The nurse will contact the provider to discuss :

Answer 6

administering a catechol-O-methyltransferase (COMT) inhibitor, such as entacapone

Question 7

Which neurotransmitter has an inhibitory action within the central nervous system?

Answer 7

Gamma-aminobutyric acid

Question 8

The nurse is providing information to a patient recently prescribed entacapone. Which statement is correct ?

Answer 8

Dosage is adjusted according to the patient’s response

Question 9

The nurse is assessing an older patient with Parkinson’s disease who was startedon entacapone 1 week ago. The patient has a history of coronary artery disease and takes an antihypertensive and aspirin. Which information would support the need for a reduction in medication dosage by the health care provider?

Answer 9

dizziness

Question 10

Which symptoms in a patient taking levodopa for Parkinson disease indicate the drug is “wearing off”

Answer 10

-difficulty swallowing
-increased tremors
-slower gait

Question 11

A nurse provides teaching for a patient who is newly diagnosed with Parkinson disease. Which statement by the patient indicates understanding of the drug therapy for this disease ?

Answer 11

“A levodopa/carbidopa combination is used to improve motor function”

Question 12

A nursing student wants to know how carbidopa can be effective for treating Parkinson disease if it prevents the conversion of levodopa to dopamine. the nurse explains that carbidopa:

Answer 12

does not cross the blood-brain barrier

Question 13

A patient newly diagnosed with Parkinson disease is prescribed an oral dopamine agonist. Which precaution is most important to teach the patient and family about the timing for taking this drug?

Answer 13

“Take the drug 30 to 60 min before meals on an empty stomach”

Question 14

The nurse provides teaching for a patient who will begin taking rotigotine to treat Parkinson disease. What will the nurse include in teaching?

Answer 14

“if you need to stop this drug, your provider will order a gradual withdrawal”

Question 15

A patient has been diagnosed with Parkinson disease and begins treatment with levodopa/carbidopa. After several monthsof therapy, the patient reports no change in symptoms. The nurse will expect the provider to:

Answer 15

re-evaluate the diagnosis

Question 16

A patient who has begun taking levodopa/carbidopa reports feeling lightheaded and dizzy, especially when standing up from a sitting position. What will the nurse recommend?

Answer 16

Increasing salt and water intake

Question 17

Which adverse effects associated with levodopa therapy would support thee nursing diagnosis Risk for injury ?

Answer 17

Orthostatic hypotension

Question 18

A nurse is discussing motor symptoms with a patient with Parkinson disease who has been taking levodopa/carbidopa for 9 months and who is now having regular tics. Which statement by the patient indicates understanding of this symptom?

Answer 18

” I may need to try a lower dose of Sinemet to reduce my tics”

Question 19

A patient newly diagnosed with Parkinson disease has been taking levodopa/carbidopa for several weeks and complains of nausea and vomitting. The nurse tells the patient to discuss what with the provider?

Answer 19

Taking a lower dose with a low-protein snack

Question 20

A nursing student. wants to know why a patient who has been taking levodopa for years will now receive levodopa/carbidopa. The nurse explains the reasons that levodopa as a single agent is no longer available. Which statement by the student indicates a need for further education?

Answer 20

“Combination products cause fewer dyskiniesias and decreased psychosis

Question 20

Why are carbidopa and levodopa usually given together?

Answer 20

Carbidopa enhances the action of levodopa, and less drug is needed

Question 21

How does the drug tolcapone relieve symptoms of Parkinson disease

Answer 21

Suppresses the activity of an enzyme that normally breaks down naturally occurring dopamine

Question 22

A patient with Parkinson disease is taking levodopa/carbidopa along with amantadine 400 mg/day to treat dyskinesias. The patient reports having increased dyskinesias several months after beginning the amantadine. The nurse will contact the provider to discuss which action?

Answer 22

Interrupting treatment with amantadine for several weeks

Question 22

The nurse is teaching a patient with Parkinson’s disease about levodopa. Which statement by the nurse is accurate regarding drug administration?

Answer 22

“take this medication with food or antacids to reduce GI upset”

Question 23

The nurse is preparing to begin administration of apomorphine to a patient. Before administering, the nurse will perform a baseline assessment of the patient’s :

Answer 23

-mobility
-orientation
-alertness
-vital signs

Question 24

When assessing a patient with Parkinson disease who takes a carbidopa/levodopa combination drug, you find that he now has almost constant muscle movements that look like uncoordinated dancing. What is your best action ?

Answer 24

Hold the next drug dose and report the finding to the healthcare provider.

Question 25

A nurse is teaching a group of nurses about Parkinson medications. The nurse is correct to state that one side effect associated with pramipexole that is less likely to occur with other dopamine agonists is :

Answer 25

sleep attacks

Question 26

Parkinson’s disease has which characteristic symptoms :

Answer 26

-muscle tremors
-posture alterations
-slow body movement

Question 27

What is the rationale for administering levodopa instead of dopamine for treatment of Parkinson’s disease ?

Answer 27

Dopamine does not cross the blood-brain barrier when administered orally

Question 28

A patient with Parkinson disease is taking levodopa/carbidopa. The prescriber orders bromocriptine to treat dyskinesias. The nurse notes that the patient is agitated, and the patient reports having frequent nightmares. The nurse will contact the provider to discuss

Answer 28

reducing the dose of bromocriptine

Question 29

Which cholinergic symptoms of Parkinson’s disease are reduced with anticholinergic drugs

Answer 29

tremors and drooling

Question 30

Dopamine agonists have been linked with which adverse effects in patients with Parkinson’s disease

Answer 30

Sudden sleep events

Question 31

A patient taking rasagiline is assessed by the nurse to have a lasting significant increase in blood pressure. When reviewing the patient’s current list of medications, the nurse decides to hold the next dose of :

Answer 31

ciprofloxacin

Question 32

When a patient taking a monoamine oxidase B inhibitor receives his dietary tray, the nurse knows to remove the :

Answer 32

cheese

Question 33

The nurse is providing education to a patient recently placed on selegiline disintegrating tablets. Which statement by the patient indicates a need for further teaching ?

Answer 33

“I will place the tablet on my tongue before breakfast”

Question 34

Which vitamin will reduce the therapeutic effects of levodopa?

Answer 34

B6