The Nervous System Degenerative Diseases

Question 1

A patient taking donepezil for Alzheimer disease is accompanied by a caregiver for a follow-up examination.

For which caregiver statement should the nurse contact the healthcare provider?
a) “It’s getting harder to complete dressing and bathing.”
b) “The amount of sweating is increasing.”
c) “Drooling occurs for no reason.”
d) “Waking up with nightmares happens almost every night.”

Answer 1

a) “It’s getting harder to complete dressing and bathing.”

Question 2

The nurse is discussing medication therapy used to treat Parkinson disease (PD).

Which statement should the nurse include in the explanation of the use of levodopa in the treatment of this disease?
a) “It decreases the level of dopamine in the brain.”
b) “The effects are seen almost immediately.”
c) “It is a precursor in the synthesis of dopamine.”
d) “It decreases the level of acetylcholine in the brain.”

Answer 2

c) “It is a precursor in the synthesis of dopamine.”

Question 3

A patient with long-term Parkinson disease is prescribed benztropine.

For which adverse effect should the nurse monitor this patient?
a) Diarrhea
b) Dry mouth
c) Diaphoresis
d) Lethargy

Answer 3

b) Dry mouth

Question 4

The nurse teaches the family of a patient with Parkinson disease about symptoms.

Which should the nurse instruct about bradykinesia?
a) t results in stooped posture and poor balance.
b) It results in a lack of facial expression.
c) It is characterized by rubbing the forefinger and thumb together in a circular motion.
d) It is the most noticeable symptom of the disease.

Answer 4

d) It is the most noticeable symptom of the disease.

Question 5

A patient is diagnosed with Alzheimer disease.

For which reason should the nurse assess the patient’s cognitive functioning?
a) Obtain a baseline before beginning medication therapy
b) Determine if the symptoms are age-related changes
c) Determine which medication may be prescribed to treat the symptoms
d) Determine if any family members are at risk for developing the disease

Answer 5

a) Obtain a baseline before beginning medication therapy

Question 6

The spouse of a patient with Alzheimer disease asks how the prescribed cholinesterase inhibitor helps with the symptoms.

Which statement should the nurse include in the teaching session?
a) “The medication will cure the disease.”
b) “The medication will help with tremors of the hands.”
c) “The medication will not cure the disease but may slow progression of memory loss.”
d) “The medication will improve the ability to ambulate.”

Answer 6

c) “The medication will not cure the disease but may slow progression of memory loss.”

Question 7

The nurse explains the involuntary muscle movements in Parkinson disease.

Which neurotransmitter should the nurse explain balances the effects of dopamine in the brain?
a) Serotonin
b) Acetylcholine
c) Dopamine
d) Glutamate

Answer 7

b) Acetylcholine

Question 8

A patient with Parkinson disease stopped taking the levodopa/carbidopa medication because symptoms were not improving.

For which health problem should the nurse assess this patient?
a) On-off syndrome
b) Facial paralysis
c) Severe bradycardia
d) Neuroleptic malignant syndrome

Answer 8

d) Neuroleptic malignant syndrome

Question 9

A caregiver reports that a patient with Parkinson disease is demonstrating paranoid behavior.

Which response should the nurse make?
a) “This should be reported to the healthcare provider because the medication can cause paranoia.”
b) “Maybe the medication dose is too high.”
c) “Stop the medication until the next healthcare provider appointment.”
d) “Increase the number of doses of medication each day.”

Answer 9

a) “This should be reported to the healthcare provider because the medication can cause paranoia.”

Question 10

The nurse instructs the family of a patient with Parkinson disease about prescribed medication.

For which reason should the family be directed to report any new muscle twitching or increase in tremors?
a) The medication dose may be too high.
b) The medication might not be taken as prescribed.
c) The patient may be experiencing a wearing-off effect.
d) The patient may be taking a medication that is adversely effecting this medication.

Answer 10

c) The patient may be experiencing a wearing-off effect.

Question 11

A patient taking medication for Parkinson disease reports constipation and dry mouth.

Which medication should the nurse suspect is causing these effects?
a) Alemtuzumab (Lemtrada)
b) Benztropine (Cogentin)
c) Fingolimod (Gilenya)
d) Dalfampridine (Ampyra)

Answer 11

b) Benztropine (Cogentin)

Question 12

An older patient with Parkinson disease reports that the prescribed medication is not effectively controlling symptoms.

Which information should the nurse include when responding to the patient’s concern?
a) “The medication can be immediately discontinued, and the healthcare provider will be alerted.”
b) “When the drug serum level is low, the drug may stop working.”
c) “The medication will offer a cure if taken as prescribed over the ordered duration.”
d) “Experiencing periodic issues with effectiveness is not abnormal and can be addressed.”

Answer 12

d) “Experiencing periodic issues with effectiveness is not abnormal and can be addressed.”

Question 13

A patient asks why the medication levodopa is not controlling the symptoms of Parkinson disease.

Which statement should the nurse include in this discussion?
a) “It often takes several months to achieve the desired results.”
b) “You should have seen results in less than a week if it was taken as prescribed.”
c) “You will see optimum effects from the drug in long-term use.”
d) “The healthcare provider may just prescribe carbidopa as an alternative.”

Answer 13

a) “It often takes several months to achieve the desired results.”

Question 14

The nurse assesses a patient with Alzheimer disease.

Which family member statement about the patient should indicate the need for teaching about the disease process?
a) “We should call the healthcare provider if the incidents of forgetfulness increase.”
b) “We should journal changes in mood over the next 2 weeks.”
c) “He’s just forgetful, and that’s normal, isn’t it?”
Unselected
d) “He is getting older, but drastic changes should be reported.”

Answer 14

c) “He’s just forgetful, and that’s normal, isn’t it?”
Unselected

Question 15

The family of a patient with Parkinson disease asks if the newly prescribed medications will cure the disease.

Which information should the nurse include in the response?
a) “The medication will not cure the disease, but it will help to improve memory.”
b) “The medication will not cure the disease, but it will increase the ability to perform activities such as eating, walking, and bathing.”
c) “The medication will cure the disease by enabling the regrowth of neurons that produce dopamine.”
d) “The medication will cure the disease by enabling the regrowth of neurons that produce acetylcholine.”

Answer 15

b) “The medication will not cure the disease, but it will increase the ability to perform activities such as eating, walking, and bathing.”

Question 16

The nurse is discussing the pathophysiology of Alzheimer disease (AD).

Which neurotransmitter imbalance should the nurse explain occurs in this disease?
a) Excess of serotonin
b) Excess of norepinephrine
c) Excess of dopamine
d) Deficiency of acetylcholine

Answer 16

d) Deficiency of acetylcholine

Question 17

During a home visit, the nurse assesses a patient who is receiving pharmacotherapy for Parkinson disease.

For which anticipated therapeutic effect should the nurse observe?
a) Decreased tremors or rigidity
b) Increased daytime sleeping
c) Maintaining a balanced diet
d) Decreased medication dosage

Answer 17

a) Decreased tremors or rigidity

Question 18

The nurse reviews the pathophysiology of Parkinson disease.

Which neurotransmitter should the nurse identify as responsible for slowing nerve impulses through the spinal neurons in this disease process?
a) Acetylcholine
b) Adrenaline
c) Dopamine
d) Serotonin

Answer 18

c) Dopamine

Question 19

The nurse instructs the family of a patient with Alzheimer disease about donepezil.

Which family member statement should indicate that further teaching is needed?
a) “The symptoms should stop or slightly improve.”
b) “We’re glad there is a medication to stop the dementia.”
c) “We will give the medication orally as ordered.”
d) “We will give the medication once a day.”

Answer 19

b) “We’re glad there is a medication to stop the dementia.”

Question 20

A patient with Parkinson disease is taking the maximum dose of levodopa.

For which reason should the nurse expect pramipexole to be prescribed?
a) It has limited side effects.
b) It causes minimal incidences of orthostatic hypotension.
c) It is not associated with agranulocytosis.
d) It improves the motor symptoms of Parkinson disease.

Answer 20

d) It improves the motor symptoms of Parkinson disease.

Question 21

The patient with multiple sclerosis (MS) is having ongoing symptoms despite medication therapy.

Which should the nurse anticipate being prescribed for this patient?
a) Immune modulating drugs
b) Corticosteroids
c) Memory training
d) Diet therapy

Answer 21

a) Immune modulating drugs

Question 22

A patient is diagnosed with Parkinson disease.

For which reason should the nurse expect the patient to be prescribed carbidopa in addition to levodopa?
a) It decreases the plasma level and half-life of levodopa.
b) It has many therapeutic effects on its own.
c) It inhibits the breakdown and increases the effectiveness of levodopa.
d) It aids in the breakdown of levodopa in the intestines.

Answer 22

c) It inhibits the breakdown and increases the effectiveness of levodopa.

Question 23

The nurse assesses a patient with Parkinson disease.

Which symptom should the nurse expect to observe?
a) Loss of short-term memory
b) Bradykinesia
c) Inability to think effectively
d) Tardive dyskinesia

Answer 23

b) Bradykinesia

Question 24

The family of a patient newly diagnosed with Alzheimer disease is concerned about the sudden onset of symptoms.

Which information should the nurse provide to the family?
a) “The course of Alzheimer disease is short term and will progress quickly.”
b) “You can expect to see a gradual loss of long-term memory.”
c) “You can expect to see more physical signs than mental signs as the disease progresses.”
d) “Alzheimer disease begins with very subtle signs and is often difficult to diagnose in early stages.”

Answer 24

d) “Alzheimer disease begins with very subtle signs and is often difficult to diagnose in early stages.”

Question 25

The nurse teaches a patient with Parkinson disease to dangle the legs on the side of the bed before standing.

Which potential problem should this intervention help resolve?
a) Orthostatic hypotension
b) Extreme muscle cramps
c) Altered depth perception
d) Periods of paralysis

Answer 25

a) Orthostatic hypotension

Question 26

The nurse is meeting with the family of a patient with Alzheimer disease.

For which statement should the nurse initiate a referral for family support?
a) “It’s challenging to give the night-time dose of the medication.”
b) “Sleeping in until 11 am is a daily occurrence.”
c) “We are up all night because of the constant wandering.”
d) “Watching television until 3 am is not unusual.”

Answer 26

c) “We are up all night because of the constant wandering.”

Question 27

Which of the following is NOT a neurodegenerative disorder?
1. Parkinson’s disease
2. Alzheimer’s dementia
3. Cerebrovascular accident (CVA)
4. Multiple sclerosis

Answer 27

3. Cerebrovascular accident (CVA)

Question 28

Which neurotransmitter is associated with Parkinson’s disease?
1. Acetylcholine
2. Dopamine
3. Norepinephrine
4. Serotonin

Answer 28

2. Dopamine