Deck 13: Antiparkinsonian Drugs

Question 1

An older adult patient who takes trihexyphenidyl begins taking diphenhydramine (Benadryl) for cold symptoms.The nurse should carefully monitor this patient for what possible anticholinergic effect?

A) Polyuria
B) Tachycardia
C) Constipation
D) Hypothermia

Answer 1

Tachycardia

Question 2

Which statement by the nurse indicates an understanding of the safe and effective administration of an anticholinergic medication?

A) "Avoid eating foods high in tyramine."
B) "Do not abruptly stop taking the drug."
C) "Take oral medications on an empty stomach."
D) "Take a multivitamin and mineral supplement daily."

Answer 2

"Do not abruptly stop taking the drug."

Question 3

The nurse caring for a patient receiving a dopaminergic drug should assess the individual for early symptoms of what schizophrenia-associated condition?

A) Psychosis
B) Fluid imbalance
C) Tardive dyskinesia
D) Labile hypertension

Answer 3

Psychosis

Question 4

A patient who is receiving an antipsychotic drug is restless, paces, and cannot sit still when watching television.The nurse should use which term to document these findings?

A) Dystonia
B) Akathisia
C) Dyskinesia
D) Bradykinesia

Question 5

The nurse providing patient teaching regarding an anticholinergic drug demonstrates an understanding of this classification of medication by including what instruction?

A) Limiting fluid intake to 1000 mL/day
B) Limiting strenuous activity on hot days
C) Eating small, frequent meals to decrease nausea
D) Wearing adequate clothing to prevent hypothermia

Question 6

Of the patients the nurse will see at the mental health center, which one should be assessed most carefully for extrapyramidal side effects (EPSEs)?

A) 59-year-old man with a 20-year history of severe mental who is prescribed olanzapine.
B) 18-year-old woman experiencing a first episode of schizophrenia who is prescribed haloperidol.
C) 26-year-old man diagnosed with generalized anxiety disorder who is prescribed lorazepam.
D) 30-year-old woman diagnosed with depression who is prescribed amitriptyline.

Question 7

When developing a teaching plan for a patient receiving benztropine, what is a priority nursing consideration?

A) Anticholinergic drugs often cause blurred vision.
B) Urinary frequency may impair the patient's concentration.
C) Akathisia produced by the drug will make concentration difficult.
D) Increased peristalsis might cause gastrointestinal distress and impair concentration.

Question 8

A patient who has taken three doses of haloperidol suddenly cries out for help.The nurse observes that the patient's eyes are rolled upward in a fixed gaze.The nurse should administer which drug from the patient's PRN list?

A) Vitamin E
B) Carbidopa
C) Benztropine
D) Amantadine

Question 9

A patient has taken perphenazine for a year.The nurse observes lip smacking and grinding teeth.Which tool should the nurse use to complete the client's assessment?

A) AIMS
B) EPSE
C) SAD PERSONS
D) CAGE

Question 10

A patient prescribed haloperidol for a diagnosis of schizophrenia has a dystonic reaction.Benztropine 2 mg is given intramuscularly and then continued orally twice daily.Three days later, the patient has fever, disorientation, and tachycardia.What is the most likely cause of the latest signs and symptoms?

A) Tardive dyskinesia has emerged.
B) Benztropine toxicity has developed.
C) Extrapyramidal symptoms have returned.
D) Dopaminergic benztropine effects have exacerbated the psychosis.

Question 11

A patient who is receiving an antipsychotic drug is restless, paces, and cannot sit still when watching television.The patient says, "I couldn't sleep last night because I needed to pace." What is the expected intervention by the patient's primary health care provider?

A) A prescription for an anticholinergic drug
B) Discontinuation of the antipsychotic drug
C) A prescription for a dopaminergic medication.
D) A prescription for a bedtime antihistamine to promote sleep.

Question 12

Which patient receiving fluphenazine should be monitored most closely for extrapyramidal side effects (EPSEs)?

A) 35-year-old man
B) 45-year-old woman
C) 74-year-old woman
D) Patient diagnosed with chronic schizophrenia

Question 13

A patient who has taken three doses of haloperidol suddenly cries out for help.The nurse observes that the patient's eyes are rolled upward in a fixed gaze.The nurse should document this behavior using what term?

A) Akathisia
B) Nystagmus
C) Tardive dyskinesia
D) Oculogyric crisis

Question 14

A patient began trihexyphenidyl therapy for treatment of drug-induced parkinsonism.Which finding demonstrates a positive response to the medication?

A) Blood pressure returns to patient's normal range.
B) Gait is steady with decreased rigidity.
C) Patient reports fewer feelings of depression.
D) Patient has tremors with voluntary movement.

Question 15

A psychiatric nurse should base care of patients diagnosed with Parkinson disease and patients demonstrating extrapyramidal side effects (EPSEs) caused by antipsychotic drug therapy on what premise concerning symptoms?

A) Both conditions share similar symptoms.
B) Both sets of symptoms result from deficits in dopamine synthesis.
C) Both sets of symptoms result from acetylcholine and dopamine imbalance.
D) All associated symptoms are produced by neurodegeneration of the substantia nigra.

Question 16

Which symptom of Parkinson disease has the highest priority for nursing intervention?

A) Tremor
B) Akathisia
C) Dysphagia
D) Tardive dyskinesia

Question 17

When patients are treated with antipsychotic medications, a variety of side effects and adverse reactions may occur.Which possible reaction presents the highest risk for patient injury? (Select all that apply.)

A) Akathisia
B) Dystonic reaction
C) Neuroleptic malignant syndrome (NMS)
D) Tardive dyskinesia

Question 18

Which neurotransmitter is most affected by an anticholinergic drug?

A) Acetylcholine
B) Dopamine
C) Serotonin
D) GABA

Question 19

Which medication from a patient's pharmacologic profile is most likely to precipitate neuroleptic malignant syndrome (NMS)?

A) Diphenhydramine
B) Risperidone
C) Haloperidol
D) Clozapine

Question 20

An elderly nursing home resident has been diagnosed with type 2 diabetes, hypertension, and dementia.The patient begins taking an antipsychotic drug for agitation.Tremor and bradykinesia develop, so an anticholinergic is added to the drug regimen.Within 3 days, the patient displays a marked cognitive deficit.Which medication is the most likely cause of the cognitive change?

A) Antihypertensive
B) Anticholinergic
C) Antipsychotic
D) Antidiabetic

Question 21

A patient diagnosed with Parkinson disease begins levodopa therapy.What outcome should the nurse expect from levodopa therapy?

A) Improvement of associated symptoms related to the increase of dopamine
B) Improvement of associated symptoms related to the decrease levels of GABA
C) Reduction of any existing depression
D) Reduction in the risk of dysphagia
E) Reduction in the risk of falls associated with an unsteady gait