Deck 25: Pharmacotherapy of Degenerative Diseases of the Central Nervous System

Question 1

The nursing student asks the instructor why clients with Parkinson's disease are not given the drug dopamine.The instructor replies:
1)"The risk for hypertension is too high with dopamine; therefore, more frequent cardiac monitoring would be required."
2)"Exogenous dopamine must be administered via intravenous infusion, which usually requires a central line and continuous cardiac monitoring."
3)"Exogenous dopamine cannot cross the blood-brain barrier, and would be of little use."
4)"In elderly clients, the effects of dopamine on urinary function can pose an unacceptable risk for renal failure."

Answer 1

3

Question 2

The family member of a client with Parkinson's disease notifies the nurse that the client is demonstrating extrapyramidal symptoms.The nurse should instruct the family member to:
1)Give diphenhydramine (Benadryl)25 mg immediately by mouth.
2)Transport the client to the Emergency Department immediately.
3)Increase the dosage of the antiparkinsonian drugs.
4)Make an appointment when convenient for the client and health care provider for an evaluation.

Answer 2

2

Question 3

Which of the following assessment findings would alert the nurse to the possibility of Parkinson's disease?
1)Mask-like face
2)Rigid posture
3)Tremors
4)Shuffling gait

Answer 3

3

Question 4

A client has just been started on a dopaminergic agent for management of symptoms related to Parkinson's disease.The nurse explains that the effects of the medication should be recognizable:
1)Within 24 hours.
2)Within 2-3 days.
3)Within one week.
4)Within 2-3 weeks.

Question 5

Which of the following assessment findings in a client with Alzheimer's disease would the nurse directly attribute to the disease's effect on acetylcholine?
1)Darkened urine
2)Oriented to person only
3)Vomiting and diarrhea
4)Muscle cramps

Question 6

Which of the following can be associated with the development of secondary Parkinson's disease? Select all that apply.
1)Traumatic brain injury
2)Encephalitis or meningitis
3)Brain tumor
4)Toxins
5)Medications

Question 7

Which assessment findings would indicate the client might have Huntington's chorea rather than Alzheimer's disease?
1)Memory loss
2)Confusion
3)Involuntary muscle spasm
4)Difficulty completing tasks

Question 8

What is the relationship between acetylcholine and dopamine in the area of the brain that affects balance, posture, and involuntary muscle movement?
1)Both dopamine and acetylcholine stimulate this region of the brain.
2)Both dopamine and acetylcholine inhibit this region of the brain.
3)Dopamine stimulates while acetylcholine inhibits this region.
4)Dopamine inhibits while acetylcholine stimulates this region.

Question 9

Parkinson's disease is a degenerative disorder of the nervous system caused by the death of the neurons that produce which of the following?
1)Dopamine
2)Norepinephrine
3)Serotonin
4)Acetylcholine

Question 10

During the nurse's assessment of a client with known Parkinson's disease, the onset of which finding would be cause for concern?
1)Confusion
2)"Pill-rolling" motion of the fingers
3)Mask-like expression
4)Frequent falls

Question 11

The nurse explains to the family of a client with Alzheimer's disease that memory loss and confusion occur because of the disease's effect of which neurotransmitter?
1)Dopamine
2)Gamma-aminobutyric acid (GABA)
3)Serotonin
4)Acetylcholine

Question 12

Several senior citizens have asked the nurse to do a presentation on degenerative diseases.What does the nurse plan to teach are the most common degenerative diseases? Select all that apply.
1)Multiple sclerosis
2)Alzheimer's disease
3)Parkinson's disease
4)Huntington's chorea
5)Amyotrophic lateral sclerosis

Question 13

Which assessment findings would indicate the client might have secondary Parkinson's disease?
1)Progressive memory loss and history of fatigue
2)Confusion and difficulty performing activities of daily living
3)Involuntary muscle spasm and history of motor vehicle accident
4)Non-intentional tremor and history of a brain injury

Question 14

Which assessment findings would indicate the client might have idiopathic or primary Parkinson's disease?
1)Progression and severity of fatigue
2)Ocular diplopia and ptosis
3)Spasticity and paresis
4)Tremors and bradykinesia

Question 15

A client comes to the physician's office and describes his partner's symptoms of memory loss and difficulty completing tasks as interfering with their routine activities of daily living.He questions if these symptoms are related to Alzheimer's disease.The nurse would assess for the presence of which other symptoms to assist the physician with differential diagnosis?
1)Tremors, muscle rigidity, and abnormal gait
2)Muscle weakness and vision changes
3)Confusion and difficulty with communication
4)Involuntary muscle spasms and confusion

Question 16

The client has been diagnosed with Alzheimer's disease.What is the best medication education the nurse can give to the client's spouse?
1)"Symptoms will improve as long as the medication is taken daily at the same time."
2)"Symptoms should begin to improve in a few days."
3)"There is no cure.The medication might help with symptoms for a period of time."
4)"The medication has side effects that require periodic breaks from treatment."

Question 17

The nurse plans to teach a class about Alzheimer's disease to a caregivers' support group.What will the best plan of the nurse include? Select all that apply.
1)Memory difficulties are an early symptom of the disease.
2)Chronic inflammation of the brain can be a cause of the disease.
3)Depression and aggressive behavior are common with the disease.
4)Pharmacologic therapies are highly effective in treating Alzheimer's disease.
5)Glutamergic inhibitors are the most common class of drugs for treating Alzheimer's disease.

Question 18

The spouse of a client with Parkinson's disease asks how taking the medication will help with symptoms.What is the best response?
1)"The medication will prevent muscle wasting in your spouse."
2)"The medication will facilitate your spouse's ability to walk, dress, and eat."
3)"The medication will boost your spouse's energy and appetite."
4)"The medication will balance serotonin and acetylcholine in your spouse's brain."

Question 19

When assessing a client for the typical signs and symptoms of Parkinson's disease, the nurse would expect to find:
1)Tremors, a mask-like facial expression, and a rigid posture.
2)A mask-like expression and generalized muscle weakness.
3)Shuffling gait, confusion, and postural instability.
4)Tremors and hyperkinesia.

Question 20

When teaching a community course on health problems that the older adult might encounter, the nurse describes a disorder that is characterized by confusion, progressive memory loss, and the inability to think clearly.The nurse is describing symptoms consistent with:
1)Huntington's chorea.
2)Parkinson's disease.
3)Alzheimer's disease.
4)Schizophrenia.

Question 21

The client receives benztropine (Cogentin)and tells the nurse he is going on a Caribbean cruise.Which of the following would the nurse include in the patient teaching?
1)"Limit your activity while on the cruise."
2)"Be sure to wear a hat and sunglasses."
3)"Take a multivitamin every day to keep you healthy."
4)"If you miss a dose, take the next dose at its regularly scheduled time."

Question 22

The nurse is teaching a class for caregivers of clients with Alzheimer's disease.The nurse determines that learning has occurred when the caregivers make which statement?
1)"There aren't any drugs that are effective in treating this disease."
2)"There are drugs that will help to decrease the symptoms for a period of time."
3)"There are drugs that can control the symptoms for many years."
4)"There are effective drugs, but they cannot be used over a long period of time."

Question 23

The client takes an aspirin, a multivitamin, and an antihistamine every day.What is the best instruction by the nurse when the patient is prescribed levodopa (Larodopa)?
1)"These medications are safe to take with levodopa (Larodopa)."
2)"You should not take the aspirin with your levodopa (Larodopa)."
3)"You should not take the multivitamin with your levodopa (Larodopa)."
4)"You should not take the antihistamine with your levodopa (Larodopa)."

Question 24

The nurse plans care for a client with Parkinson's disease.What will the best plan for the nurse include?
1)Monitor the client for development of psychotic symptoms.
2)Teach to limit exercise to decrease the risk for fractures.
3)Monitor the client's ability to chew and eat.
4)Assess peripheral circulation for presence of thrombophlebitis.

Question 25

The client receives levodopa (Larodopa).The nurse has completed medication education, and determines that learning has occurred when the client makes which statement?
1)"I need to check my pulse before I take this medication."
2)"I must avoid eating leafy green vegetables in my diet."
3)"I must increase the fiber in my diet."
4)"I need to increase my daily intake of protein."

Question 26

The nurse prepares to administer benztropine (Cogentin)to the client.The nurse holds the dose and notifies the physician based on which of the following assessment findings?
1)A pulse of 108
2)A blood pressure reading of 88/60 mm/Hg
3)A temperature of 100.2°F
4)A respiratory rate of 14

Question 27

The client has Parkinson's disease, and develops depression.What education would the nurse provide to the client's family?
1)"Depression is a common problem with Parkinson's disease."
2)"The depression is most likely a side effect of the medications taken to treat the symptoms."
3)"Eventually anyone who has a brain disease will develop depression."
4)"Depression is very easy to treat, and a wide variety of medications are available."

Question 28

An elderly client is receiving levodopa (Larodopa).The nurse would be concerned primarily about which of the following?
1)Muscle twitching
2)Diarrhea
3)Dark urine
4)Hypertension

Question 29

The client is prescribed tacrine (Cognex)as treatment for Alzheimer's disease.Which laboratory test would the nurse monitor?
1)Renal function tests
2)Serum amylase levels
3)Complete blood count
4)Liver function tests