Question 1

Which reaction occurs as a result of prescribing carbidopa-levodopa?&#10;A) Idiosyncratic&#10;B) Additive&#10;C) Hypersensitivity&#10;D) Tolerance

Accepted Answer

Carbidopa-levodopa is a combination drug used for the treatment of Parkinson's disease. Carbidopa facilitates the transport of levodopa to the brain and decreases its peripheral breakdown, which increases its effectiveness. Both drugs have an additive effect, meaning that their combination enhances the therapeutic effect of levodopa. Idiosyncratic reactions are unpredictable and rare drug reactions that can occur without prior exposure to the drug. Hypersensitivity reactions are immune-mediated allergic reactions to the drug. Tolerance occurs when the body becomes desensitized to a drug's effects, requiring higher doses to achieve the same effect.

Question 2

Which are characteristic symptoms of Parkinson's disease? (Select all that apply.)&#10;A) Muscle tremors&#10;B) Posture alterations&#10;C) Muscle flaccidity&#10;D) Tachycardia&#10;E) Slow body movement

Accepted Answer

Parkinson's disease is characterized by muscle tremors, posture alterations, and slow body movement. Muscle flaccidity and tachycardia are not typically associated with Parkinson's disease.

Question 3

The nurse is providing information to a patient recently prescribed entacapone. Which statement is correct?&#10;A) This medication is not to be taken with carbidopa-levodopa.&#10;B) Dosage is adjusted according to the patient's response.&#10;C) There will be fewer incidences of dopaminergic effects, such as confusion.&#10;D) This medication increases the production of dopamine in the brain.

Accepted Answer

Dosage of entacapone is adjusted according to the patient's response. A combination of entacapone, carbidopa, and levodopa is used in the management of Parkinson's disease. Entacapone is a COMT inhibitor that acts by increasing the bioavailability of levodopa.

Question 4

Which adverse effects associated with levodopa therapy would support the nursing diagnosis Risk for Injury?&#10;A) Nausea and vomiting&#10;B) Orthostatic hypotension&#10;C) Anorexia and depression&#10;D) Tachycardia and palpitations

Accepted Answer

Orthostatic hypotension is a common adverse effect of levodopa therapy and can increase the risk for falls and injury in older adults. Nausea and vomiting, anorexia and depression, tachycardia and palpitations may be associated with levodopa therapy, but they do not directly support the nursing diagnosis of Risk for Injury.

Question 5

Dopamine agonists have been linked with which adverse effects in patients with Parkinson's disease?&#10;A) Oculogyric crisis&#10;B) Tardive dyskinesia&#10;C) Sudden sleep events&#10;D) Akathisia

Accepted Answer

Dopamine agonists have been linked with sudden sleep events, which can be dangerous if they occur while driving or operating machinery. Oculogyric crisis, tardive dyskinesia, and akathisia are adverse effects that can occur with other medications, such as antipsychotics.

Question 6

Which vitamin will reduce the therapeutic effects of levodopa? A) A B) B₆ C) C D) D

Accepted Answer

Vitamin B6 (pyridoxine) can reduce the therapeutic effects of levodopa, which is commonly used to treat Parkinson's disease. Therefore, patients taking levodopa are advised to avoid high-dose B6 supplements or foods rich in B6.

Question 7

The nurse is assessing an older patient with Parkinson's disease who was started on 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?

A) Constipation
B) Brownish orange urine
C) Drowsiness
D) Dizziness

Accepted Answer

The answer of The nurse is assessing an older patient...

Question 8

What is the rationale for administering levodopa for treatment of Parkinson's disease instead of dopamine?&#10;A) Dopamine does not cross the blood-brain barrier when administered orally.&#10;B) Levodopa is much less expensive.&#10;C) The half-life of dopamine is too short.&#10;D) Dopamine has too many reactions with other medications.

Accepted Answer

Dopamine cannot cross the blood-brain barrier when taken orally, so levodopa (a precursor to dopamine) is administered instead. It can cross the barrier and is then converted into dopamine in the brain.

Question 9

What is the pharmacologic action of entacapone, a potent catechol-O-methyl transferase (COMT) inhibitor?&#10;A) Slows the deterioration of dopaminergic nerve cells&#10;B) Inhibits the relative excess of dopaminergic activity&#10;C) Reduces the destruction of dopamine in peripheral tissues&#10;D) Enhances the cholinergic symptoms of Parkinson's disease

Accepted Answer

Entacapone is a potent COMT inhibitor which reduces the peripheral breakdown of levodopa, being used in combination with levodopa and carbidopa to treat Parkinson's disease. The drug increases the amount of levodopa available to the brain, thus enhancing and prolonging its effects. It does not slow the deterioration of dopaminergic nerve cells or inhibit an excess in dopaminergic activity. Additionally, entacapone does not enhance cholinergic symptoms of Parkinson's disease.

Question 10

The nurse is teaching a patient with Parkinson's disease about levodopa. Which statement by the nurse is accurate regarding drug administration?&#10;A) &#34;Take this medication in between meals.&#34;&#10;B) &#34;Take this medication at bedtime to prevent dizziness.&#34;&#10;C) &#34;Take this medication when your tremors get worse.&#34;&#10;D) &#34;Take this medication with food or antacids to reduce GI upset.&#34;

Accepted Answer

Levodopa is best taken with food or antacids to reduce gastrointestinal (GI) upset. Taking the medication in between meals may delay absorption and decrease effectiveness, as protein in the diet can compete for absorption of levodopa. Bedtime dosing is not recommended as it can cause insomnia and vivid dreams. Taking the medication only when tremors get worse does not prevent symptom fluctuation and may not provide consistent symptom control.

Question 11

What points should be included when teaching a patient about the use of apomorphine for treatment of Parkinson's disease? (Select all that apply.)&#10;A) The restoration of function resulting from stimulation of dopamine receptors is permanent.&#10;B) Apomorphine may be administered intravenously for rapid relief.&#10;C) Apomorphine does not have any opioid activity.&#10;D) A multidose injector pen is commonly used to administer apomorphine.&#10;E) You may experience nausea and vomiting, which can be treated with trimethobenzamide (Tigan).&#10;F) You may experience sleep attacks or episodes of daytime sleepiness.

Accepted Answer

The answer of What points should be included when teaching...

Question 12

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?&#10;A) &#34;This medication will help slow the development of symptoms.&#34;&#10;B) &#34;I will place the tablet on my tongue before breakfast.&#34;&#10;C) &#34;I may need to use a stool softer for constipation.&#34;&#10;D) &#34;I should not push the tablet through the foil.&#34;

Accepted Answer

The answer of The nurse is providing education to a...

Question 13

Which cholinergic symptoms of Parkinson's disease are reduced with anticholinergic drugs?&#10;A) Cognitive impairments&#10;B) Rigidity&#10;C) Tremors and drooling&#10;D) Postural abnormalities

Accepted Answer

The answer of Which cholinergic symptoms of Parkinson's disease are...

Deck 15: Drugs Used for Parkinsons Disease