Question 1

The wife of a client with Parkinson disease (PD)expresses frustration about trying to communicate with her husband.What can the nurse do to facilitate communication between the client and spouse?
A)Recommend that the client and spouse learn sign language.
B)Suggest that the spouse obtain a hearing aid.
C)Consult with speech therapy for exercises to aid the client with speech and language.
D)Suggest the client and spouse communicating by writing.

Accepted Answer

Speech therapy can provide exercises to help the client with PD improve their speech and language abilities. This can help facilitate communication between the client and their spouse. Learning sign language or using a hearing aid may not be appropriate or necessary for this particular situation. While writing can be a helpful tool, it is important to also work on improving verbal communication. Therefore, consulting with a speech therapist is the best option.

Question 2

The nurse is caring for a 30-year-old female client who was recently diagnosed with Parkinson disease (PD).Which of the following statements should the nurse include in the teaching for this client?
A)"Having the early-onset form of PD puts you at greater risk for dementia."
B)"If you get pregnant,it is highly unlikely that you will be able to carry the baby to term."
C)"Given your age,your PD is likely to progress more slowly than it does for people who develop the condition later in life."
D)"You can continue using birth control pills,because PD medications do not have an impact on their efficacy."

Accepted Answer

Parkinson disease typically progresses more slowly in younger individuals, so the nurse should teach the client that her younger age may be an advantage in terms of disease progression. A is incorrect because there is not necessarily a greater risk for dementia with early-onset PD. B is incorrect because PD does not necessarily affect the ability to carry a baby to term. D is incorrect because some PD medications may interact with hormonal birth control, so the client should discuss options with her healthcare provider.

Question 3

The nurse is planning care for a client with Parkinson disease (PD).Which of the following nursing interventions aimed at the client's spouse would best support the client's continued mobility?
A)Suggesting that the spouse use a blender to make foods easier for the client to swallow
B)Reviewing the client's medication administration schedule with the spouse
C)Instructing the spouse to ambulate the client at least four times a day
D)Instructing the spouse on proper turning and repositioning techniques

Accepted Answer

Regular ambulation is important in promoting mobility for clients with Parkinson disease. Instructing the spouse to ambulate the client at least four times a day would provide the client with opportunities to move and maintain mobility. Suggestions for food preparation and medication administration may also be important for the client's overall care, but they may not directly impact the client's mobility. Turning and repositioning techniques may be important for preventing skin breakdown but may not specifically address mobility.

Question 4

The nurse instructs a client with Parkinson disease (PD)about levodopa/carbidopa.Which client statement indicates that this teaching has been effective?
A)"I should eat a high-protein diet when taking this medication."
B)"When taking this medication,I should sit up for several minutes before going from lying down to standing up."
C)"This medication will not affect my blood pressure medications."
D)"Given enough time,this medication will cure my Parkinson disease."

Accepted Answer

This statement indicates that the client understands the orthostatic hypotension side effect of levodopa/carbidopa and knows to sit up slowly to avoid it. A high-protein diet can actually decrease the effectiveness of the medication, so choice A is incorrect. Choice C is incorrect because levodopa/carbidopa can interact with some blood pressure medications. Choice D is incorrect because there is currently no cure for Parkinson disease.

Question 5

A client complains of a right-hand tremor,increasing weakness,and muscles that feel tight.The nurse notes that the client has poor voice volume and facial muscles that do not move easily.The nurse recognizes that these symptoms are consistent with which condition?
A)Parkinson disease
B)Spinal cord injury
C)Cerebrovascular accident
D)Multiple sclerosis

Accepted Answer

The symptoms described are consistent with Parkinson disease, which is a progressive disorder of the nervous system that affects movement. The tremors, weakness, and muscle tightness are common motor symptoms, while the poor voice volume and facial muscle stiffness are non-motor symptoms.

Question 6

The nurse completes a teaching session for a young adult client who was recently diagnosed with Parkinson disease (PD).Which client statement indicates this teaching has been effective?
A)"I could have prevented PD with diet and exercise."
B)"I probably have a genetic mutation that caused my PD."
C)"My brain contains too much of a chemical called dopamine."
D)"Most people with PD first experience symptoms when they are about my age."

Accepted Answer

A)Early-onset PD is likely due to a genetic mutation. Increasing age is a risk factor for the disease, and diagnosis as a young adult is uncommon. PD is associated with decreased dopamine levels in the brain, not an excess of dopamine. Although consuming a healthy, pesticide-free diet is recommended, dietary intake has not been definitively linked to development of PD.
B)Early-onset PD is likely due to a genetic mutation. Increasing age is a risk factor for the disease, and diagnosis as a young adult is uncommon. PD is associated with decreased dopamine levels in the brain, not an excess of dopamine. Although consuming a healthy, pesticide-free diet is recommended, dietary intake has not been definitively linked to development of PD.
C)Early-onset PD is likely due to a genetic mutation. Increasing age is a risk factor for the disease, and diagnosis as a young adult is uncommon. PD is associated with decreased dopamine levels in the brain, not an excess of dopamine. Although consuming a healthy, pesticide-free diet is recommended, dietary intake has not been definitively linked to development of PD.
D)Early-onset PD is likely due to a genetic mutation. Increasing age is a risk factor for the disease, and diagnosis as a young adult is uncommon. PD is associated with decreased dopamine levels in the brain, not an excess of dopamine. Although consuming a healthy, pesticide-free diet is recommended, dietary intake has not been definitively linked to development of PD.

Question 7

In clients with Parkinson disease,increasing doses of and long-term exposure to levodopa can cause which of the following conditions?
A)Dyskinesia
B)Insomnia
C)Hypertension
D)Compulsive behavior

Accepted Answer

Increasing doses of and long-term exposure to levodopa can cause dyskinesia, which is a movement disorder characterized by involuntary muscle movements. Insomnia and hypertension may be side effects of levodopa, but they are not related to increasing doses or long-term exposure. Compulsive behavior is a potential side effect of dopamine agonists, not levodopa.

Question 8

Which of the following terms is used to describe osteoarthritis (OA)that is caused by an underlying condition,such as injury,congenital malformation,or metabolic disease?
A)Idiopathic
B)Secondary
C)Localized
D)Generalized

Accepted Answer

Secondary osteoarthritis is caused by an underlying condition, as opposed to idiopathic osteoarthritis, which has no known cause. Localized and generalized refer to the extent of joint involvement, and are not specific to the cause of the OA.

Question 9

Which of the following is not a common clinical manifestation of Parkinson disease (PD)?
A)Restless leg syndrome
B)Cogwheel rigidity
C)Malignant hypertension
D)Pill-rolling

Accepted Answer

Restless leg syndrome, cogwheel rigidity, and pill-rolling are all common clinical manifestations of Parkinson disease. Malignant hypertension, on the other hand, is not typically associated with PD.

Question 10

Why do clients with Parkinson disease (PD)nearly always take carbidopa in combination with levodopa?
A)Carbidopa minimizes the conversion of levodopa to dopamine within the brain,thus minimizing levodopa's unwanted side effects.
B)Carbidopa enhances levodopa's conversion to dopamine throughout the body,thus intensifying levodopa's effectiveness.
C)Carbidopa prevents levodopa from converting to dopamine until it reaches the brain,thus minimizing levodopa's unwanted side effects.
D)Carbidopa prevents levodopa's conversion to dopamine in the brain,thus intensifying levodopa's effectiveness.

Accepted Answer

A)Levodopa is a natural chemical that can cross the blood-brain barrier and be converted directly to dopamine in the brain. Levodopa can also be converted to dopamine outside the brain, which leads to the most common side effects of nausea and orthostatic hypotension. Therefore, levodopa is almost always given in combination with carbidopa, which prevents levodopa from converting to dopamine until it reaches the brain.
B)Levodopa is a natural chemical that can cross the blood-brain barrier and be converted directly to dopamine in the brain. Levodopa can also be converted to dopamine outside the brain, which leads to the most common side effects of nausea and orthostatic hypotension. Therefore, levodopa is almost always given in combination with carbidopa, which prevents levodopa from converting to dopamine until it reaches the brain.
C)Levodopa is a natural chemical that can cross the blood-brain barrier and be converted directly to dopamine in the brain. Levodopa can also be converted to dopamine outside the brain, which leads to the most common side effects of nausea and orthostatic hypotension. Therefore, levodopa is almost always given in combination with carbidopa, which prevents levodopa from converting to dopamine until it reaches the brain.
D)Levodopa is a natural chemical that can cross the blood-brain barrier and be converted directly to dopamine in the brain. Levodopa can also be converted to dopamine outside the brain, which leads to the most common side effects of nausea and orthostatic hypotension. Therefore, levodopa is almost always given in combination with carbidopa, which prevents levodopa from converting to dopamine until it reaches the brain.

Question 11

Which of the following procedures used in the treatment of osteoarthritis (OA)involves removing a small amount of bone at the articulating surface of the joint and fitting a metal replacement over the end of the bone?
A)Osteotomy
B)Arthroplasty
C)Arthroscopy
D)Joint resurfacing

Accepted Answer

A)In joint resurfacing, a small amount of bone is removed at the articulating surface of the joint and a metal replacement is fitted over the end of the bone. Osteotomy involves surgical removal of a wedge of bone above or below the joint to realign the joint and shift the weight away from the damaged portion of the joint. Arthroscopy entails insertion of a small fiber optic light source, magnifying lens, and camera into the joint to visualize the joint structures. Arthroplasty is total joint replacement, in which a surgeon removes the damaged joint surfaces and replaces them with plastic, metal, or ceramic prostheses.
B)In joint resurfacing, a small amount of bone is removed at the articulating surface of the joint and a metal replacement is fitted over the end of the bone. Osteotomy involves surgical removal of a wedge of bone above or below the joint to realign the joint and shift the weight away from the damaged portion of the joint. Arthroscopy entails insertion of a small fiber optic light source, magnifying lens, and camera into the joint to visualize the joint structures. Arthroplasty is total joint replacement, in which a surgeon removes the damaged joint surfaces and replaces them with plastic, metal, or ceramic prostheses.
C)In joint resurfacing, a small amount of bone is removed at the articulating surface of the joint and a metal replacement is fitted over the end of the bone. Osteotomy involves surgical removal of a wedge of bone above or below the joint to realign the joint and shift the weight away from the damaged portion of the joint. Arthroscopy entails insertion of a small fiber optic light source, magnifying lens, and camera into the joint to visualize the joint structures. Arthroplasty is total joint replacement, in which a surgeon removes the damaged joint surfaces and replaces them with plastic, metal, or ceramic prostheses.
D)In joint resurfacing, a small amount of bone is removed at the articulating surface of the joint and a metal replacement is fitted over the end of the bone. Osteotomy involves surgical removal of a wedge of bone above or below the joint to realign the joint and shift the weight away from the damaged portion of the joint. Arthroscopy entails insertion of a small fiber optic light source, magnifying lens, and camera into the joint to visualize the joint structures. Arthroplasty is total joint replacement, in which a surgeon removes the damaged joint surfaces and replaces them with plastic, metal, or ceramic prostheses.

Question 12

A client with Parkinson disease (PD)ambulates with a shuffling gait and leans slightly forward.When seated,the client conducts a conversation,reads,and is able to self-feed without assistance.Which nursing diagnosis is a priority for this client?
A)Ineffective Coping
B)Impaired Physical Mobility
C)Imbalanced Nutrition: More than Body Requirements
D)Anxiety

Accepted Answer

The client's shuffling gait and leaning forward suggest impaired physical mobility, which can increase the risk for falls and injury. This should be the priority nursing diagnosis in this case. While the client may have other issues such as anxiety or ineffective coping, these would not be as immediately life-threatening as impaired physical mobility. Imbalanced nutrition: More than body requirements is not supported by the information given about the client's ability to self-feed.

Question 13

Clients with osteoarthritis (OA)can reduce their risk of further joint damage by doing which of the following?
A)Applying topical analgesic creams as prescribed
B)Avoiding movement of affected joints
C)Taking acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs)before joint pain becomes severe
D)Receiving cortisone injections in affected joints no more than three times per year

Accepted Answer

A)Because frequent use of corticosteroids can cause joint damage, clients should receive cortisone injections in affected weight-bearing joints no more than three or four times per year. Avoiding movement of affected joints does not reduce the risk of joint damage; rather, it worsens the effects of OA. Applying topical analgesics and taking acetaminophen and NSAIDs reduces the pain of OA but does not reduce the risk of further joint damage.
B)Because frequent use of corticosteroids can cause joint damage, clients should receive cortisone injections in affected weight-bearing joints no more than three or four times per year. Avoiding movement of affected joints does not reduce the risk of joint damage; rather, it worsens the effects of OA. Applying topical analgesics and taking acetaminophen and NSAIDs reduces the pain of OA but does not reduce the risk of further joint damage.
C)Because frequent use of corticosteroids can cause joint damage, clients should receive cortisone injections in affected weight-bearing joints no more than three or four times per year. Avoiding movement of affected joints does not reduce the risk of joint damage; rather, it worsens the effects of OA. Applying topical analgesics and taking acetaminophen and NSAIDs reduces the pain of OA but does not reduce the risk of further joint damage.
D)Because frequent use of corticosteroids can cause joint damage, clients should receive cortisone injections in affected weight-bearing joints no more than three or four times per year. Avoiding movement of affected joints does not reduce the risk of joint damage; rather, it worsens the effects of OA. Applying topical analgesics and taking acetaminophen and NSAIDs reduces the pain of OA but does not reduce the risk of further joint damage.

Question 14

The nurse is evaluating the care of a client with Parkinson disease (PD).Which finding indicates an improvement in the client's nutritional status?
A)The client filled out the menu card for each meal.
B)The client coughs frequently when drinking fluids.
C)The client was able to feed himself and had no weight change in 1 week.
D)The client had a 4-pound weight loss in 1 week.

Accepted Answer

The fact that the client was able to feed himself and had no weight change in 1 week indicates an improvement in the client's nutritional status. Parkinson's disease can result in dysphagia, or difficulty swallowing, which can lead to inadequate nutrition. The fact that the client was able to feed himself suggests that he may be better able to manage his dysphagia and maintain an adequate diet. The lack of weight change indicates that the client is not losing weight and may be gaining weight, which is a positive indication of nutritional status. The other answer choices do not indicate an improvement in nutritional status: filling out the menu card does not necessarily mean the client is eating well, coughing frequently when drinking fluids suggests possible dysphagia, and a 4-pound weight loss in 1 week is a significant and concerning amount of weight loss.

Question 15

The interdisciplinary treatment team proposes interventions to improve and maintain physical function for an adult client with Parkinson disease (PD).Which of the following interventions are supported by research? Select all that apply.
A)Low-intensity treadmill training
B)Walking barefoot indoors
C)Use of resistance bands
D)Active and passive range-of-motion exercises
E)High-intensity treadmill training

Accepted Answer

A)Research studies have shown improvements on the 6-minute walk test of individuals with PD after participation in low-intensity and high-intensity treadmill training, strength training (such as with resistance bands), and range-of-motion exercises. Use of shoes with non-slip soles is advised.
B)Research studies have shown improvements on the 6-minute walk test of individuals with PD after participation in low-intensity and high-intensity treadmill training, strength training (such as with resistance bands), and range-of-motion exercises. Use of shoes with non-slip soles is advised.
C)Research studies have shown improvements on the 6-minute walk test of individuals with PD after participation in low-intensity and high-intensity treadmill training, strength training (such as with resistance bands), and range-of-motion exercises. Use of shoes with non-slip soles is advised.
D)Research studies have shown improvements on the 6-minute walk test of individuals with PD after participation in low-intensity and high-intensity treadmill training, strength training (such as with resistance bands), and range-of-motion exercises. Use of shoes with non-slip soles is advised.
E)Research studies have shown improvements on the 6-minute walk test of individuals with PD after participation in low-intensity and high-intensity treadmill training, strength training (such as with resistance bands), and range-of-motion exercises. Use of shoes with non-slip soles is advised.

Question 16

A middle-aged female client states to the nurse,"I have noticed a slight tremor in my left hand when it's at rest.I think I might have Parkinson disease because my mother had it." Which response by the nurse is the most appropriate?
A)"Having a close relative with Parkinson disease can increase your chance of developing it as well."
B)"You shouldn't worry too much,because Parkinson disease has a higher prevalence in males."
C)"It is unlikely that you have the same illness as your mother."
D)"You probably don't have Parkinson disease.Your mother was probably exposed to a toxin that caused her illness."

Accepted Answer

The most appropriate response is to acknowledge the client's concern and provide accurate information. By stating that having a close relative with Parkinson disease increases one's chance of developing the disease, the nurse is providing accurate information without causing undue anxiety. Option B is incorrect because it is not a reassuring response and also provides inaccurate information. Option C is incorrect because it is not an appropriate response to the client's concerns. Option D is incorrect because it is not an appropriate response and provides inaccurate information.

Question 17

Which of the following treatment options would least likely be considered for a 71-year-old client with osteoarthritis (OA)?
A)Physical therapy
B)Administration of nonsteroidal anti-inflammatory drugs (NSAIDs)
C)Weekly tai chi sessions
D)Administration of narcotics

Accepted Answer

A)Acetaminophen is a first-line medication for older adults due to its efficacy and safety. Narcotics are a second-line choice, because they are safer than NSAIDs for older adults. Mindfulness exercises and complementary health approaches such as yoga or tai chi may assist older adults in increasing mobility and reducing pain levels. Physical therapy is especially important in older adults to maintain or improve mobility of joint(s).
B)Acetaminophen is a first-line medication for older adults due to its efficacy and safety. Narcotics are a second-line choice, because they are safer than NSAIDs for older adults. Mindfulness exercises and complementary health approaches such as yoga or tai chi may assist older adults in increasing mobility and reducing pain levels. Physical therapy is especially important in older adults to maintain or improve mobility of joint(s).
C)Acetaminophen is a first-line medication for older adults due to its efficacy and safety. Narcotics are a second-line choice, because they are safer than NSAIDs for older adults. Mindfulness exercises and complementary health approaches such as yoga or tai chi may assist older adults in increasing mobility and reducing pain levels. Physical therapy is especially important in older adults to maintain or improve mobility of joint(s).
D)Acetaminophen is a first-line medication for older adults due to its efficacy and safety. Narcotics are a second-line choice, because they are safer than NSAIDs for older adults. Mindfulness exercises and complementary health approaches such as yoga or tai chi may assist older adults in increasing mobility and reducing pain levels. Physical therapy is especially important in older adults to maintain or improve mobility of joint(s).

Question 18

Which of the following procedures would be most appropriate to repair a finger joint that is affected by severe osteoarthritis (OA)?
A)Osteotomy
B)Joint resurfacing
C)Joint fusion
D)Internal fixation

Accepted Answer

Joint fusion, also known as arthrodesis, is the most appropriate procedure for severe osteoarthritis in a finger joint. This procedure involves removing the damaged cartilage and fusing the bones together using screws, plates, or other hardware. This helps to eliminate pain and improve stability, but does limit mobility in the affected joint. Osteotomy, joint resurfacing, and internal fixation may be used for other types of joint damage, but are not typically used for severe OA in the finger joints.

Question 19

A client is being evaluated for Parkinson disease (PD).Which findings on the Unified Parkinson Disease Rating Scale (UPDRS)would be considered positive for PD? Select all that apply.
A)Diarrhea
B)Dystonia
C)Retropulsion
D)Hyperphonia
E)Festination

Accepted Answer

A)The UPDRS rates clients in 42 different areas of function. Positive findings for PD include retropulsion (the tendency to fall backward), festination (rapid walking as if trying to run), and dystonia (twisting and repetitive movements). Diarrhea and hyperphonia (loud voice)are not symptoms of PD. Constipation and hypophonia (soft voice)are symptoms of PD.
B)The UPDRS rates clients in 42 different areas of function. Positive findings for PD include retropulsion (the tendency to fall backward), festination (rapid walking as if trying to run), and dystonia (twisting and repetitive movements). Diarrhea and hyperphonia (loud voice)are not symptoms of PD. Constipation and hypophonia (soft voice)are symptoms of PD.
C)The UPDRS rates clients in 42 different areas of function. Positive findings for PD include retropulsion (the tendency to fall backward), festination (rapid walking as if trying to run), and dystonia (twisting and repetitive movements). Diarrhea and hyperphonia (loud voice)are not symptoms of PD. Constipation and hypophonia (soft voice)are symptoms of PD.
D)The UPDRS rates clients in 42 different areas of function. Positive findings for PD include retropulsion (the tendency to fall backward), festination (rapid walking as if trying to run), and dystonia (twisting and repetitive movements). Diarrhea and hyperphonia (loud voice)are not symptoms of PD. Constipation and hypophonia (soft voice)are symptoms of PD.
E)The UPDRS rates clients in 42 different areas of function. Positive findings for PD include retropulsion (the tendency to fall backward), festination (rapid walking as if trying to run), and dystonia (twisting and repetitive movements). Diarrhea and hyperphonia (loud voice)are not symptoms of PD. Constipation and hypophonia (soft voice)are symptoms of PD.

Question 20

A nurse is teaching the parents of a client who was recently diagnosed with osteoarthritis (OA)about their child's condition.Which statement by the parents indicates the need for further instruction?
A)"Our daughter's OA is likely related to a joint injury she sustained last year."
B)"Most kids with OA usually have only one or two affected joints."
C)"Because our daughter developed OA as a child,she is more likely to become disabled as a result of this condition."
D)"Our daughter may outgrow her OA as she ages."

Accepted Answer

While OA can lead to disability over time, the statement that the child is "more likely to become disabled" is incorrect. It is important to provide additional education to clarify the impact of OA on the child's future mobility and function. The other statements are generally accurate and do not indicate a need for further instruction.

Quiz 13: Mobility

The wife of a client with Parkinson disease (PD) expresses frustration about trying to communicate with her husband.What can the nurse do to facilitate communication between the client and spouse?

The nurse is caring for a 30-year-old female client who was recently diagnosed with Parkinson disease (PD) .Which of the following statements should the nurse include in the teaching for this client?

The nurse is planning care for a client with Parkinson disease (PD) .Which of the following nursing interventions aimed at the client's spouse would best support the client's continued mobility?

The nurse instructs a client with Parkinson disease (PD) about levodopa/carbidopa.Which client statement indicates that this teaching has been effective?

A client complains of a right-hand tremor,increasing weakness,and muscles that feel tight.The nurse notes that the client has poor voice volume and facial muscles that do not move easily.The nurse recognizes that these symptoms are consistent with which condition?

The nurse completes a teaching session for a young adult client who was recently diagnosed with Parkinson disease (PD) .Which client statement indicates this teaching has been effective?

In clients with Parkinson disease,increasing doses of and long-term exposure to levodopa can cause which of the following conditions?

Which of the following terms is used to describe osteoarthritis (OA) that is caused by an underlying condition,such as injury,congenital malformation,or metabolic disease?

Which of the following is not a common clinical manifestation of Parkinson disease (PD) ?

Why do clients with Parkinson disease (PD) nearly always take carbidopa in combination with levodopa?

Which of the following procedures used in the treatment of osteoarthritis (OA) involves removing a small amount of bone at the articulating surface of the joint and fitting a metal replacement over the end of the bone?

A client with Parkinson disease (PD) ambulates with a shuffling gait and leans slightly forward.When seated,the client conducts a conversation,reads,and is able to self-feed without assistance.Which nursing diagnosis is a priority for this client?

Clients with osteoarthritis (OA) can reduce their risk of further joint damage by doing which of the following?

The nurse is evaluating the care of a client with Parkinson disease (PD) .Which finding indicates an improvement in the client's nutritional status?

The interdisciplinary treatment team proposes interventions to improve and maintain physical function for an adult client with Parkinson disease (PD) .Which of the following interventions are supported by research? Select all that apply.

A middle-aged female client states to the nurse,"I have noticed a slight tremor in my left hand when it's at rest.I think I might have Parkinson disease because my mother had it." Which response by the nurse is the most appropriate?

Which of the following treatment options would least likely be considered for a 71-year-old client with osteoarthritis (OA) ?

Which of the following procedures would be most appropriate to repair a finger joint that is affected by severe osteoarthritis (OA) ?

A client is being evaluated for Parkinson disease (PD) .Which findings on the Unified Parkinson Disease Rating Scale (UPDRS) would be considered positive for PD? Select all that apply.

A nurse is teaching the parents of a client who was recently diagnosed with osteoarthritis (OA) about their child's condition.Which statement by the parents indicates the need for further instruction?