Question 1

The nurse is caring for a patient who is receiving trihexyphenidyl (Artane)to treat parkinsonism.The patient reports having a dry mouth,and the nurse notes a urine output of 300 mL in the past 8 hours.Which action will the nurse perform?

Accepted Answer

Urinary retention can occur with anticholinergic medications.Dry mouth is a harmless side effect.The nurse should report the lower than expected urine output to the provider.Increasing fluid intake will not increase urine output in the patient with urinary retention.Renal function tests are not indicated since this is a neuromuscular problem of the bladder caused by the medication.

Question 2

The nurse is teaching a patient who has Parkinson's disease about the side effects of carbidopa-levodopa.Which statement by the patient indicates a need for further teaching?

Accepted Answer

Taking carbidopa-levodopa with food decreases absorption of the drug,although gastrointestinal distress may decrease when the medication is taken with food.Cholinergic side effects are common.Orthostatic hypotension occurs early and will resolve over time.Nightmares and mental disturbances should be reported.

Question 3

A patient is taking entacapone (Comtan)along with carbidopa-levodopa to treat parkinsonism.The nurse notes that the patient's urine is orange in color.The nurse will

Accepted Answer

Entacapone can cause the urine to be dark yellow to orange.It does not indicate drug toxicity,liver effects,or changes in renal function.

Question 4

The spouse of a patient newly diagnosed with mild,unilateral symptoms of Parkinson's disease (PD)asks the nurse what,besides medication,can be done to manage the disease.The nurse will

Accepted Answer

PD is a progressive disorder.Nonpharmacologic measures can lessen symptoms and help patients and families cope with the disorder.Although the aging process may contribute to the development of PD,it is not necessarily a normal part of aging.Treatment may slow the progression but does not arrest or cure the disease.

Question 5

Which antiviral medication improves symptoms of Parkinson's disease in some patients?

Accepted Answer

Amantadine is an antiviral drug that acts on dopamine receptors and is sometimes used to treat Parkinson's disease (PD).The other drugs listed do not work for PD patients.

Question 6

The nurse is teaching a family member about an elderly parent's new prescription for tacrine (Cognex)to treat Alzheimer's disease (AD).The family member asks what to expect from this drug.The nurse will respond that the patient will

Accepted Answer

Tacrine can help to increase cognitive function for patients with mild to moderate AD.For the most part,drugs to treat AD do not result in improvement of symptoms but help slow the progress.

Question 7

A patient who has parkinsonism will begin taking selegiline HCl (Eldepryl)to treat symptoms.What information will the nurse include when teaching this patient about this drug?

Accepted Answer

Selegiline (Eldepryl)inhibits monoamine oxidase-B,and it has similar adverse reactions to other monoamine oxidase inhibitors.Patients should be cautioned against consuming foods containing tyramine because of the risk of hypertensive crisis.Red wine is high in tyramine.Use of this drug may delay,but will not prevent,the need for levodopa.Severe adverse drug interactions may occur between this drug and tricyclic antidepressants.

Question 8

The nurse is preparing to administer a first dose of benztropine (Cogentin)to a patient diagnosed with parkinsonism.The nurse would notify the patient's provider if the patient had a history of which condition?

Accepted Answer

Patients with a history of glaucoma should not take anticholinergic medications.Anticholinergics are not contraindicated in patients who have asthma,hypertension,or irritable bowel disease.

Question 9

A patient who has parkinsonism will begin taking carbidopa-levodopa.What information will the nurse include when teaching this patient about this medication?

Accepted Answer

Carbidopa-levodopa can cause orthostatic hypotension,so patients should be taught to take care when getting out of bed or a chair.Darkening of the urine and perspiration is a harmless side effect.Patients should take the drug with low-protein foods to improve drug transport to the CNS.Carbidopa-levodopa should not be discontinued abruptly because rebound parkinsonism may occur; insomnia is an expected adverse effect of the drug,and the patient should report this effect to his or her health care provider.

Question 10

An older patient exhibits a shuffling gait,lack of facial expression,and tremors at rest.The nurse will expect the provider to order which medication for this patient?

Accepted Answer

This patient is exhibiting signs of Parkinson's disease and should be treated with carbidopa-levodopa.The other drugs are used to treat Alzheimer's disease.

Question 11

A nursing student asks the nurse to differentiate the pathology of Alzheimer's disease from that of Parkinson's disease.Which description is correct?

Accepted Answer

Parkinson's disease (PD)is characterized by an imbalance of dopamine (DA)and acetylcholine (ACh)caused by an unexplained degeneration of the dopaminergic neurons allowing the excitatory response of acetylcholine to exceed the inhibitory response of dopamine.Alzheimer's disease (AD)may result from decreased ACh,degeneration of cholinergic neurons,and neuritic plaques.Dopamine does not appear to play a role in Alzheimer's disease.

Question 12

The nurse is providing teaching for the family of a patient who has been newly diagnosed with Alzheimer's disease (AD).Which statement by the family member indicates understanding of the teaching?

Accepted Answer

AD is chronic and progressive,and there is no cure.It affects memory and personality.The onset is usually between 45 and 65 years.Symptoms cannot be arrested but may be slowed with treatment.

Question 13

A nursing student asks the nurse why patients who have parkinsonism receive a combination of carbidopa and levodopa.The nurse will explain that the combination product

Accepted Answer

Without carbidopa,about 99% of levodopa is converted to dopamine before crossing the blood-brain barrier,causing peripheral adverse effects.When carbidopa is added,the enzyme decarboxylase is inhibited,allowing levodopa to cross into the brain before being converted to the active metabolite dopamine.The result is less levodopa required to achieve the desired effect.The drug still has many side effects,but the peripheral effects are lessened.

Question 14

A patient who has parkinsonism has been taking carbidopa-levodopa and has shown improvement in symptoms but develops dystonic movements,nausea,and vomiting.Which medication will the nurse expect the provider to order for this patient to replace carbidopa-levodopa?

Accepted Answer

Bromocriptine is often used for patients who do not tolerate carbidopa-levodopa.Amantadine is useful for treating Parkinson's disease but does not have sustained effects.Benztropine is given to reduce muscle rigidity and some tremors.Tacrine is used to treat Alzheimer's disease.

Question 15

The nurse is caring for an 80-year-old patient who has Alzheimer's disease who will begin taking rivastigmine (Exelon).What will the nurse include in the plan of care for this patient?

Accepted Answer

Patients taking rivastigmine for Alzheimer's disease are at risk for falls and loss of balance.Caregivers should assist with standing and walking.The drug is taken twice daily,and it should be taken on an empty stomach.NSAIDs increase gastrointestinal side effects.

Question 16

A patient who has Parkinson's disease is being treated with the anticholinergic medication benztropine (Cogentin).The nurse will tell the patient that this drug will have which effect?

Accepted Answer

Benztropine is given to reduce rigidity and some of the tremors.It does not enhance walking or reduce bradykinesia or improve mental function.

Question 17

The nurse is helping to develop a plan of care for a patient who has advanced Alzheimer's disease.The patient will be taking a new medication.Which is a realistic goal for this patient?

Accepted Answer

For the most part,drugs to treat AD do not result in improvement of symptoms but help slow the progress.The most realistic care plan for a patient with advanced AD is that they will receive appropriate and safe care.

Quiz 23: Drugs for Neurological Disorders: Parkinsonism and Alzheimer’s Disease

The nurse is caring for a patient who is receiving trihexyphenidyl (Artane) to treat parkinsonism.The patient reports having a dry mouth,and the nurse notes a urine output of 300 mL in the past 8 hours.Which action will the nurse perform?

The nurse is teaching a patient who has Parkinson's disease about the side effects of carbidopa-levodopa.Which statement by the patient indicates a need for further teaching?

A patient is taking entacapone (Comtan) along with carbidopa-levodopa to treat parkinsonism.The nurse notes that the patient's urine is orange in color.The nurse will

The spouse of a patient newly diagnosed with mild,unilateral symptoms of Parkinson's disease (PD) asks the nurse what,besides medication,can be done to manage the disease.The nurse will

Which antiviral medication improves symptoms of Parkinson's disease in some patients?

The nurse is teaching a family member about an elderly parent's new prescription for tacrine (Cognex) to treat Alzheimer's disease (AD) .The family member asks what to expect from this drug.The nurse will respond that the patient will

A patient who has parkinsonism will begin taking selegiline HCl (Eldepryl) to treat symptoms.What information will the nurse include when teaching this patient about this drug?

The nurse is preparing to administer a first dose of benztropine (Cogentin) to a patient diagnosed with parkinsonism.The nurse would notify the patient's provider if the patient had a history of which condition?

A patient who has parkinsonism will begin taking carbidopa-levodopa.What information will the nurse include when teaching this patient about this medication?

An older patient exhibits a shuffling gait,lack of facial expression,and tremors at rest.The nurse will expect the provider to order which medication for this patient?

A nursing student asks the nurse to differentiate the pathology of Alzheimer's disease from that of Parkinson's disease.Which description is correct?

The nurse is providing teaching for the family of a patient who has been newly diagnosed with Alzheimer's disease (AD) .Which statement by the family member indicates understanding of the teaching?

A nursing student asks the nurse why patients who have parkinsonism receive a combination of carbidopa and levodopa.The nurse will explain that the combination product

A patient who has parkinsonism has been taking carbidopa-levodopa and has shown improvement in symptoms but develops dystonic movements,nausea,and vomiting.Which medication will the nurse expect the provider to order for this patient to replace carbidopa-levodopa?

The nurse is caring for an 80-year-old patient who has Alzheimer's disease who will begin taking rivastigmine (Exelon) .What will the nurse include in the plan of care for this patient?

A patient who has Parkinson's disease is being treated with the anticholinergic medication benztropine (Cogentin) .The nurse will tell the patient that this drug will have which effect?

The nurse is helping to develop a plan of care for a patient who has advanced Alzheimer's disease.The patient will be taking a new medication.Which is a realistic goal for this patient?