Chapter 14 Drugs Used for Parkinson’s Disease

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Chapter 14  Drugs Used for Parkinson’s Disease

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

MULTIPLE CHOICE

1. Which adverse effects associated with levodopa therapy would support the nursing diagnosis risk for injury?
a.
Nausea and vomiting
b.
Orthostatic hypotension
c.
Anorexia and depression
d.
Tachycardia and palpitations

ANS: B
When initiating levodopa therapy, orthostatic hypotension may occur. Although generally mild, patients may experience dizziness and weakness. Symptoms usually resolve within 1 or 2 weeks once tolerance is developed to the levodopa therapy. Orthostatic hypotension increases the risk for injury in Parkinson’s patients because they are also experiencing alterations in gait patterns. Although nausea, vomiting, anorexia, and depression are adverse effects of levodopa, they do not contribute to a risk for falling. Tachycardia and palpitations are not common adverse effects of levodopa.

DIF: Cognitive Level: Application REF: Page 208 OBJ: 6
TOP: Nursing Process Step: Diagnosis
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
NOT: CONCEPT(S): Clinical Judgment; Patient Education; Safety

2. Which vitamin will reduce the therapeutic effects of levodopa?
a.
A
b.
B6
c.
C
d.
D

ANS: B
Pyridoxine (vitamin B6) will reduce the therapeutic effects of levodopa in oral doses of 5 to 10 mg or more. Generally, diets typically have less than 1 mg of vitamin B6 and therefore are not restricted. The ingredients in multivitamins, however, must be assessed. Vitamins A, C, and D do not affect therapy with levodopa.

DIF: Cognitive Level: Comprehension REF: Page 208 OBJ: 6
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Patient Education

3. Which cholinergic symptoms of Parkinson’s disease are reduced with anticholinergic drugs?
a.
Cognitive impairments
b.
Rigidity
c.
Tremors and drooling
d.
Postural abnormalities

ANS: C
Anticholinergic drugs will reduce the severity of tremors and drooling in patients with Parkinson’s disease. Anticholinergics are most useful when used in combination with levodopa. Anticholinergic drugs do not affect cognitive impairments. Anticholinergics have little effect on rigidity or on postural abnormalities.

DIF: Cognitive Level: Knowledge REF: Page 215 OBJ: 7
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Patient Education

4. What is the pharmacologic action of entacapone, a potent catechol O methyl transferase (COMT) inhibitor?
a.
Slows the deterioration of dopaminergic nerve cells
b.
Inhibits the relative excess of dopaminergic activity
c.
Reduces the destruction of dopamine in peripheral tissues
d.
Enhances the cholinergic symptoms of Parkinson’s disease

ANS: C
Entacapone, a COMT inhibitor, reduces dopamine destruction in peripheral tissues. This significantly increases the amount of dopamine available to reach the brain. Entacapone, when used with carbidopa levodopa therapy, results in more constant dopaminergic stimulation. Entacapone is not effective when used alone. Entacapone does not affect the nerve cells but blocks enzymes that break down levodopa. Parkinson’s disease is characterized by a relative deficit of dopaminergic activity. Entacapone does not affect cholinergic symptoms of Parkinson’s disease.

DIF: Cognitive Level: Knowledge REF: Page 202 OBJ: 5
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Patient Education

5. The nurse is teaching a patient with Parkinson’s disease about levodopa. Which statement by the nurse is accurate regarding drug administration?
a.
“Take this medication in between meals.”
b.
“Take this medication at bedtime to prevent dizziness.”
c.
“Take this medication when your tremors get worse.”
d.
“Take this medication with food or antacids to reduce GI upset.”

ANS: D
Levodopa causes nausea, vomiting, and anorexia. Therefore, administration should be in divided doses with food or antacids to decrease gastrointestinal (GI) irritation. Levodopa should be taken with food. Levodopa must be taken on a regular schedule as prescribed to provide therapeutic results.

DIF: Cognitive Level: Application REF: Page 208 OBJ: 6
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Patient Education

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