Parkinson's disease Pharmacology Chapter 15: NCLEX Questions

Parkinson's disease Pharmacology Chapter 15: NCLEX

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CH. 15: Antiparkinson Drugs NCLEX

18 terms bshanesyPreview Pharm 10 terms laci A patient with Parkinson's disease who has been positively responding to carbidopa-levodopa (Sinemet) asks the nurse, "Why have I suddenly developed a relapse of my symptoms." Which explanation by the nurse is appropriate?"This is called the "on-off phenomenon." Your health care provider can change your medication regimen to help manage this effect." When teaching a patient about carbidopa-levodopa (Sinemet), what information should the nurse include about this medication?Carbidopa decreases levodopa's conversion in the periphery, increasing the levodopa available to cross the blood-brain barrier.Which antiparkinson drug causes an increase in the levels of dopaminergic stimulation in the central nervous system (CNS) and therefore allows a decreased dose of other medications?Selegiline (Eldepryl) What is the goal of pharmacologic therapy in treating Parkinson's disease?To balance cholinergic and dopaminergic activity in the brain The patient asks the nurse to explain the difference between carbidopa-levodopa (Sinemet) and ropinirole (Requip). How will the nurse respond?"Ropinirole is a dopamine agonist that has fewer adverse effects than carbidopa- levodopa." The nurse is caring for a patient with Parkinson's disease who has been taking entacapone (Comtan) for the past week to treat an on-off phenomenon. The patient expresses concern over brown-orange urine. What information will the nurse provide to the patient?This is a normal adverse effect of entacapone (Comtan) and is not harmful.

A patient who has been taking antiparkinson medications for years begins to have increased symptoms on a constant basis. In documenting these symptoms, what term will the nurse use?Wearing-off phenomenon The nurse is providing care for a patient with a diagnosis of Parkinson's disease who has preexisting liver failure.What class of medications, if prescribed, would the nurse question?Catechol ortho-methyltransferase (COMT) inhibitors A patient with Parkinson's disease discusses with the nurse experiencing insomnia recently. The patient asks the nurse, "Can I take my old prescription of benzodiazepine that is prescribed to treat my insomnia?" What does the nurse know about the use of benzodiazepines in patients taking levodopa (Larodopa)?Use of benzodiazepines decreases the therapeutic effect of the levodopa and may result in an increase in the symptoms of Parkinson's disease.A patient is prescribed selegiline (Eldepryl), an MAO-B inhibitor, as adjunctive therapy in treatment of Parkinson's disease. What potential adverse effects should the nurse include in education for this patient? (Select all that apply.) Insomnia, headache, depression, blood pressure changes When doing an admission drug history, the nurse notes that the patient has a prescription for lithium (Lithobid).The nurse suspects that this patient has been diagnosed with which condition?Bipolar disorder Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) both function by which mechanism?Block the reuptake of neurotransmitters at nerve endings A patient diagnosed with depression is being discharged with a prescription for TCAs after no improvement of symptoms on an SSRI. Which instruction should the nurse include about this new medication?There is a risk of toxicity when this medication is taken with alcohol.A patient who is prescribed duloxetine (Cymbalta) comes to the medical clinic complaining of restlessness, sweating, and tremors. The nurse suspects serotonin syndrome and questions the patient regarding concurrent use of which herbal product or dietary supplement?St. John's wort A patient with a diagnosis of depression is being discharged with a prescription for an MAOI. Which instruction should the nurse include for this medication?Avoid eating aged cheese What is another approved and indicated use for the antidepressant bupropion (Zyban)?Smoking cessation

A patient prescribed lorazepam (Ativan) for the treatment of anxiety states, "I feel drowsy all the time, and it's interfering with every aspect of my life." The nurse knows that a better drug therapy option for this patient is which anxiolytic medication?Buspirone (BuSpar) Which statement by the patient indicates the need for additional teaching on phenothiazine (Thorazine) drug therapy?"It is okay to take this drug with a small glass of wine to help relax me." Which laboratory test should be monitored closely to assess for a potential life-threatening adverse effect to clozapine (Clozaril)?Complete blood count The nurse is monitoring a patient taking an antipsychotic medication for extrapyramidal symptoms. Which clinical finding indicates an adverse effect of this drug?Muscle cramps of the head and neck What atypical antipsychotic medication should the nurse anticipate the health care provider prescribing for treatment of refractory schizophrenia?Risperidone (Risperdal) While obtaining a medication history from a patient, the nurse notes that the patient is currently prescribed naltrexone (ReVia). The nurse should question the patient about a previous history of which substance abuse?Opioid A patient reports severe back pain and asks the nurse for medication "to take the pain away." Nursing assessment findings on the physical examination include mydriasis, rhinorrhea, diaphoresis, lacrimation, blood pressure of 160/84 mmHg, heart rate of 116 beats/min, and respiratory rate of 24 breaths/min. Which condition would the nurse suspect?Opioid withdrawal An unresponsive young adult is taken to the emergency department by friends. The friends tell the nurse, "We were too scared to call 911 because we were at a party popping roofies." Which medication would the nurse expect to administer to this patient?Flumazenil (Romazicon) The nurse is providing care for a patient in the emergency department who reports a headache and weakness and is noted to have cardiac dysrhythmias on the electrocardiogram. The patient is talkative, restless, anxious, and asking to leave the emergency department.The nurse suspects that the patient might be taking which abuse substance?Stimulants

The nurse is reading a patient's substance abuse history on admission to inpatient rehabilitation. The patient states to the nurse, "I have been increasing my drug dosage to get the same effect." What is the patient experiencing?Tolerance The nurse is providing care to a patient with a diagnosis of an overdose. The health care provider prescribes flumazenil (Romazicon) for the patient. What type of overdose does the nurse suspect?Benzodiazepines A nurse working in behavioral medicine is aware of associated long-term consequences of alcohol abuse.What potential vitamin deficiency can occur and potentially lead to Wernicke's encephalopathy?Vitamins B1 The nurse is caring for a patient with a history of chronic alcohol abuse. The nurse recognizes the need to closely monitor the patient for which withdrawal signs and symptoms?Tremors Agitation Hypertension The nurse is educating a group of college students about substance abuse. When discussing the potential use and abuse of stimulants, the nurse is aware these drugs are commonly abused and cause what signs and symptoms?(Select all that apply.) Weight loss Elevated mood Increased alertness