NCLEX Review Questions Chapter 2...

Pharm Chpt 20 "Drugs for Parkinson's, Alzheimer's & Multiple Sclerosis NCLEX Questions ScienceMedicineNursing laci_nurse Save NCLEX Review Questions Chapter 2...21 terms emily222_Preview

Chapter 26: Drugs for Multiple Scler...

13 terms chimiraePreview Chapter 14 NCLEX Questions - Drug...14 terms KimScaddenPreview NCLEX 110 term kan The family member caring for a client with Parkinson's disease at home notifies the nurse that the client is demonstrating extrapyramidal

symptoms. The nurse should instruct the caregiver to:

• Give diphenhydramine (Benadryl) 25 mg p.o.
• Transport the client to the Emergency Department.
• Increase dosage of antiparkinsonism drugs.
• Make an appointment with the health care provider for evaluation.

Answer: b. Transport the client to the Emergency Department.

Objective: Explain the neurochemical basis for Parkinson's disease, focusing on the roles of dopamine and acetylcholine in the brain.Rationale: The symptoms can cause severe muscle spasms and can be life-threatening without intervention. The client should be transported to the Emergency Department. Diphenhydramine must be given parenterally for effective treatment.The client asks what can be expected from drug therapy for treatment of parkinsonism. The best response by the nurse would be:

• That a cure can be expected within six months.
• That symptoms can be reduced, and the ability to perform ADLs can be improved.
• That disease progression will be stopped.
• That EPS will be prevented.

Answer: b. That symptoms can be reduced, and the ability to perform ADLs can be improved.Objective: Describe the nurse's role in the pharmacologic management of Parkinson's disease and Alzheimer's disease.Rationale: Pharmacotherapy does not cure the disease, but it does improve the client's ability to perform normal activities, such as eating, bathing, and walking. The symptoms are often reversed if medications are taken long-term.

Levodopa (Laradopa) is prescribed for a client with Parkinson's disease. The nurse's discharge teaching should include: (Select all that apply.)

• Monitor the blood pressure every two hours for the first two weeks.
• Expect the urine color to be orange.
• Report the development of diarrhea.
• Report to the lab for a follow-up of liver and renal function tests.
• Avoid taking the medication with high-protein meals.

Answer: d. Report to the lab for a follow-up of liver and renal function tests.; e. Avoid taking the medication with high-protein meals.Objective: For each of the drug classes listed in Drugs at a Glance, know representative drug examples, and explain their mechanisms of action, primary action, and important adverse effects.Rationale: A decrease in kidney and liver function could slow the metabolism and excretion of the drug, leading to overdose and toxicity.Protein decreases the absorption of levodopa. Blood pressure needs to be closely monitored when the dose is adjusted. It might cause urine and sweat to darken in color. It does not cause diarrhea.The nurse provides nutritional counseling for a client receiving levodopa. The client should be encouraged to:

• Lower the intake of simple carbohydrates.
• Increase vitamin B6 intake.
• Avoid foods such as ham, sweet potatoes, and oatmeal.
• Decrease intake of dairy products.

Answer: c. Avoid foods such as ham, sweet potatoes, and oatmeal.

Objective: For each of the drug classes listed in Drugs at a Glance, know representative drug examples, and explain their mechanisms of action, primary action, and important adverse effects.Rationale: Ham, sweet potatoes, and oatmeal are high in pyridoxine (vitamin B6). Pyridoxine reduces the effects of levodopa.A client receiving an anticholinergic drug for treatment of Parkinson's disease complains of dry mouth. Nursing intervention should include

advising the client to:

• Take the drug with food or milk.
• Chew sugarless gum, and suck on sugarless hard candy.
• Use mouthwash before taking the drug.
• Rinse mouth with warm water.

Answer: b. Chew sugarless gum, and suck on sugarless hard candy.

Objective: Describe the nurse's role in the pharmacologic management of Parkinson's disease and Alzheimer's disease.Rationale: Frequent drinking of cool liquids, sucking on hard candy or ice chips, and chewing sugarless gum can add moisture to the mucous membranes.

A client has been started on benztropine (Cogentin) for relief of parkinsonian symptoms. Which of the following statements made by the client best indicates that the drug is producing a therapeutic effect?

• "My hands aren't as shaky as they used to be."
• "I feel so calm and relaxed."
• "I can tie my shoes now without difficulty."
• "That annoying lip smacking is much less frequent."

Answer: a. "My hands aren't as shaky as they used to be."

Objective: For each of the drug classes listed in Drugs at a Glance, know representative drug examples, and explain their mechanisms of action, primary action, and important adverse effects.Rationale: Cogentin blocks excess cholinergic stimulation and helps to suppress tremors. It does not affect symptoms of tardive dyskinesia, such as lip smacking. It does not affect mood.Donepezil (Aricept) is prescribed for a client with Alzheimer's disease. The nurse determines that the medication is having positive effects when what is observed?

• Absence of wandering
• Decreased progression of memory loss
• Increase in "pin rolling"
• Regaining the ability to drive a car

Answer: b. Decreased progression of memory loss

Objective: Explain the goals of pharmacotherapy for Alzheimer's disease, and the efficacy of existing medications.Rationale: Aricept is effective in the early stages of Alzheimer's disease. It might slow or decrease progression of symptoms, but it will not reverse behaviors that are lost.The lab results of a client treated for Alzheimer's disease reveals increased liver function tests. The nurse recognizes that the drug most likely to

cause this side effect is:

• Rivastigmine tartrate (Exelon).
• Donepezil (Aricept).
• Tacrine (Cognex).
• Galantamine (Reminyl).

Answer: c. Tacrine (Cognex).

Objective: Categorize drugs used in the treatment of Alzheimer's disease and Parkinson's disease based on their classifications and mechanisms of action.Rationale: Acetylcholinesterase inhibitors used for treatment of Alzheimer's disease cause a variety of side effects. Elevated liver enzymes are specifically associated with tacrine (Cognex) use.

A client with Alzheimer's disease has been receiving medication therapy for several months. The nurse should teach the client and caregiver to

report signs of overdose, which include:

• Bradycardia and muscle weakness.
• Tachycardia and hypertension.
• Abdominal pain and dry mouth.
• Emotional withdrawal and tachypnea.

Answer: a. Bradycardia and muscle weakness.

Objective: Use the nursing process to care for clients receiving drug therapy for degenerative diseases of the CNS.Rationale: An overdose of drugs to treat Alzheimer's disease could occur if they are taken improperly, or if decreased liver or renal function occurs. Symptoms of overdose include severe nausea/vomiting, sweating, salivation, hypotension, bradycardia, convulsions, and increased muscle weakness, including respiratory muscles.During the initial treatment with levodopa for clients with Parkinson's disease, nursing interventions should include:

• Monitoring for suicidal ideation.
• Observing for EPS.
• Providing safety to prevent falls.
• Increasing foods high in vitamin B6, such as bananas and liver.

Answer: c. Providing safety to prevent falls.

Objective: Categorize drugs used in the treatment of Alzheimer's disease and Parkinson's disease based on their classifications and mechanisms of action.Rationale: Orthostatic hypotension is likely during early treatment. Clients should be protected from falls. Suicidal ideation is monitored when clients are first started on antidepressants. EPS occurs with some antipsychotic medications. Bananas and liver are high in vitamin B6 and will decrease absorption of levodopa. Terms (10) Hide definitions