NCLEX Questions Parkinson's, AD, and Seizures

NCLEX Questions Parkinson's, AD, and Seizures Leave the first rating Students also studied Terms in this set (10) Save

NEURO NCLEX QUESTIONS

36 terms kidniki77Preview Lehne's Pharm CH. 19 Drugs for Park...10 terms Brittnee_Rogers8 Preview Pharmacology final 45 terms artaylor21Preview Chapte 15 terms chis A patient taking levodopa/carbidopa [Sinemet] for Parkinson disease experiences frequent "on-off" episodes (i.e., the abrupt loss of effect). Which action by the nurse is best?A.Administer the medication when the patient has an empty stomach.B.Instruct the patient to avoid high-protein foods.C.Have the patient increase the intake of vitamin B6.D.Discontinue the drug for 10 days (for a "drug holiday").

• Instruct the patient to avoid high-protein foods.

Rationale: Meals high in protein can reduce therapeutic responses to levodopa

and may trigger an abrupt loss of effect.A patient is prescribed the dopamine agonist pramipexole [Mirapex]. Which statement made by the patient indicates a need for further teaching?A."The drug should be taken with food to prevent nausea." B."I may experience hallucinations while taking this drug." C."I should rise slowly to prevent dizziness and fainting." D."This drug will stop the progression of Parkinson disease."

• "This drug will stop the progression of Parkinson disease."

Rationale: Dopamine agonists will improve the patient's ability to complete

activities of daily living, but they are not a cure and will not delay the progression of Parkinson disease.The nurse is caring for a patient who is receiving pramipexole [Mirapex]. The nurse is most concerned if the patient makes which statement?A."I take this pill even when I feel good." B."Sometimes I just fall asleep without warning." C."The pills make me sleepy, so I take a nap in the afternoon." D."I have noticed that this medicine makes me constipated."

• "Sometimes I just fall asleep without warning."

Rationale: Pramipexole may cause sleep attacks; patients should inform the

prescriber and avoid potentially hazardous activities.

A patient with mild symptoms of AD is prescribed donepezil [Aricept]. Which statement made by the patient indicates the need for further teaching?A."The drug will improve transmission by neurons in my brain." B."I may experience an upset stomach while taking this drug." C."I will take the drug every night at bedtime with a snack." D."The drug will stop damage to the neurons in my brain."

• "The drug will stop damage to the neurons in my brain."

•Rationale: Donepezil is a cholinesterase inhibitor that increases the availability of acetylcholine at cholinergic synapses. Transmission by neurons that have not yet been destroyed will be enhanced. The drug will not stop disease progression, but it may slow progression by a few months. Common adverse effects include nausea and diarrhea. Donepezil should be taken at bedtime and can be taken with or without food.The nurse prepares to administer memantine [Namenda] to a patient with severe AD. The nurse should assess what before administering of the medication?A.Hemoglobin and hematocrit B.Blood urea nitrogen and serum creatinine C.Aspartate aminotransferase and alanine aminotransferase D.Erythrocyte sedimentation rate and neutrophil count

• Blood urea nitrogen and serum creatinine

Rationale: Memantine undergoes little metabolism and is excreted largely

unchanged in the urine. Clearance is reduced in patients with renal impairment. In patients with moderate renal impairment, a dosage reduction may be needed, regardless of the formulation used. In patients with severe renal impairment, memantine should be avoided.A patient is concerned about developing AD. What should the nurse include in the teaching plan?A.Estrogen replacement therapy improves cognitive functioning.B.No solid evidence supports the use of drugs to prevent AD.C.Naproxen taken daily after the age of 50 years decreases the risk of AD.D.Daily doses of ginkgo biloba can prevent cognitive decline.B.No solid evidence supports the use of drugs to prevent AD.

Rationale: No solid evidence indicates that drugs, nutrients, supplements,

exercise, cognitive training, or any other intervention can prevent AD or delay cognitive decline.A 15-year-old patient has a tonic-clonic seizure disorder and is prescribed phenytoin. Which term best describes the absorption rate of oral phenytoin?A.Rapid B.Slow C.Erratic D.Moderate

• Slow

Rationale: Phenytoin is absorbed slowly through the GI tract. It's absorbed much more rapidly when administered IV.A 11-yrear-old patient develops myoclonic seizures.Which potential adverse reaction ;makes it unlikely that valproate will be prescribed for this patient/ A.Liver toxicity B.CNS sedation C.Respiratory depression D.Hyperthermia

• Liver toxicity

Rationale: When administered to children and patients taking other

anticonvulsants, valproate carries a risk of potential fatal liver toxicity.

A patient is prescribed phenytoin [Dilantin] for epileptic seizures. Which of the following is the priority for patient teaching?A.Teach the patient to adjust the dose according to the presence of symptoms.B.Tell the patient to take the medication with meals.C.Inform the patient about the prevention of gingival hyperplasia.D.Teach the patient to avoid the abrupt cessation of treatment.D.Teach the patient to avoid the abrupt cessation of treatment.Rationale: The most important concept is to teach the patient to avoid the abrupt cessation of treatment. This could lead to a life-threatening seizure or to status epilepticus. The patient should not adjust the dose without consulting the prescriber. Although teaching the patient to take the medication with meals and teaching the patient how to avoid gingival hyperplasia are indicated, they are not the priority.A patient is newly prescribed carbamazepine [Tegretol] for seizure control. It is most important for the nurse to teach the patient to avoid which food?A.Tomatoes B.Grapefruit juice C.Spinach D.Kiwi fruit

• Grapefruit juice

Rationale: Grapefruit juice can inhibit the metabolism of carbamazepine, thereby causing plasma levels to rise. Grapefruit juice may increase the peak and trough levels of carbamazepine by up to 40%.