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Neurologic Pharmacology NCLEX Questions and Answers Already Graded A

A client is being treated in the clinic for an exacerbation of multiple sclerosis. The nurse would anticipate administering which drug?

• Diazepam (Valium)
• Interferon b1b (Betaseron)
• Lioresal (Baclofen)
• Methylprednisolone (Solu-Cortef) ✔✔B ~ Drugs used to treat exacerbations in ambulatory

clients include Interferon b1b, Interferon b1a (Avonex), and glatiramer acetate (Copaxone).Diazepam and lioresal could be used to treat spasticity, while steroids are used for acute relapses.

A client with MG began to experience a sudden worsening of her condition with difficulty in breathing. The nurse explains that this complication of MG is usually initially treated with

• admission and administration of IV corticosteroids.
• an increased dose of anticholinesterase drugs.
• bolus doses of atropine titrated to effect.

• rest and increased sleep. ✔✔B ~ With myasthenic crisis, if an increase in the dosage of the

anticholinesterase drug does not improve the weakness, endotracheal intubation and mechanical ventilation may be required. None of the other options is used to treat a myasthenic crisis.

A client is receiving donepezil (Aricept) for moderate Alzheimer's disease. The nurse would assess that teaching goals for this medication have been met when the client's spouse says

• Aricept works by blocking oxygen free radicals in the brain.
• Depression has been the worst part so I'm glad this pill will control it.
• I'm anxious to see how much improvement the medications allows.
• This medicine will prevent further deterioration in condition. ✔✔C ~ Several medications are

used to retain Ach in the neurojunctions of the brain. They can have small but noticeable effects and may temporarily lead to improvements. However, no drug stops the progression of AD.Aricept does not work to block oxygen free radical action, however; some studies show that alpha-tocopherol (vitamin E) and selegiline have this action. Aricept does not work on depression; often clients with AD also need antidepressants.

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?

• Carbidopa-levodopa (Sinemet)
• Donepezil (Aricept)

• Rivastigmine (Exelon)
• Tacrine (Cognex) ✔✔A ~ 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.

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

• Alzheimer's disease involves a possible excess of acetylcholine and neuritic plaques.
• Alzheimer's disease is caused by decreased amounts of dopamine and degeneration of

cholinergic neurons.

• Parkinson's disease is characterized by an imbalance of dopamine and acetylcholine.
• Parkinson's disease involves increased dopamine production and decreased acetylcholine.

✔✔C ~ 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.

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

• allows larger doses of levodopa to be given without causing increased adverse reactions.

• causes more levodopa to be converted to dopamine before crossing the blood-brain barrier.
• eliminates almost all drug side effects of both levodopa and carbidopa.
• reduces peripheral side effects by inhibiting decarboxylase in the peripheral nervous system.

✔✔D ~ 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.

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

• Acyclovir (Zovirax)
• Amantadine HCl (Symmetrel)
• Interferon (INF)
• Zanamivir (Relenza) ✔✔B ~ 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.

A patient who has parkinsonism has been taking carbidopa-levodopa and has shown improvement in symptoms but develops dystonic movements, nausea, and vomiting. Which