Chapter 24: Care of Patients with Peripheral Nerve and Degenerative Diseases

Chapter 24: Care of Patients with Peripheral Nerve and Degenerative Diseases

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse is explaining Parkinson disease to the student nurse. Which statement indicates that the student nurse correctly understands the pathophysiology of the disease?

a.	“Regardless of the actual etiology, Parkinson disease is caused by depletion of dopamine and excess of acetylcholine.”
b.	“The pathophysiology of the disease is caused by the deterioration of the myelin sheath of the basal ganglia.”
c.	“Excess dopamine and deficient acetylcholine are the cause of Parkinson disease.”
d.	“When there is decreased dopamine uptake at receptors in brain cells, Parkinson disease results.”

 

 

ANS:  A

The specific cause of Parkinson disease is unknown, but the basic pathophysiology is depletion of dopamine and excess of acetylcholine.

 

PTS:   1                    DIF:    Cognitive Level: Comprehension     REF:   553

OBJ:   1 (theory)       TOP:   Parkinson Disease: Pathophysiology

KEY:  Nursing Process Step: Evaluation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

2. The nurse is assessing a patient with Parkinson disease. Which statement likely characterizes this patient’s tremors?

a.	Tremors occur constantly.
b.	Tremors decrease with voluntary movement.
c.	Tremors are absent when the body is at rest.
d.	Tremors are characterized by tonic/clonic muscle activity.

 

 

ANS:  B

Tremors in Parkinson disease decrease with voluntary movement, are absent during sleep, and occur when the body is at rest. Parkinsonian muscle activity is that of “pill rolling.” Tonic/clonic movement is associated with seizures.

 

PTS:   1                    DIF:    Cognitive Level: Comprehension     REF:   554

OBJ:   1 (theory)       TOP:   Parkinson Disease: Signs

KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

3. Which problem statement/nursing diagnosis is most appropriate for a person with Parkinson disease?

a.	Risk for falls related to unsteady gait.
b.	Ineffective airway clearance related to drooling.
c.	Risk for impaired skin integrity related to tremor.
d.	Nutrition: less than body requirements related to nausea.

 

 

ANS:  A

Rigidity and impaired balance with the propulsive gait create a risk for falls. The tremor decreases with voluntary movement, making eating relatively trouble free. Drooling is not a threat for aspiration, and there is no characteristic nausea.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   557, Nursing Care Plan 24-1

OBJ:   3 (theory)       TOP:   Parkinson Disease: Nursing Diagnoses

KEY:  Nursing Process Step: Planning

MSC:  NCLEX: Physiological Integrity: Reduction of Risk Potential

 

4. To enhance more erect posture in the patient with Parkinson disease, the nurse should encourage the patient to practice which activity?

a.	Imagine stepping over an object.
b.	Sleep in the prone position.
c.	Walk with a marching step.
d.	Limit exercise to increase joint mobility.

 

 

ANS:  B

The nurse should teach the patient to consciously assume correct posture. Sleeping in the prone position without a pillow will help to improve erect posture. Imagining stepping over something helps prevent “freezing” when walking. Walking may also improve by having the patient think about imaginary lines across the pathway on which to walk. The patient should be encouraged to exercise; the physical therapist will institute an exercise program to help the patient maintain muscle function and promote joint mobility.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   559

OBJ:   3 (theory)       TOP:   Parkinson Disease: Improving Posture

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

5. The caregiver of a patient with Parkinson disease is concerned with the patient’s recent weight loss. The home health nurse should suggest which modification to help the caregiver enhance the patient’s nutrition?

a.	Provide six mini-meals throughout the day.
b.	Be sure to increase milk and cheese daily in the diet.
c.	Limit fluid intake in order to increase the appetite.
d.	Prepare larger meals of fibrous foods.

 

 

ANS:  A

Mini-meals can be eaten before food cools since it takes longer for the patient with Parkinson disease to eat. Large meals are overwhelming and may become unappetizing before they can be consumed. Reduced fluid and increased dairy products increase the threat of constipation.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   559

OBJ:   3 (theory)       TOP:   Parkinson Disease: Nutrition

KEY:  Nursing Process Step: Planning

MSC:   NCLEX: Physiological Integrity: Basic Care and Comfort