Chapter 13: Antiparkinsonian Drugs

Chapter 13: Antiparkinsonian Drugs

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A psychiatric nurse should base care of patients diagnosed with Parkinson’s disease and patients demonstrating extrapyramidal side effects (EPSEs) caused by antipsychotic drug therapy on the premise that symptoms:

a.	are the same for both problems.
b.	result from deficits in dopamine synthesis.
c.	result from acetylcholine and dopamine imbalance.
d.	are produced by neurodegeneration of the substantia nigra.

 

 

ANS:  C

In both problems, acetylcholine and dopamine are not in balance. In Parkinson’s disease, this results from neurodegeneration of the substantia nigra, and in the case of EPSEs, the cause is blockade of dopamine receptors in the basal ganglia. The other options are not valid premises.

 

DIF:    Cognitive level: Understanding        REF:   pp. 130-131    TOP:   Nursing process: Planning

MSC:  NCLEX: Physiologic Integrity

 

2. A patient who is receiving an antipsychotic drug is restless, paces, and cannot sit still when watching television. The nurse should use which term to document these findings?

a.	Dystonia
b.	Akathisia
c.	Dyskinesia
d.	Bradykinesia

 

 

ANS:  B

A patient with akathisia describes feeling restless, jittery, and unable to sit, and has restless legs that feel better only if the patient is moving. Dystonia refers to sustained, twisted muscle contractions. Dyskinesia refers to jerky motions. Bradykinesia refers to slow movement.

 

DIF:    Cognitive level: Understanding        REF:   p. 131

TOP:   Nursing process: Implementation     MSC:  NCLEX: Physiologic Integrity

 

3. A patient who is receiving an antipsychotic drug is restless, paces, and cannot sit still when watching television. The patient says, “I couldn’t sleep last night because I needed to pace.” The nurse’s communication to the health care provider would be to suggest:

a.	prescribing an anticholinergic drug.
b.	discontinuing the antipsychotic drug.
c.	prescribing dopaminergic medication.
d.	using an antihistamine at bedtime to promote sleep.

 

 

ANS:  A

The patient’s motor symptoms can be assessed as akathisia. Anticholinergic medication provides relief for some patients. The nurse should report the patient’s symptoms to the health care provider and anticipate the order to begin anticholinergic therapy. The other options do not provide acceptable alternatives.

 

DIF:    Cognitive level: Applying                REF:   p. 133

TOP:   Nursing process: Implementation     MSC:  NCLEX: Physiologic Integrity

 

4. A patient who has taken three doses of haloperidol (Haldol) suddenly cries out for help. The nurse observes that the patient’s eyes are rolled upward in a fixed gaze. The nurse should assess this finding as:

a.	akathisia.
b.	nystagmus.
c.	tardive dyskinesia.
d.	an oculogyric crisis.

 

 

ANS:  D

Oculogyric crisis is a specific dystonia in which the eyes roll upward and remain in a fixed position. It results from involuntary muscle spasms and occurs early in the course of treatment. Akathisia refers to motor restlessness. Nystagmus refers to a different type of abnormal eye movements. Tardive dyskinesia refers to abnormal movements primarily of the face and mouth muscles.

 

DIF:    Cognitive level: Understanding        REF:   p. 132

TOP:   Nursing process: Assessment           MSC:  NCLEX: Physiologic Integrity