Chapter 15: Antiparkinson Drugs

Chapter 15: Antiparkinson Drugs

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient has been taking selegiline (Eldepryl), 20 mg/day for 1 month. Today, during his office visit, he tells the nurse that he forgot and had a beer with dinner last evening, and “felt awful.” What did the patient most likely experience?

a.	Hypotension
b.	Hypertension
c.	Urinary discomfort
d.	Gastrointestinal upset

 

 

ANS:  B

At doses that exceed 10 mg/day, selegiline becomes a nonselective monoamine oxidase inhibitor (MAOI), contributing to the development of the cheese effect, so-called because it interacts with tyramine-containing foods (cheese, red wine, beer, and yogurt) and can cause severe hypertension.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension)    REF:   p. 238

TOP:   NURSING PROCESS: Evaluation

MSC:  NCLEX: Physiological Integrity: Reduction of Risk Potential

 

2. A patient has been given a prescription for levodopa-carbidopa (Sinemet) for her newly diagnosed Parkinson’s disease. She asks the nurse, “Why are there two drugs in this pill?” The nurse’s best response reflects which fact?

a.	Carbidopa allows for larger doses of levodopa to be given.
b.	Carbidopa prevents the breakdown of levodopa in the periphery.
c.	There are concerns about drug-food interactions with levodopa therapy that do not exist with the combination therapy.
d.	Carbidopa is the biologic precursor of dopamine and can penetrate into the central nervous system.

 

 

ANS:  B

When given in combination with levodopa, carbidopa inhibits the breakdown of levodopa in the periphery and thus allows smaller doses of levodopa to be used. Lesser amounts of levodopa result in fewer unwanted adverse effects. Levodopa, not carbidopa, is the biologic precursor of dopamine and can penetrate into the CNS.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   p. 243

TOP:   NURSING PROCESS: Implementation

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. When a patient is taking an anticholinergic such as benztropine (Cogentin) as part of the treatment for Parkinson’s disease, the nurse should include which information in the teaching plan?

a.	Minimize the amount of fluid taken while on this drug.
b.	Discontinue the medication if adverse effects occur.
c.	Take the medication on an empty stomach to enhance absorption.
d.	Use artificial saliva, sugarless gum, or hard candy to counteract dry mouth.

 

 

ANS:  D

Dry mouth can be managed with artificial saliva through drops or gum, frequent mouth care, forced fluids, and sucking on sugar-free hard candy. Anticholinergics should be taken with or after meals to minimize GI upset and must not be discontinued suddenly. The patient must drink at least 3000 mL/day unless contraindicated. Drinking water is important, even if the patient is not thirsty or in need of hydration, to prevent and manage the adverse effect of constipation.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   p. 246

TOP:   NURSING PROCESS: Planning

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. A patient has been treated with antiparkinson medications for 3 months. What therapeutic responses should the nurse look for when assessing this patient?

a.	Decreased appetite
b.	Gradual development of cogwheel rigidity
c.	Newly developed dyskinesias
d.	Improved ability to perform activities of daily living

 

 

ANS:  D

Therapeutic responses to antiparkinson agents include an improved sense of well-being, improved mental status, increased appetite, increased ability to perform activities of daily living and to concentrate and think clearly, and less intense parkinsonian manifestations.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   p. 247

TOP:   NURSING PROCESS: Evaluation

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation