Question 1

Anticholinergic

Accepted Answer

drug that opposes the effects of acetylcholine at acetylcholine receptor sites

Question 2

Bradykinesia

Accepted Answer

difficulty in performing intentional movements and extreme slowness and sluggishness; characteristic of Parkinson\'s disease

Question 3

Corpus Striatum

Accepted Answer

part of the brain that reacts with the substantia nigra to maintain a balance of suppression and stimulation

Question 4

Dopaminergic

Accepted Answer

drug that increases the effects of dopamine at receptor sites

Question 5

Parkinson\'s Disease

Accepted Answer

debilitating disease, characterized by progressive loss of coordination and function, which results from the degeneration of dopamine-producing cells in the substantia nigra

Question 6

Parkinsonism

Accepted Answer

Parkinson\'s disease-like extrapyramidal symptoms that are adverse effects associated with particular drugs or brain injuries.

Question 7

Substantia Nigra

Accepted Answer

a part of the brain rich in dopamine and dopamine receptors; site of degenerating neurons in Parkinson\'s disease

Question 8

Parkinson\'s disease signs and symptoms of the disease

Accepted Answer

damaged neurons in the basal ganglia of the brain

Question 9

The corpus striatum is connected to the substantia nigra by a series of neurons that use

Accepted Answer

gamma-aminobutyric acid, an inhibitory neurotransmitter

Question 10

If a child needs an antiparkinsonian drug

Accepted Answer

diphenhydramine is the drug of choice

Question 11

The mainstay of treatment for Parkinson\'s disease

Accepted Answer

Levodopa

Question 12

Levodopa is almost always given in combination form with

Accepted Answer

Carbidopa as a fixed-combination drug (Sinemet)a

Question 13

A newer drug that directly stimulates dopamine receptors

Accepted Answer

Ropinirole- also used to treat restless leg syndrome

Question 14

Initial monotherapy or as an adjunct therapy with levodopa.

Accepted Answer

Rasagiline

Question 15

Apomorphine must be given

Accepted Answer

Subcutaneously

Question 16

The dopaminergics are usually given

Accepted Answer

Orally

Question 17

If dopaminergics are combined with monoamine oxidase inhibitors (MAOIs),

Accepted Answer

therapeutic effects increase and a risk of hypertensive crisis exists

Question 18

Levodopa is contraindicated in patients with a history or presence of suspicious

Accepted Answer

Skin lesions

Question 19

The MAOI should be stopped

Accepted Answer

14 days before beginning therapy with a dopaminergic

Question 20

The combination of levodopa with

Accepted Answer

vitamin B6 or with phenytoin may lead to decreased efficacy of the levodopa

Question 21

Patients who take dopaminergics should be cautioned to avoid

Accepted Answer

over-the-counter vitamins

Question 22

Patients using rasagiline should avoid

Accepted Answer

- tyramine-containing foods - St. John\'s wort - meperidine - other analgesics

Question 23

Benztropine and diphenhydramine are available in

Accepted Answer

oral and intramuscular/intravenous forms

Question 24

Trihexyphenidyl is only available in

Accepted Answer

oral form

Question 25

Anticholinergics should be administer these agents cautiously in the following conditions

Accepted Answer

- tachycardia - dysrhythmias  - hypertension  - hypotension

Question 26

Anticholinergic prototype

Accepted Answer

Benztropine

Question 27

Dopaminergic Prototype

Accepted Answer

Levodopa

Question 28

Stalevo is a fixed-combination tablet containing

Accepted Answer

levodopa, carbidopa, and entacapone

Question 29

Parkinson\'s disease is a progressive, chronic neurological disorder that is usually

Accepted Answer

known to affect people of all ages with no known cause.

Question 30

Parkinson\'s disease reflects an imbalance between inhibitory and stimulating activity of nerves in the

Accepted Answer

basal ganglia

Question 31

The main underlying problem with Parkinson\'s disease seems to be a decrease in the neurotransmitter

Accepted Answer

dopamine

Question 32

Anticholinergic drugs are effective in early Parkinson\'s disease. They act

Accepted Answer

to block stimulating effects of acetylcholine in the brain to bring activity back into balance.

Question 33

A patient receiving an anticholinergic drug for Parkinson\'s disease is planning a winter trip to Tahiti. The temperature in Tahiti is 70 degrees warmer than at home. What precautions should the patient be urged to take?

Accepted Answer

Reduce dose and take precautions to reduce the risk for heat stroke

Question 34

Replacing dopamine in the brain would seem to be the best treatment for Parkinson\'s disease. This is difficult because dopamine

Accepted Answer

cannot cross the blood-brain barrier

Question 35

A patient taking levodopa and over-the-counter megavitamins might experience

Accepted Answer

return of Parkinson\'s symptoms

Question 36

A patient who has been diagnosed with Parkinson\'s disease for many years and whose symptoms were controlled using Sinemet has started to exhibit increasing signs of the disease. Possible treatment might include

Accepted Answer

combination therapy with an anticholinergic drug

Question 37

A client asks the nurse to explain parkinsonism to him. Which of the following possible causes of parkinsonism might be included in the explanation?

Accepted Answer

- Adverse effect of drug therapy - Brain injury - Viral infection

Question 38

No therapy is available that will stop the loss of neurons and the eventual decline of function in clients with Parkinson\'s disease. As a result, nursing care should involve which of the following interventions?

Accepted Answer

- Supportive education as drugs fail and new therapy is needed - Community and family support networking - Explanations of the adjunctive drug therapy that may be used

Question 39

A nurse is caring for a patient who has received carbidopa/levodopa. After administration of the first dose of the drug, the patient has developed gastrointestinal disturbances. Which of the following nursing interventions should the nurse perform when caring for this patient?

Accepted Answer

Administer the next drug dose with meals

Question 40

When describing the action of levodopa, which of the following would the nurse include?

Accepted Answer

Acts like replacement therapy

Question 41

A patient with Parkinson\'s disease is undergoing treatment in a health care facility. Which of the following nursing interventions should the nurse perform during ongoing assessment?

Accepted Answer

Observe the patient for various neuromuscular signs.

Question 42

The home care nurse is caring for an 80-year-old patient who is receiving carbidopa-levodopa, a dopaminergic drug used to treat Parkinson\'s disease. The nurse knows that this drug may place the patient at increased risk for

Accepted Answer

Falls

Question 43

Common side effects of anticholinergics include

Accepted Answer

Dry mouth, urinary retention, constipation, and increased pulse rate

Question 44

Indications for use of anticholinergic drugs in the treatment for Parkinsonism include

Accepted Answer

To decrease salivation, spasticity, and tremors

Question 45

A female client is prescribed centrally acting anticholinergics for her Parkinson\'s disease. Six weeks later, her daughter asks the physician to hospitalize the client for a psychiatric evaluation. The nurse anticipates that the physician will respond in what way to the daughter\'s request?

Accepted Answer

Evaluate the client for adverse reactions from the centrally acting anticholinergics

Question 46

Which of the following drugs is classified as a catechol-O-methyltransferase (COMT) inhibitor?

Accepted Answer

Entacapone (Comtan)

Question 47

A male client is diagnosed with chronic renal failure. He routinely takes amantadine for his Parkinson\'s disease with success. Why would his physician consider discontinuing the amantadine?

Accepted Answer

With amantadine, excretion is primarily via the kidneys.

Question 48

A patient receiving a dopaminergic agent complains of nausea, vomiting, and dysphagia. Which nursing diagnosis would be most appropriate for this patient?

Accepted Answer

Imbalanced nutrition: less than body requirements

Question 49

A nurse should counsel patients receiving levodopa to avoid foods high in which of the following vitamin as it reduces the effect of levodopa?

Accepted Answer

Pyridoxine (vitamin B6)

Question 50

The symptoms of parkinsonism are caused by the depletion of dopamine in which of the following?

Accepted Answer

Central nervous system

Question 51

A 60-year-old male patient has developed a tremor of the right hand with a pill rolling motion. Upon interviewing the patient, he states he sustained several head injuries playing football. Based on this information, what do you suspect the patient is suffering from?

Accepted Answer

Parkinson\'s disease

Question 52

A client is to receive trihexyphenidyl as adjunctive treatment for Parkinson\'s disease. The nurse would expect to administer this drug by which route?

Accepted Answer

Oral

Question 53

Levodopa is used as treatment for Parkinson\'s disease primarily acting as a replacement neurotransmitter

Accepted Answer

True

Question 54

A patient has been prescribed rasagiline, which is the newest irreversible MAO inhibitor used as an adjunct with levodopa (L-dopa). When educating this patient on this medication, which herbal supplement has the potential to produce hyperpyrexia and death with rasagiline?

Accepted Answer

St. John\'s Wort

Question 55

A nurse is caring for a patient who has just been diagnosed with Parkinson disease. The patient does not understand how the medication ordered, carbidopa-levodopa, is going to help her condition. Which of the following is the correct response by the nurse?

Accepted Answer

\"Carbidopa-levodopa increases the activity of dopamine in your body, which will decrease your symptoms.\"

Question 56

A female client begins tolcapone therapy, and her physician arranges for laboratory testing to be completed on a routine basis. The nurse expects which laboratory study to be ordered by the physician?

Accepted Answer

Liver transaminase enzymes

Question 57

A nurse has been invited to speak to a support group for persons with movement disorders and their families. Which of the following statements by the nurse addresses the chronic nature of these diseases and the relevant drug therapies?

Accepted Answer

\"Drugs do not cure these disorders; they instead enhance quality of life.\"

Question 58

Dopaminergic agents can exacerbate cardiovascular disease due to dopamine receptor stimulation.

Accepted Answer

True

Question 59

When reviewing the medical record of a patient receiving levodopa, which of the following would alert the nurse to the need for close monitoring?

Accepted Answer

Peptic ulcer disease

Question 60

Which of the following drugs is classified as a dopaminergic agent that treats Parkinsonism by supplementing the amount of dopamine in the brain?

Accepted Answer

Carbidopa (Lodosyn)

Question 61

A nurse is caring for 70-year-old patient who is undergoing anticholinergic drug therapy. The nurse should assess for which of the following conditions when caring for this elderly patient?

Accepted Answer

Confusion and disorientation

Question 62

Mr. Marks, age 52, is being treated for Parkinson disease. You are aware that Parkinson disease results in muscle rigidity, tremor at rest, and postural instability. What occurs in the neurons that causes these symptoms?

Accepted Answer

There is an imbalance between dopamine and acetylcholine.

Question 63

A nurse is educating a patient who has Parkinson disease and her husband about the possible adverse effects of carbidopa-levodopa. The nurse should emphasize the need for the patient and her husband to monitor for any sudden increase in

Accepted Answer

Involuntary movements.

Question 64

A patient who suffers from Parkinson\'s disease is being treated with levodopa (L-dopa). Which of the following disorders will result in the discontinuation of levodopa (L-dopa) based on a disease-related contraindication?

Accepted Answer

Narrow-angle glaucoma

Chapter 24: Antiparkinsonism Agents – Flashcards

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