Question 1

The three major features of Parkinson\'s include:

Accepted Answer

rigidity, bradykinesia, and tremors.

Question 2

A patient is newly diagnosed with Parkinson\'s disease, and levodopa (Dopar) has been prescribed. What patient teaching information should be considered a high priority for this patient?

Accepted Answer

Avoid vitamin B6 intake, since a combination with levodopa may lead to decreased efficacy.

Question 3

A nurse is speaking to a group at the Senior Citizens Center about Parkinson\'s disease. What should the nurse include in the presentation about what elderly people using anticholinergic medications should avoid?

Accepted Answer

Strenuous exercise in high environmental temperatures

Question 4

A 66-year-old woman presents at the clinic with motion sickness. The physician orders a scopolamine patch. Which statement by the client leads the nurse to believe the client knows how to use the patch?  - \"I will place it on my chest each morning after I shower.\" - \"I will use it only if I feel sick to my stomach.\"  -\"I will change the patch every 4 hours. I can use the patches for 1 week.\" -\"I will change the patch every 3 days.\"

Accepted Answer

\"I will change the patch every 3 days.\"

Question 5

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

Accepted Answer

Confusion and disorientation

Question 6

The nurse is preparing a male client for pacemaker surgery. The physician orders atropine to be given 30 minutes before the patient leaves for the operating room. The nurse knows that the physician ordered this medication for what reason?

Accepted Answer

To dry up respiratory secretions to prevent aspiration during surgery

Question 7

A client with symptomatic bradycardia has been receiving atropine for the past 4 days. The client reports constipation, a common adverse effect of the drug. What is the most important suggestion the nurse could give the client?

Accepted Answer

Increase bulk in the diet.

Question 8

An elderly woman is given scopolamine while on a cruise. She becomes very agitated and confused. The nurse knows that which is a likely reason for these symptoms?

Accepted Answer

Older clients have a greater chance of adverse reactions to cholinergic blocking drugs.

Question 9

A 57-year-old female client has a history of two myocardial infarctions in the past 3 years. She presents to the physician\'s office with symptoms of an overactive bladder. She requests an anticholinergic medication that she saw advertised on television. What does the nurse expect the physician to do for this client?

Accepted Answer

Explain to the client that the medication is contraindicated because of her medical history   p.885,887

Question 10

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 11

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

Accepted Answer

decrease salivation, spasticity, and tremors.

Question 12

Clients with what disorder should not be given anticholinergic drugs?  -Epilepsy -Attention deficit disorder -Glaucoma -Severe anxiety or hyperactivity

Accepted Answer

Glaucoma

Question 13

Atropine is derived from the belladonna plant. True or False.

Accepted Answer

True

Question 14

A student asks the pharmacology instructor to explain the action of anticholinergic agents. What would be the instructor\'s best response?

Accepted Answer

They act to block the effects of the parasympathetic nervous system.

Question 15

What may parkinsonism result from? (Select all that apply.)  Drugs Stroke Myocardial infarction Encephalitis Epilepsy

Accepted Answer

Drugs  Encephalitis

Question 16

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 nursing intervention should the nurse perform when caring for this patient?

Accepted Answer

Administer the next drug dose with meals.

Question 17

A patient who is going on a cruise is concerned about motion sickness and sees the physician, who prescribes scopolamine. The nurse informs the patient that using scopolamine may cause the patient to experience:

Accepted Answer

drowsiness.

Question 18

A 52-year-old male client is being treated for Parkinson\'s disease. The nurse is aware that Parkinson\'s 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 19

A 75-year-old male client is experiencing extrapyramidal symptoms secondary to an antipsychotic drug. Which drug would the nurse expect the physician to order to relieve these symptoms?

Accepted Answer

Anticholinergics

Question 20

A client is using a scopolamine patch for treatment of motion sickness. The nurse would instruct the client to change the patch at which frequency?

Accepted Answer

Every 3 days

Question 21

A patient is taking levodopa. What would the nurse caution the patient to avoid?

Accepted Answer

Vitamin B6

Question 22

After teaching a patient who is prescribed a scopolamine patch, the nurse determines that the teaching was successful when the patient states that she will change the patch in which time frame?

Accepted Answer

Every 3 days

Question 23

Anticholinergics do not block the effects of acetylcholine in the central nervous system. True or False.

Accepted Answer

False

Question 24

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

Accepted Answer

Carbidopa (Lodosyn)

Question 25

A nurse has been invited to speak to a support group for persons with movement disorders and their families. Which statement by the nurse addresses the chronic nature of these diseases and the relevant drug therapies?   -\"Drug therapy can consist of one or more drugs to eliminate the symptoms of these diseases.\"  -\"Drugs do not cure these disorders; they instead enhance quality of life.\" -\"Persons of all cultures are treated similarly and respond in similar ways to treatment.\"  -\"Drugs used to treat these disorders always pose a risk of severe liver and kidney dysfunction.\"

Accepted Answer

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

Question 26

The pharmacology instructor is discussing the adverse effects of anticholinergic drugs. What drug would the instructor indicate is administered to counteract the effects of atropine poisoning?

Accepted Answer

Physostigmine

Question 27

Administration of which classes of medications can decrease secretions of the upper respiratory tract?

Accepted Answer

Cholinergic blocking drug

Question 28

Which agent would a nurse expect to administer transdermally?

Accepted Answer

Scopolamine

Question 29

A male client is diagnosed with Parkinson\'s disease. The nurse visits him 1 week after hospitalization to assess his progress and medication regimen compliance. He states that there is no significant improvement in his symptoms. What is the best response by the nurse?  -\"Noticeable improvement may not occur for several weeks after the initial drug dose.\" - \"Noticeable improvement usually occurs 7 to 10 days after the initial drug dose.\" -\"You should have noticed improvement by now; I will notify your physician.\"  -\"Are you sure that you are taking the medication as ordered?\"

Accepted Answer

\"Noticeable improvement may not occur for several weeks after the initial drug dose.\"

Question 30

Unwanted anticholinergic effects include:   -wakefulness, mental alertness, and decreased fatigue. -drowsiness or sleep; decreased muscle tone; and decreased ability to move. -increasing hyperactivity, excessive talking, nervousness, and insomnia. -constipation and dry mouth.

Accepted Answer

constipation and dry mouth.

Question 31

The nurse would monitor a patient receiving a dopaminergic agent for which adverse effects. (Select all that apply.)  Nervousness Dysphagia Flushing Hypertension Urinary frequency

Accepted Answer

Nervousness Dysphagia Flushing

Question 32

A patient is prescribed dicyclomine. The nurse would expect to administer this drug by which route?

Accepted Answer

Oral

Question 33

A patient is experiencing symptoms of a hyperactive bowel. Which agent would the nurse expect to be ordered?

Accepted Answer

Dicyclomine

Question 34

Which drug is classified as a catechol-O-methyltransferase (COMT) inhibitor?  Entacapone (Comtan) Carbidopa (Lodosyn) Benztropine (Cogentin) Biperiden (Akineton)

Accepted Answer

Entacapone (Comtan)

Question 35

A patient, newly diagnosed with Parkinson\'s disease, has been prescribed an anticholinergic drug. What is a common adverse effect of anticholinergic agents used for the treatment of Parkinson\'s disease?

Accepted Answer

Urinary retention

Question 36

The nurse is writing a plan of care for a patient taking anticholinergic drugs. What is an appropriate goal for this patient\'s plan of care?  -The patient will ineffectively cope with expected effects of drugs. -The patient will demonstrate ability to self-administer drugs incorrectly. -The patient will experience relief of symptoms for which anticholinergics are given. -Verbalize appropriate knowledge of other drugs, their effects, and side effects.

Accepted Answer

The patient will experience relief of symptoms for which anticholinergics are given.

Question 37

A nurse is educating a patient newly diagnosed with Parkinson\'s disease. Which description would the nurse offer to describe the disease?

Accepted Answer

\"It is characterized abnormalities in posture.\"

Question 38

Some anticholinergic drugs have the same clinical indications in the pediatric population as in the adult population. Which statement accurately describes a difference between the populations related to the use of anticholinergics?

Accepted Answer

Adverse effects tend to be more severe in children.

Question 39

A female client is diagnosed with Parkinson\'s disease and is having difficulty performing her activities of daily living. Her physician orders pramipexole. Pramipexole may be used alone for which purpose?

Accepted Answer

To improve motor performance and improve ability to participate in usual activities of daily living

Question 40

After teaching a group of students about adjunctive therapy used to treat Parkinson\'s disease, the instructor determines that the teaching was successful when the students identify which agent as affecting catecholaimine-O-methyl transferase (COMT)?

Accepted Answer

Entacapone

Question 41

A patient is receiving rasagiline. The nurse would instruct the patient to avoid which of the following? Select all that apply.  Aged cheese Pepperoni Pickled herring Sour cream  Milk  Shellfish

Accepted Answer

Aged cheese  Pepperoni  Pickled herring  Sour cream

Question 42

While providing patient education for a patient newly diagnosed with Parkinson\'s disease and their family, the nurse would explain that Parkinson\'s disease is characterized by

Accepted Answer

postural instability.

Question 43

A patient with asthma will soon begin treatment with atropine as an adjunct to a normal drug regimen. What teaching point should the nurse include in patient education related to this new aspect of drug treatment?  -\"You might find that you have to urinate more often for the first few days that you take the drug.\"  -\"It\'s possible that your eyes will take longer to adjust to bright lights.\"  -\"If you develop diarrhea, it might be related to atropine and you should visit your doctor.\" -\"You\'ll probably find that you are producing more saliva than normal; this is a normal side effect of atropine.\"

Accepted Answer

\"It\'s possible that your eyes will take longer to adjust to bright lights.\"

Question 44

The nurse is educating a patient who has been prescribed atropine, an anticholinergic drug. Which instructions should the nurse provide to the patient?

Accepted Answer

\"Do not drive or operate machinery.\"

Question 45

The nurse is aware that cholinergic blocking agents will be used preoperatively for what type of anesthesia?

Accepted Answer

General

Question 46

A male client asks the nurse why he needs the preoperative anticholinergic medication ordered by the anesthesiologist. The nurse explains that anticholinergic drugs are given preoperatively to prevent which anesthesia associated complication?

Accepted Answer

Bradycardia

Question 47

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 48

Which action would be a priority for a client receiving apomorphine?   -Giving the drug with food  -Monitoring cardiac status  -Checking for skin lesions -Palpating the bladder

Accepted Answer

Monitoring cardiac status

Question 49

Clients with what disorder should not be given anticholinergic drugs?

Accepted Answer

Glaucoma

Question 50

What medications is the antidote for poisoning by insecticides containing organophosphates?

Accepted Answer

Atropine

Question 51

An instructor is preparing a teaching plan for a group of students about drugs used to treat Parkinson\'s disease. The nurse is planning to talk about amantadine. Which would the instructor include as an action?

Accepted Answer

Increases the release of dopamine

Question 52

The cholinergic blocking drug glycopyrrolate (Robinul) is used in conjunction with anesthesia for which reason?

Accepted Answer

Reduction of oral secretions

Question 53

The nurse has a patient who is receiving selegiline (Carbex, Eldepryl). The nurse knows that when selegiline (Carbex, Eldepryl) is administered, the nurse should assess for what adverse effects?

Accepted Answer

Elevated blood pressure

Question 54

A nurse is caring for a 59-year-old patient with Parkinson\'s disease. What would indicate to the nurse that the patient is experiencing an adverse reaction related to the drug carbidopa-levodopa?  -Altered complete blood count -Blurred vision -Dark urine -Increased urine glucose levels

Accepted Answer

Blurred vision

Question 55

Because of the systemic effects of anticholinergic drugs, patients using these drugs are more susceptible to:

Accepted Answer

heat stroke related to decreased perspiration.

Question 56

The nurse is caring for a client with glaucoma and is aware that which category of preanesthetic medication is contraindicated in this client?

Accepted Answer

Cholinergic blocking

Question 57

When administering entacapone, the nurse understands that this drug affects which enzyme?

Accepted Answer

Catecholamine-O-methyl transferase

Question 58

What would be considered a peripheral anticholinergic effect of anticholinergic drug therapy?  Delirium Blurred vision Agitation Memory loss

Accepted Answer

Blurred vision

PrepU – Chapter 47: Drug Therapy for Parkinson’s Disease and Anticholinergics – Flashcards

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