Drugs for Alzheimers and Parkinsons Disease

Understanding Pharmacology Essentials for Medication Safety

Nursing
23
Questions
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True/False
19
Choices
4
Essay
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Questions

Q1
Free

Which is the common underlying pathophysiology of both Alzheimers disease and Parkinsons disease?

Multiple Choice
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A) Both are neurodegenerative diseases.
B) Both are forms of dementia.
C) Both involve interrupted transmission of nerve impulses.
D) Both are primarily caused and directly related to environmental factors.
Answer:
C) Both involve interrupted transmission of nerve impulses.

Explanation:
Alzheimers disease is a form of dementia. Parkinsons disease is a neurodegenerative disease. Both illnesses involve interrupted nerve impulse transmissions.
Q2
Free

Which symptom is often the earliest to occur in a patient with Alzheimers disease?

Multiple Choice
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A) Difficulty solving simple math problems
B) Problems performing simple tasks
C) Mild forgetfulness
D) Inability to read
Answer:
C) Mild forgetfulness

Explanation:
Alzheimers disease symptoms begin very slowly. In the early stage, the first symptom is mild forgetfulness, which is sometimes confused with age-related memory changes.
Q3
Free

For which patient does the nurse watch most closely for symptoms of Alzheimers disease?

Multiple Choice
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A) 45-year-old with Down syndrome
B) 50-year-old with a whiplash injury
C) 60-year-old with hypertension
D) 75-year-old with a smoking history
Answer:
D) 75-year-old with a smoking history

Explanation:
Age is the greatest risk factor for development of Alzheimers disease. A patient with Down syndrome has an increased risk by age 50 to 60 years. Whiplash and head injuries, hypertension, smoking, and high cholesterol all increase the risk for Alzheimers disease.
Q4

Which statement made by a patient with Alzheimers disease indicates to the nurse the need for additional teaching?

Multiple Choice
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A) When I have been taking donepezil for 6 weeks I should regain my memories.
B) The only way to be sure that I have Alzheimers disease is by autopsy after I die.
C) Even with medication, eventually I will need total care to prevent complications.
D) The rivastigmine I am taking will slow down the progression of my symptoms.
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Q5

A newly admitted patient with Alzheimers disease who has been prescribed memantine (Namenda) has developed the symptoms of vomiting, drooling, heart rate of 56 beats per minute, and muscle weakness. What is the nurses best action?

Multiple Choice
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A) Contact the prescriber and ask for an order for an as-needed antiemetic drug.
B) Place the patient on a heart monitor and check the heart rate every 2 hours.
C) Hold the drug dose and contact the prescriber immediately.
D) Give the drug exactly as ordered.
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Q6

Which strategy best supports safe medication administration for patients with Alzheimers disease?

Multiple Choice
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A) Include the patients care provider when teaching about the patients drugs.
B) Provide written guidelines about each drug to the patient.
C) Create a chart listing the drugs, dosages, and times they should be taken.
D) Suggest that the patient set up the drugs each week in labeled boxes.
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Q7

A patient with Alzheimers disease is prescribed rivastigmine (Exelon). What action does the nurse take to prevent a common side effect?

Multiple Choice
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A) Give the drug with a full glass of water.
B) Administer the drug with meals twice a day.
C) Assess the patients level of consciousness.
D) Keep an accurate record of all patient food intake.
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Q8

What is the most important precaution for the nurse to teach a patient who is prescribed transdermal rivastigmine (Exelon)?

Multiple Choice
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A) Always remove old patches daily and apply the new patch to a different site.
B) Report any difficulty starting the urinary stream to your prescriber immediately.
C) Place the patch on the neck or forehead so that the drug reaches the brain more quickly.
D) For best drug absorption, hold a warm wet washcloth over the patch for 5 minutes after applying it.
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Q9

For which patient must the drug donepezil (Aricept) for Alzheimers disease be avoided?

Multiple Choice
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A) 54-year-old woman with early onset Alzheimers disease
B) 67-year-old man who also takes drugs for type 2 diabetes
C) 72-year-old woman who is 20 lb underweight
D) 72-year old man who is unable to sit or stand
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Q10

Which statement is true about how drugs for Parkinsons disease work?

Multiple Choice
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A) Dopaminergic drugs decrease the amount of dopamine activity in the brain.
B) COMT inhibitors allow a larger amount of levodopa to reach the brain, which lowers the brains dopamine levels.
C) MAO-B inhibitors facilitate the enzyme monoamine oxidase B that breaks down dopamine in the brain.
D) Anticholinergic drugs block cholinergic nerve impulses to minimize tremors and rigidity.
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Q11

A patient with Parkinsons disease who has been prescribed entacapone (Comtan) tells the nurse about muscle aches, weakness, and having dark cola-colored urine. What is the nurses best action?

Multiple Choice
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A) Send a urine specimen to the laboratory for urinalysis.
B) Help the patient back to bed and instruct him or her to rest.
C) Tell the patient that these are expected side effects of the drug.
D) Hold the drug and notify the prescriber immediately.
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Q12

Which blood laboratory test result is most important for the nurse to check before administering the first prescribed dose of carbadopa-levodopa (Sinemet) to a patient?

Multiple Choice
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A) International normalized ratio (INR)
B) Blood urea nitrogen (BUN) level
C) White blood cell (WBC) count
D) Lactate dehydrogenase (LDH)
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Q13

For which adverse effect does the nurse monitor in a patient with Parkinsons disease after administering ropinirole (Requip)?

Multiple Choice
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A) Neuroleptic malignant syndrome
B) Depression with suicidal tendencies
C) Central nervous system depression
D) Narcolepsy or sleep attacks
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Q14

A patient with Parkinsons disease informs the nurse that the stiffness and slowness of movements associated with the illness have become worse. What does the nurse teach the patient about this change?

Multiple Choice
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A) These changes are normal and expected as your disease progresses.
B) You will need to use a walker at all times to avoid falls and accidents.
C) Whenever your symptoms worsen, contact your prescriber right away.
D) If your prescriber increases your drug dosage these functions will improve.
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Q15

A patient taking entacapone (Comtan) for Parkinsons disease informs the nurse that his urine is now brownish-orange in color. What is the nurses best action?

Multiple Choice
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A) Explain that this is an expected side effect and is not harmful.
B) Collect a urine sample and send it to the laboratory for urinalysis.
C) Hold the drug and immediately notify the prescriber.
D) Instruct the patient to increase his intake of fluids.
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Q16

What safety precaution must the nurse teach a patient with Parkinsons disease who is prescribed benztropine (Cogentin)?

Multiple Choice
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A) Always dress warmly and avoid extended exposure to cold weather.
B) Stay indoors in an air-conditioned setting during hot weather.
C) Change positions slowly to avoid dizziness or light-headedness.
D) Avoid alcohol intake because drowsiness is associated with this drug.
Answer:

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Q17

A patient who has been prescribed carbidopa-levodopa (Sinemet) informs the nurse that a dark spot on his arm is getting larger. What is the nurses best action?

Multiple Choice
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A) Measure the size of the spot and document the finding.
B) Inform the patient that this is an expected side effect of the drug.
C) Administer the drug as ordered by the prescriber.
D) Hold the drug and contact the prescriber about this change.
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Q18

Why is bromocriptine (Parlodel) not recommended for women who are breastfeeding?

Multiple Choice
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A) It stops the production of milk.
B) It enters the milk and slows infant growth.
C) It enters the milk and causes symptoms of Parkinsons disease in the infant.
D) It is a pregnancy category C drug and has been found to cause birth defects in animals.
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Q19

A patient is prescribed entacapone (Comtan) 800 mg per day. The drug is available in 200-mg tablets. How many tablets does the nurse give?

Multiple Choice
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A) 2
B) 4
C) 6
D) 8
Answer:

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Q20

[Multiple Response] Which information must be included when documenting a patients seizure? (Select all that apply.)
a. Time of seizure onset
b. Total duration of the seizure
c. Patients ability to swallow during seizure
d. Incontinence during seizure
e. Patient orientation after seizure

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Q21

[Multiple Response] Which are major symptoms of Parkinsons disease? (Select all that apply.)
a. Bradycardia
b. Rigidity
c. Abnormal gait
d. Tremor at rest
e. Lack of facial expression

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Q22

[Multiple Response] What are the goals of treatment for Parkinsons disease? (Select all that apply.)
a. Help the patient to maintain a high quality of life.
b. Reduce side effects of drug therapy.
c. Regain as much function as possible.
d. Minimize the patients disability.
e. Prolong the patients life span.

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Q23

[Multiple Response] A patient has been prescribed rasagiline (Azilect). Which foods must the nurse teach the patient to avoid? (Select all that apply.)
a. Green leafy vegetables
b. Aged cheeses
c. Sour cream
d. Fresh apples and pears
e. Soy sauce

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