Nu 158 Exam 1 - Galen College
A nurse is assessing a client diagnosed with Parkinson's disease. Which of the following
findings should the nurse report to the healthcare provider immediately?
A. Pill-rolling tremor in the right hand
B. Cogwheel rigidity in both upper extremities
C. Shuffling gait with a stooped posture
D. Episodes of freezing while ambulating, increasing in frequency
Correct Answer: D
Rationale:: Freezing episodes that increase in frequency may indicate worsening mobility
and higher fall risk. This change requires prompt intervention to ensure safety.
Which clinical manifestation is most characteristic of Parkinson's disease?
A. Muscle flaccidity
B. Hyperactive reflexes
C. Pill-rolling tremor
D. Sudden onset of muscle weakness
Correct Answer: C
Rationale:: A resting "pill-rolling" tremor is a hallmark symptom of Parkinson's disease,
particularly affecting the hands.
The nurse is providing discharge instructions to a client newly diagnosed with Parkinson's
disease. Which statement by the client indicates a need for further teaching?
A. "I should exercise to maintain mobility."
B. "I may notice my handwriting becoming smaller."
C. "I will avoid walking alone due to the risk of freezing."
D. "These symptoms should go away after a few weeks of medication."
Correct Answer: D
Rationale:: Parkinson's disease is chronic and progressive. Medications can help control
symptoms but will not cure the disease or make symptoms disappear completely.
,A nurse is caring for a client with Parkinson's disease who reports feelings of hopelessness
and has a flat affect. Which action should the nurse take first?
A. Encourage increased physical activity.
B. Assess for suicidal ideation.
C. Educate the client on disease progression.
D. Refer the client to a support group.
Correct Answer: B
Rationale:: Flat affect and hopelessness can be signs of depression. The nurse must first assess
for suicidal ideation, which is a safety concern.
The motor symptoms of Parkinson's disease are primarily caused by:
A. Overproduction of dopamine in the brain
B. Degeneration of dopamine-producing neurons in the substantia nigra
C. Inflammation of the spinal cord and peripheral nerves
D. Decreased production of acetylcholine in the cerebral cortex
Correct Answer: B
Rationale:: Parkinson's disease is caused by the progressive degeneration of dopamine-
producing neurons in the substantia nigra, leading to the motor symptoms seen in the
condition.
A nurse is developing a plan of care for a client with Parkinson's disease who experiences
bradykinesia. Which of the following interventions should be included?
A. Instruct the client to walk quickly to avoid freezing.
B. Encourage the client to perform tasks when tired to build endurance.
C. Teach the client to rock side to side to initiate movement.
D. Advise the client to avoid all physical activity to conserve energy.
Correct Answer: C
Rationale:: Rocking side to side is a strategy to overcome freezing episodes. Clients should be
taught techniques to initiate and continue movement safely.
A client with Parkinson's disease is at risk for aspiration due to drooling and impaired
swallowing. Which of the following dietary modifications should the nurse recommend?
,A. Provide thin liquids and dry foods.
B. Offer frequent, large meals to reduce fatigue.
C. Recommend high-protein meals with medications.
D. Offer thickened liquids and small, frequent meals.
Correct Answer: D
Rationale:: Thickened liquids and small, frequent meals reduce the risk of aspiration and help
manage fatigue during meals.
A nurse is assessing a client with Parkinson's disease. Which of the following should the
nurse expect to observe? (Select all that apply.)
A. Shuffling gait
B. Hyperreflexia
C. Mask-like facial expression
D. Resting tremor
E. Flaccid muscle tone
Correct Answers: A, C, D
Rationale:: Common signs of Parkinson's include a shuffling gait, a mask-like facial
expression, and a resting tremor. Hyperreflexia and flaccid tone are not typical.
The nurse is teaching a client newly prescribed levodopa-carbidopa. Which of the following
statements by the client indicates a need for further teaching?
A. "I should take the medication with food to prevent nausea."
B. "This medication may make my urine darker in color."
C. "I can stop taking this medication when my symptoms improve."
D. "I should avoid high-protein meals when taking this drug."
Correct Answer: C
Rationale:: Levodopa-carbidopa must be taken consistently. Stopping the medication
abruptly can cause serious complications, including a sudden return of symptoms.
Which nursing diagnosis is most appropriate for a client in the early stages of Parkinson's
disease?
, A. Risk for infection related to immobility
B. Risk for disturbed body image related to facial changes and motor symptoms
C. Impaired memory related to neurodegeneration
D. Ineffective airway clearance related to excessive mucus production
Correct Answer: B
Rationale:: In the early stages, clients may begin to notice facial changes (mask-like
expression), tremors, and shuffling gait, all of which can affect body image and self-esteem.
A nurse is developing a plan of care for a client with Parkinson's disease. Which of the
following interventions is most important to reduce the risk of injury?
A. Encourage the client to rest frequently during the day.
B. Provide a cane for ambulation without assessment.
C. Keep the client's environment clutter-free and well-lit.
D. Instruct the client to limit movement to conserve energy.
Correct Answer: C
Rationale:: Clients with Parkinson's are at increased risk for falls due to poor balance and
shuffling gait. A clear and well-lit environment promotes safety.
A client newly diagnosed with Parkinson's disease is prescribed carbidopa-levodopa. The
client asks how this medication works. Which of the following responses by the nurse is
correct?
A. "It increases the levels of serotonin in your brain."
B. "It helps your brain convert protein into muscle."
C. "It helps your brain make more dopamine to improve movement."
D. "It reduces inflammation in the spinal cord."
Correct Answer: C
Rationale:: Carbidopa-levodopa helps replenish dopamine, a neurotransmitter that is
deficient in Parkinson's disease, improving motor function.
A nurse is teaching a client about carbidopa-levodopa therapy. Which of the following
statements by the client indicates a need for further teaching?
A. "I might have to wait a few weeks before seeing improvement."
A nurse is assessing a client diagnosed with Parkinson's disease. Which of the following
findings should the nurse report to the healthcare provider immediately?
A. Pill-rolling tremor in the right hand
B. Cogwheel rigidity in both upper extremities
C. Shuffling gait with a stooped posture
D. Episodes of freezing while ambulating, increasing in frequency
Correct Answer: D
Rationale:: Freezing episodes that increase in frequency may indicate worsening mobility
and higher fall risk. This change requires prompt intervention to ensure safety.
Which clinical manifestation is most characteristic of Parkinson's disease?
A. Muscle flaccidity
B. Hyperactive reflexes
C. Pill-rolling tremor
D. Sudden onset of muscle weakness
Correct Answer: C
Rationale:: A resting "pill-rolling" tremor is a hallmark symptom of Parkinson's disease,
particularly affecting the hands.
The nurse is providing discharge instructions to a client newly diagnosed with Parkinson's
disease. Which statement by the client indicates a need for further teaching?
A. "I should exercise to maintain mobility."
B. "I may notice my handwriting becoming smaller."
C. "I will avoid walking alone due to the risk of freezing."
D. "These symptoms should go away after a few weeks of medication."
Correct Answer: D
Rationale:: Parkinson's disease is chronic and progressive. Medications can help control
symptoms but will not cure the disease or make symptoms disappear completely.
,A nurse is caring for a client with Parkinson's disease who reports feelings of hopelessness
and has a flat affect. Which action should the nurse take first?
A. Encourage increased physical activity.
B. Assess for suicidal ideation.
C. Educate the client on disease progression.
D. Refer the client to a support group.
Correct Answer: B
Rationale:: Flat affect and hopelessness can be signs of depression. The nurse must first assess
for suicidal ideation, which is a safety concern.
The motor symptoms of Parkinson's disease are primarily caused by:
A. Overproduction of dopamine in the brain
B. Degeneration of dopamine-producing neurons in the substantia nigra
C. Inflammation of the spinal cord and peripheral nerves
D. Decreased production of acetylcholine in the cerebral cortex
Correct Answer: B
Rationale:: Parkinson's disease is caused by the progressive degeneration of dopamine-
producing neurons in the substantia nigra, leading to the motor symptoms seen in the
condition.
A nurse is developing a plan of care for a client with Parkinson's disease who experiences
bradykinesia. Which of the following interventions should be included?
A. Instruct the client to walk quickly to avoid freezing.
B. Encourage the client to perform tasks when tired to build endurance.
C. Teach the client to rock side to side to initiate movement.
D. Advise the client to avoid all physical activity to conserve energy.
Correct Answer: C
Rationale:: Rocking side to side is a strategy to overcome freezing episodes. Clients should be
taught techniques to initiate and continue movement safely.
A client with Parkinson's disease is at risk for aspiration due to drooling and impaired
swallowing. Which of the following dietary modifications should the nurse recommend?
,A. Provide thin liquids and dry foods.
B. Offer frequent, large meals to reduce fatigue.
C. Recommend high-protein meals with medications.
D. Offer thickened liquids and small, frequent meals.
Correct Answer: D
Rationale:: Thickened liquids and small, frequent meals reduce the risk of aspiration and help
manage fatigue during meals.
A nurse is assessing a client with Parkinson's disease. Which of the following should the
nurse expect to observe? (Select all that apply.)
A. Shuffling gait
B. Hyperreflexia
C. Mask-like facial expression
D. Resting tremor
E. Flaccid muscle tone
Correct Answers: A, C, D
Rationale:: Common signs of Parkinson's include a shuffling gait, a mask-like facial
expression, and a resting tremor. Hyperreflexia and flaccid tone are not typical.
The nurse is teaching a client newly prescribed levodopa-carbidopa. Which of the following
statements by the client indicates a need for further teaching?
A. "I should take the medication with food to prevent nausea."
B. "This medication may make my urine darker in color."
C. "I can stop taking this medication when my symptoms improve."
D. "I should avoid high-protein meals when taking this drug."
Correct Answer: C
Rationale:: Levodopa-carbidopa must be taken consistently. Stopping the medication
abruptly can cause serious complications, including a sudden return of symptoms.
Which nursing diagnosis is most appropriate for a client in the early stages of Parkinson's
disease?
, A. Risk for infection related to immobility
B. Risk for disturbed body image related to facial changes and motor symptoms
C. Impaired memory related to neurodegeneration
D. Ineffective airway clearance related to excessive mucus production
Correct Answer: B
Rationale:: In the early stages, clients may begin to notice facial changes (mask-like
expression), tremors, and shuffling gait, all of which can affect body image and self-esteem.
A nurse is developing a plan of care for a client with Parkinson's disease. Which of the
following interventions is most important to reduce the risk of injury?
A. Encourage the client to rest frequently during the day.
B. Provide a cane for ambulation without assessment.
C. Keep the client's environment clutter-free and well-lit.
D. Instruct the client to limit movement to conserve energy.
Correct Answer: C
Rationale:: Clients with Parkinson's are at increased risk for falls due to poor balance and
shuffling gait. A clear and well-lit environment promotes safety.
A client newly diagnosed with Parkinson's disease is prescribed carbidopa-levodopa. The
client asks how this medication works. Which of the following responses by the nurse is
correct?
A. "It increases the levels of serotonin in your brain."
B. "It helps your brain convert protein into muscle."
C. "It helps your brain make more dopamine to improve movement."
D. "It reduces inflammation in the spinal cord."
Correct Answer: C
Rationale:: Carbidopa-levodopa helps replenish dopamine, a neurotransmitter that is
deficient in Parkinson's disease, improving motor function.
A nurse is teaching a client about carbidopa-levodopa therapy. Which of the following
statements by the client indicates a need for further teaching?
A. "I might have to wait a few weeks before seeing improvement."
