NUR 256 Exam 2: (Latest 2026/2027 Update) Neurologic, Cardiac,
Respiratory & Hematologic Disorders | Q&A | Grade A | 100%
Correct (Verified Answers)
Complete Review: Parkinson's, Myasthenia Gravis, MS, GBS, MI, Heart Failure, DVT, Anemia, COPD, TB & ABGs
SUBJECT SOURCE FORMAT
Medical-Surgical Nursing / NUR 256 Galen Exam 2 Study Guide 2026/2027 Q&A Guide with Rationale
Q1
What are the cardinal (main) motor symptoms of Parkinson's disease?
CORRECT ANSWER
Tremor at rest, rigidity, bradykinesia, postural instability
RATIONALE
• TRAP mnemonic: Tremor at rest, Rigidity, Akinesia/Bradykinesia, Postural instability.
• Bradykinesia is slowness of movement; postural instability leads to falls.
• These four are required for diagnosis of idiopathic Parkinson's.
Q2
What is the purpose of anticholinergic medications in Parkinson's disease?
CORRECT ANSWER
Reduce tremors and muscle rigidity by blocking acetylcholine
RATIONALE
• Parkinson's has relative dopamine deficiency and acetylcholine excess.
• Anticholinergics help restore balance, especially for tremor.
• Avoid in elderly due to confusion, dry mouth, urinary retention.
, Q3
Nursing considerations for levodopa-carbidopa include:
CORRECT ANSWER
Give on time, avoid high-protein meals, change positions slowly, monitor dyskinesia and hallucinations
RATIONALE
• High protein competes for absorption; give 30-60 min before meals.
• Abrupt withdrawal can cause neuroleptic malignant syndrome.
• Dark urine/sweat is harmless but needs patient education.
Q4
How do you differentiate myasthenic crisis from cholinergic crisis using the Tensilon test?
CORRECT ANSWER
Positive Tensilon (improved strength) = myasthenic crisis; Negative (no change or worse) = cholinergic
crisis
RATIONALE
• Edrophonium (Tensilon) is a short-acting acetylcholinesterase inhibitor.
• If weakness improves → need more pyridostigmine (myasthenic).
• If weakness worsens → cholinergic excess; hold meds and give atropine.
Q5
Nursing actions for a patient in cholinergic crisis:
CORRECT ANSWER
Hold anticholinesterase drugs, maintain airway, administer atropine sulfate
RATIONALE
• Cholinergic crisis = excessive acetylcholine (SLUDGE, muscle weakness).
• Atropine blocks muscarinic receptors; keep trach tray at bedside.
• Distinguish from myasthenic crisis by Tensilon test.
Respiratory & Hematologic Disorders | Q&A | Grade A | 100%
Correct (Verified Answers)
Complete Review: Parkinson's, Myasthenia Gravis, MS, GBS, MI, Heart Failure, DVT, Anemia, COPD, TB & ABGs
SUBJECT SOURCE FORMAT
Medical-Surgical Nursing / NUR 256 Galen Exam 2 Study Guide 2026/2027 Q&A Guide with Rationale
Q1
What are the cardinal (main) motor symptoms of Parkinson's disease?
CORRECT ANSWER
Tremor at rest, rigidity, bradykinesia, postural instability
RATIONALE
• TRAP mnemonic: Tremor at rest, Rigidity, Akinesia/Bradykinesia, Postural instability.
• Bradykinesia is slowness of movement; postural instability leads to falls.
• These four are required for diagnosis of idiopathic Parkinson's.
Q2
What is the purpose of anticholinergic medications in Parkinson's disease?
CORRECT ANSWER
Reduce tremors and muscle rigidity by blocking acetylcholine
RATIONALE
• Parkinson's has relative dopamine deficiency and acetylcholine excess.
• Anticholinergics help restore balance, especially for tremor.
• Avoid in elderly due to confusion, dry mouth, urinary retention.
, Q3
Nursing considerations for levodopa-carbidopa include:
CORRECT ANSWER
Give on time, avoid high-protein meals, change positions slowly, monitor dyskinesia and hallucinations
RATIONALE
• High protein competes for absorption; give 30-60 min before meals.
• Abrupt withdrawal can cause neuroleptic malignant syndrome.
• Dark urine/sweat is harmless but needs patient education.
Q4
How do you differentiate myasthenic crisis from cholinergic crisis using the Tensilon test?
CORRECT ANSWER
Positive Tensilon (improved strength) = myasthenic crisis; Negative (no change or worse) = cholinergic
crisis
RATIONALE
• Edrophonium (Tensilon) is a short-acting acetylcholinesterase inhibitor.
• If weakness improves → need more pyridostigmine (myasthenic).
• If weakness worsens → cholinergic excess; hold meds and give atropine.
Q5
Nursing actions for a patient in cholinergic crisis:
CORRECT ANSWER
Hold anticholinesterase drugs, maintain airway, administer atropine sulfate
RATIONALE
• Cholinergic crisis = excessive acetylcholine (SLUDGE, muscle weakness).
• Atropine blocks muscarinic receptors; keep trach tray at bedside.
• Distinguish from myasthenic crisis by Tensilon test.
