Chapter 7
Med Surg Final Exam ATI Questions
1. A nurse is caring for a client
who displays signs of stage III 3. A nurse is reinforcing teaching 5. A nurse is caring for a client
Parkinson’s disease. Which of the with a client who has Parkinson’s who has Parkinson’s disease and
following actions should the disease and has a new is starting to display
nurse include in the plan of care? prescription for bromocriptine. bradykinesia. Which of the
Which of the following following is an appropriate
A. Recommend a community instructions should the nurse action by the nurse?
support group. include in the teaching? A. Teach the client to walk more
B. Integrate a daily A. Rise slowly when standing. quickly when ambulating.
exercise routine.
B. Expect urine to become B. Complete passive
C. Provide a walker for dark-colored. range-of-motion exercises daily.
ambulation.
C. Avoid foods containing C. Place the client on a
D. Perform ADLs for the client. tyramine. low-protein, low-calorie diet.
2. A nurse is developing a plan of D. Report any skin discoloration. D. Give the client extra time
care for the nutritional needs of a to perform activities.
client who has stage IV
4. A nurse is assessing a client for
Parkinson’s disease. Which manifestations of Parkinson’s disease.
actions should Which of the following are expected
the nurse include in the plan findings? (Select all that apply.)
of care? (Select all that apply.) A. Decreased vision
A. Provide three large B. Pill-rolling tremor of the fingers
balanced meals C. Shuffling gait
daily.
D. Drooling
B. Record diet and
E. Bilateral ankle edema
fluid intake daily.
F. Lack of facial expression
C. Document weight
every other week.
D. Place the client in Fowler’s
position to eat.
E. Offer nutritional supplements
between meals.
,RN ADULT MEDICAL SURGICAL NURSING CHAPTER 7 PARKINSON’S DISEASE 43
, Chapter
7
Application Exercises Key PRACTICE Active Learning Scenario
1. A. The client/family should be involved in a community support
group at the onset of the disease process to enhance coping
mechanisms. A nurse is preparing a plan of care for a client who has a new diagnosis of P
Learning Template: System Disorder to complete this item.
B. The client should perform daily exercises with the onset of the
disease process to promote mobility and independence for as long as ALTERATION IN HEALTH (DIAGNOSIS):
possible. Define Parkinson’s disease.
C. CORRECT: The client should use a walker for
COMPLICATIONS: Identify four.
ambulation in stage III of Parkinson’s disease because NURSING CARE: Describe six nursing actions.
movement
slows down significantly and gait disturbances occur.
D. The client loses ability to perform ADLs during stage V
of Parkinson’s disease and is dependent on others for
care at that time. During earlier stages, the client should
be encouraged to remain as independent as possible.
NCLEX® Connection: Safety and Infection Control,
Accident/Error/Injury Prevention
2. A. The nurse should plan to provide small frequent
meals during the day to maintain adequate nutrition.
B. CORRECT: The nurse should record the client’s
diet and fluid intake daily to assess for dietary needs PRACTICE Answer
and to maintain adequate nutrition and hydration.
C. The nurse should document the client’s weight weekly to identify Using the ATI Active Learning Template: System Disorder
weight loss and intervene to maintain the client’s weight. ALTERATION IN HEALTH (DIAGNOSIS): Parkinson’s disease is a debilitating conditi
production and an increase in secretion of acetylcholine, causing resting tremor, slow
D. The nurse should ensure that the client is sitting
COMPLICATIONS
upright for meals rather than in a supported Fowler’s
position, where the client’s head is elevated to 45 to Aspiration due to pharyngeal muscle involvement making swallowing difficult
60°. Orthostatic hypotension, slow movement, and muscle rigidity
Change in speech pattern: slow, monotonous speech
E. CORRECT: The nurse should offer nutritional Altered emotional changes that can include depression and fear
supplements between meals to maintain the client’s NURSING CARE
weight. Add thickener to liquids to prevent aspiration.
Consult with a dietitian about appropriate diet.
NCLEX® Connection: Basic Care and Comfort, Encourage periods of rest between activities.
Nutrition and Oral Hydration Allow adequate time to rise slowly from a sitting to standing position.
3. A. CORRECT: Orthostatic hypotension is a common adverse effect of Encourage slower speech when expressing thoughts.
bromocriptine, a dopamine receptor agonist. Therefore, rising slowly Observe for signs of depression and dementia.
when standing up will decrease the risk of dizziness and NCLEX® Connection: Physiological Adaptation, Illness Management
lightheadedness.
B. The client should expect urine to turn dark when
taking entacapone, a COMT inhibitor. Dark urine is
not an expected finding when taking bromocriptine.
C. The client should avoid tyramine in the diet when taking
selegiline, a monoamine type B inhibitor. However,
bromocriptine does not interact with foods that contain
tyramine.
D. Skin discoloration is an adverse effect of amantadine, an anti-viral
medication. However it is not an adverse effect of bromocriptine.
NCLEX® Connection: Pharmacological and Parenteral Therapies,
Adverse Effects/Contraindications/Side Effects/Interactions
4. A. Decreased vision is not an expected finding in a client who has PD.
B. CORRECT: The client who has PD can manifest pill-rolling
tremors of the fingers due to overstimulation of the basal
ganglia by acetylcholine, making controlled movement difficult.
C. CORRECT: The client who has PD can manifest
shuffling gait because of overstimulation of the basal
ganglia by acetylcholine, making controlled movement
difficult.
D. CORRECT: The client who has PD can manifest drooling because
of overstimulation of the basal ganglia by acetylcholine, making
the controlled movement of swallowing secretions difficult.
E. Bilateral ankle edema is not an expected
finding in a client who has PD, but can be an
adverse effect of certain medications used for
treatment.
F. CORRECT: The client who has PD can manifest a lack of
facial expressions due to overstimulation of the basal
ganglia by acetylcholine, making controlled movement
difficult.
NCLEX® Connection: Physiological Adaptation, Pathophysiology
5. A. The client who has PD develops a propulsive gait and tends to walk
increasingly rapidly. The client should be reminded to stop
occasionally when walking to prevent a propulsive gait and decrease
the risk for falls.
B. The nurse should encourage active, not passive,
, range-of-motion exercises to promote mobility in
the client who has PD and is displaying
bradykinesia.
C. The client who has PD often requires high-calorie, high-protein
supplements between meals in order to maintain adequate
weight.
D. CORRECT: Bradykinesia is abnormally slowed movement and is
seen in clients who have PD. The client should be given extra
time to perform activities and should be encouraged to remain
active.
NCLEX® Connection: Reduction of Risk Potential,
System Specific Assessments
Med Surg Final Exam ATI Questions
1. A nurse is caring for a client
who displays signs of stage III 3. A nurse is reinforcing teaching 5. A nurse is caring for a client
Parkinson’s disease. Which of the with a client who has Parkinson’s who has Parkinson’s disease and
following actions should the disease and has a new is starting to display
nurse include in the plan of care? prescription for bromocriptine. bradykinesia. Which of the
Which of the following following is an appropriate
A. Recommend a community instructions should the nurse action by the nurse?
support group. include in the teaching? A. Teach the client to walk more
B. Integrate a daily A. Rise slowly when standing. quickly when ambulating.
exercise routine.
B. Expect urine to become B. Complete passive
C. Provide a walker for dark-colored. range-of-motion exercises daily.
ambulation.
C. Avoid foods containing C. Place the client on a
D. Perform ADLs for the client. tyramine. low-protein, low-calorie diet.
2. A nurse is developing a plan of D. Report any skin discoloration. D. Give the client extra time
care for the nutritional needs of a to perform activities.
client who has stage IV
4. A nurse is assessing a client for
Parkinson’s disease. Which manifestations of Parkinson’s disease.
actions should Which of the following are expected
the nurse include in the plan findings? (Select all that apply.)
of care? (Select all that apply.) A. Decreased vision
A. Provide three large B. Pill-rolling tremor of the fingers
balanced meals C. Shuffling gait
daily.
D. Drooling
B. Record diet and
E. Bilateral ankle edema
fluid intake daily.
F. Lack of facial expression
C. Document weight
every other week.
D. Place the client in Fowler’s
position to eat.
E. Offer nutritional supplements
between meals.
,RN ADULT MEDICAL SURGICAL NURSING CHAPTER 7 PARKINSON’S DISEASE 43
, Chapter
7
Application Exercises Key PRACTICE Active Learning Scenario
1. A. The client/family should be involved in a community support
group at the onset of the disease process to enhance coping
mechanisms. A nurse is preparing a plan of care for a client who has a new diagnosis of P
Learning Template: System Disorder to complete this item.
B. The client should perform daily exercises with the onset of the
disease process to promote mobility and independence for as long as ALTERATION IN HEALTH (DIAGNOSIS):
possible. Define Parkinson’s disease.
C. CORRECT: The client should use a walker for
COMPLICATIONS: Identify four.
ambulation in stage III of Parkinson’s disease because NURSING CARE: Describe six nursing actions.
movement
slows down significantly and gait disturbances occur.
D. The client loses ability to perform ADLs during stage V
of Parkinson’s disease and is dependent on others for
care at that time. During earlier stages, the client should
be encouraged to remain as independent as possible.
NCLEX® Connection: Safety and Infection Control,
Accident/Error/Injury Prevention
2. A. The nurse should plan to provide small frequent
meals during the day to maintain adequate nutrition.
B. CORRECT: The nurse should record the client’s
diet and fluid intake daily to assess for dietary needs PRACTICE Answer
and to maintain adequate nutrition and hydration.
C. The nurse should document the client’s weight weekly to identify Using the ATI Active Learning Template: System Disorder
weight loss and intervene to maintain the client’s weight. ALTERATION IN HEALTH (DIAGNOSIS): Parkinson’s disease is a debilitating conditi
production and an increase in secretion of acetylcholine, causing resting tremor, slow
D. The nurse should ensure that the client is sitting
COMPLICATIONS
upright for meals rather than in a supported Fowler’s
position, where the client’s head is elevated to 45 to Aspiration due to pharyngeal muscle involvement making swallowing difficult
60°. Orthostatic hypotension, slow movement, and muscle rigidity
Change in speech pattern: slow, monotonous speech
E. CORRECT: The nurse should offer nutritional Altered emotional changes that can include depression and fear
supplements between meals to maintain the client’s NURSING CARE
weight. Add thickener to liquids to prevent aspiration.
Consult with a dietitian about appropriate diet.
NCLEX® Connection: Basic Care and Comfort, Encourage periods of rest between activities.
Nutrition and Oral Hydration Allow adequate time to rise slowly from a sitting to standing position.
3. A. CORRECT: Orthostatic hypotension is a common adverse effect of Encourage slower speech when expressing thoughts.
bromocriptine, a dopamine receptor agonist. Therefore, rising slowly Observe for signs of depression and dementia.
when standing up will decrease the risk of dizziness and NCLEX® Connection: Physiological Adaptation, Illness Management
lightheadedness.
B. The client should expect urine to turn dark when
taking entacapone, a COMT inhibitor. Dark urine is
not an expected finding when taking bromocriptine.
C. The client should avoid tyramine in the diet when taking
selegiline, a monoamine type B inhibitor. However,
bromocriptine does not interact with foods that contain
tyramine.
D. Skin discoloration is an adverse effect of amantadine, an anti-viral
medication. However it is not an adverse effect of bromocriptine.
NCLEX® Connection: Pharmacological and Parenteral Therapies,
Adverse Effects/Contraindications/Side Effects/Interactions
4. A. Decreased vision is not an expected finding in a client who has PD.
B. CORRECT: The client who has PD can manifest pill-rolling
tremors of the fingers due to overstimulation of the basal
ganglia by acetylcholine, making controlled movement difficult.
C. CORRECT: The client who has PD can manifest
shuffling gait because of overstimulation of the basal
ganglia by acetylcholine, making controlled movement
difficult.
D. CORRECT: The client who has PD can manifest drooling because
of overstimulation of the basal ganglia by acetylcholine, making
the controlled movement of swallowing secretions difficult.
E. Bilateral ankle edema is not an expected
finding in a client who has PD, but can be an
adverse effect of certain medications used for
treatment.
F. CORRECT: The client who has PD can manifest a lack of
facial expressions due to overstimulation of the basal
ganglia by acetylcholine, making controlled movement
difficult.
NCLEX® Connection: Physiological Adaptation, Pathophysiology
5. A. The client who has PD develops a propulsive gait and tends to walk
increasingly rapidly. The client should be reminded to stop
occasionally when walking to prevent a propulsive gait and decrease
the risk for falls.
B. The nurse should encourage active, not passive,
, range-of-motion exercises to promote mobility in
the client who has PD and is displaying
bradykinesia.
C. The client who has PD often requires high-calorie, high-protein
supplements between meals in order to maintain adequate
weight.
D. CORRECT: Bradykinesia is abnormally slowed movement and is
seen in clients who have PD. The client should be given extra
time to perform activities and should be encouraged to remain
active.
NCLEX® Connection: Reduction of Risk Potential,
System Specific Assessments
