Med Surg Final Exam ATI Questions.
, Chapter 7 Application Exercises
1. A nurse is caring for a client 3. A nurse is reinforcing teaching 5. A nurse is caring for a client who
who displays signs of stage III with a client who has Parkinson’s has Parkinson’s disease and is
Parkinson’s disease. Which of the disease and has a new prescription starting to display bradykinesia.
following actions should the nurse for bromocriptine. Which of the Which of the following is an
include in the plan of care? following instructions should the appropriate action by the nurse?
A. Recommend a community nurse include in the teaching? A. Teach the client to walk more
support group. A. Rise slowly when standing. quickly when ambulating.
B. Integrate a daily B. Expect urine to become B. Complete passive
exercise routine. dark-colored. range-of-motion exercises daily.
C. Provide a walker for C. Avoid foods containing C. Place the client on a
ambulation. tyramine. low-protein, low-calorie diet.
D. Perform ADLs for the client. D. Report any skin discoloration. D. Give the client extra time
to perform activities.
2. A nurse is developing a plan of 4. A nurse is assessing a client for
care for the nutritional needs of a manifestations of Parkinson’s disease.
client who has stage IV Parkinson’s Which of the following are expected
disease. Which actions should findings? (Select all that apply.)
the nurse include in the plan of A. Decreased vision
care? (Select all that apply.)
B. Pill-rolling tremor of the fingers
A. Provide three large
C. Shuffling gait
balanced meals daily.
D. Drooling
B. Record diet and fluid
intake daily. E. Bilateral ankle edema
C. Document weight F. Lack of facial expression
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
1. A. The client/family should be involved in a community support group PRACTICE Active Learning Scenario
at the onset of the disease process to enhance coping mechanisms.
B. The client should perform daily exercises with the onset of the disease A nurse is preparing a plan of care for a client who has
process to promote mobility and independence for as long as possible. a new diagnosis of Parkinson’s disease. What should
C. CORRECT: The client should use a walker for ambulation
the nurse include in the plan of care? Use the ATI Active
in stage III of Parkinson’s disease because movement Learning Template: System Disorder to complete this item.
slows down significantly and gait disturbances occur.
D. The client loses ability to perform ADLs during stage V Define Parkinson’s disease.
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 and
to maintain adequate nutrition and hydration.
C. The nurse should document the client’s weight weekly to identify
weight loss and intervene to maintain the client’s weight.
D. The nurse should ensure that the client is sitting upright ALTERATION IN HEALTH (DIAGNOSIS): Parkinson’s disease
for meals rather than in a supported Fowler’s position, is a debilitating condition that progresses to complete
where the client’s head is elevated to 45 to 60°. dependent care. The disease involves a decrease in dopamine
E. CORRECT: The nurse should offer nutritional supplements production and an increase in secretion of acetylcholine, causing
between meals to maintain the client’s weight. resting tremor, slowed movement, and muscular rigidity.
NCLEX ® Connection: Basic Care and Comfort,
Aspiration due to pharyngeal muscle
Nutrition and Oral Hydration
involvement making swallowing difficult
3. A. CORRECT: Orthostatic hypotension is a common adverse effect of Orthostatic hypotension, slow movement, and muscle rigidity
bromocriptine, a dopamine receptor agonist. Therefore, rising slowly Change in speech pattern: slow, monotonous speech
when standing up will decrease the risk of dizziness and lightheadedness. Altered emotional changes that can include depression and fear
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. Add thickener to liquids to prevent aspiration.
Consult with a dietitian about appropriate diet.
C. The client should avoid tyramine in the diet when taking Encourage periods of rest between activities.
selegiline, a monoamine type B inhibitor. However, bromocriptine
does not interact with foods that contain tyramine. Allow adequate time to rise slowly from
a sitting to standing position.
D. Skin discoloration is an adverse effect of amantadine, an anti-viral Encourage slower speech when expressing thoughts.
medication. However it is not an adverse effect of bromocriptine.
Observe for signs of depression and dementia.
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
, Chapter 8 Application Exercises
1. A nurse is providing teaching to the 3. A nurse is making a home visit to 4. A nurse is caring for a client who has
partner of an older adult client who a client who has AD. The client’s AD and falls frequently. Which of the
has Alzheimer’s disease and has a new partner states that the client is following actions should the nurse
prescription for donepezil. Which of often disoriented to time and take first to keep the client safe?
the following statements by the partner place, is unsteady on his feet, and A. Keep the call light near the client.
indicates the teaching is effective? has a history of wandering. Which
B. Place the client in a room
A. “This medication should increase of the following safety measures
close to the nurses’ station.
my husband’s appetite.” should the nurse review with the
partner? (Select all that apply.) C. Encourage the client to
B. “This medication should help ask for assistance.
my husband sleep better.” A. Remove floor rugs.
B. Have door locks that can D. Remind the client to walk
C. “This medication should help with someone for support.
my husband’s daily function.” be easily opened.
D. “This medication should increase C. Provide increased 5. A nurse is caring for a client who has
my husband’s energy level.” lighting in stairwells. Alzheimer’s disease. A family member
D. Install handrails in of the client asks the nurse about risk
2. A nurse working in a long-term care the bathroom. factors for the disease. Which of the
facility is planning care for a client in following should be included in the
E. Place the mattress on the floor.
stage V of Alzheimer’s disease. Which nurse’s response? (Select all that apply.)
of the following interventions should A. Exposure to metal
be included in the plan of care? waste products
A. Use a gait belt for ambulation. B. Long-term estrogen therapy
B. Thicken all liquids. C. Sustained use of vitamin E
C. Provide protective D. Previous head injury
undergarments.
E. History of herpes infection
D. Assist with ADLs.
RN ADULT MEDICAL SURGICAL NURSING CHAPTER 8 ALZHEIMER’S DISEASE 47
, Chapter 7 Application Exercises
1. A nurse is caring for a client 3. A nurse is reinforcing teaching 5. A nurse is caring for a client who
who displays signs of stage III with a client who has Parkinson’s has Parkinson’s disease and is
Parkinson’s disease. Which of the disease and has a new prescription starting to display bradykinesia.
following actions should the nurse for bromocriptine. Which of the Which of the following is an
include in the plan of care? following instructions should the appropriate action by the nurse?
A. Recommend a community nurse include in the teaching? A. Teach the client to walk more
support group. A. Rise slowly when standing. quickly when ambulating.
B. Integrate a daily B. Expect urine to become B. Complete passive
exercise routine. dark-colored. range-of-motion exercises daily.
C. Provide a walker for C. Avoid foods containing C. Place the client on a
ambulation. tyramine. low-protein, low-calorie diet.
D. Perform ADLs for the client. D. Report any skin discoloration. D. Give the client extra time
to perform activities.
2. A nurse is developing a plan of 4. A nurse is assessing a client for
care for the nutritional needs of a manifestations of Parkinson’s disease.
client who has stage IV Parkinson’s Which of the following are expected
disease. Which actions should findings? (Select all that apply.)
the nurse include in the plan of A. Decreased vision
care? (Select all that apply.)
B. Pill-rolling tremor of the fingers
A. Provide three large
C. Shuffling gait
balanced meals daily.
D. Drooling
B. Record diet and fluid
intake daily. E. Bilateral ankle edema
C. Document weight F. Lack of facial expression
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
1. A. The client/family should be involved in a community support group PRACTICE Active Learning Scenario
at the onset of the disease process to enhance coping mechanisms.
B. The client should perform daily exercises with the onset of the disease A nurse is preparing a plan of care for a client who has
process to promote mobility and independence for as long as possible. a new diagnosis of Parkinson’s disease. What should
C. CORRECT: The client should use a walker for ambulation
the nurse include in the plan of care? Use the ATI Active
in stage III of Parkinson’s disease because movement Learning Template: System Disorder to complete this item.
slows down significantly and gait disturbances occur.
D. The client loses ability to perform ADLs during stage V Define Parkinson’s disease.
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 and
to maintain adequate nutrition and hydration.
C. The nurse should document the client’s weight weekly to identify
weight loss and intervene to maintain the client’s weight.
D. The nurse should ensure that the client is sitting upright ALTERATION IN HEALTH (DIAGNOSIS): Parkinson’s disease
for meals rather than in a supported Fowler’s position, is a debilitating condition that progresses to complete
where the client’s head is elevated to 45 to 60°. dependent care. The disease involves a decrease in dopamine
E. CORRECT: The nurse should offer nutritional supplements production and an increase in secretion of acetylcholine, causing
between meals to maintain the client’s weight. resting tremor, slowed movement, and muscular rigidity.
NCLEX ® Connection: Basic Care and Comfort,
Aspiration due to pharyngeal muscle
Nutrition and Oral Hydration
involvement making swallowing difficult
3. A. CORRECT: Orthostatic hypotension is a common adverse effect of Orthostatic hypotension, slow movement, and muscle rigidity
bromocriptine, a dopamine receptor agonist. Therefore, rising slowly Change in speech pattern: slow, monotonous speech
when standing up will decrease the risk of dizziness and lightheadedness. Altered emotional changes that can include depression and fear
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. Add thickener to liquids to prevent aspiration.
Consult with a dietitian about appropriate diet.
C. The client should avoid tyramine in the diet when taking Encourage periods of rest between activities.
selegiline, a monoamine type B inhibitor. However, bromocriptine
does not interact with foods that contain tyramine. Allow adequate time to rise slowly from
a sitting to standing position.
D. Skin discoloration is an adverse effect of amantadine, an anti-viral Encourage slower speech when expressing thoughts.
medication. However it is not an adverse effect of bromocriptine.
Observe for signs of depression and dementia.
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
, Chapter 8 Application Exercises
1. A nurse is providing teaching to the 3. A nurse is making a home visit to 4. A nurse is caring for a client who has
partner of an older adult client who a client who has AD. The client’s AD and falls frequently. Which of the
has Alzheimer’s disease and has a new partner states that the client is following actions should the nurse
prescription for donepezil. Which of often disoriented to time and take first to keep the client safe?
the following statements by the partner place, is unsteady on his feet, and A. Keep the call light near the client.
indicates the teaching is effective? has a history of wandering. Which
B. Place the client in a room
A. “This medication should increase of the following safety measures
close to the nurses’ station.
my husband’s appetite.” should the nurse review with the
partner? (Select all that apply.) C. Encourage the client to
B. “This medication should help ask for assistance.
my husband sleep better.” A. Remove floor rugs.
B. Have door locks that can D. Remind the client to walk
C. “This medication should help with someone for support.
my husband’s daily function.” be easily opened.
D. “This medication should increase C. Provide increased 5. A nurse is caring for a client who has
my husband’s energy level.” lighting in stairwells. Alzheimer’s disease. A family member
D. Install handrails in of the client asks the nurse about risk
2. A nurse working in a long-term care the bathroom. factors for the disease. Which of the
facility is planning care for a client in following should be included in the
E. Place the mattress on the floor.
stage V of Alzheimer’s disease. Which nurse’s response? (Select all that apply.)
of the following interventions should A. Exposure to metal
be included in the plan of care? waste products
A. Use a gait belt for ambulation. B. Long-term estrogen therapy
B. Thicken all liquids. C. Sustained use of vitamin E
C. Provide protective D. Previous head injury
undergarments.
E. History of herpes infection
D. Assist with ADLs.
RN ADULT MEDICAL SURGICAL NURSING CHAPTER 8 ALZHEIMER’S DISEASE 47
