TEST BANK INTRODUCTORY CLINICAL
PHARMACOLOGY 12TH EDITION By Susan M Ford
Chapter 27, Antiparkinson Drugs
1. The nurse is preparing to administer pramipexole to a client with Parkinson
disease. The nurse notes the client is also prescribed verapamil. Which potential
reaction should the nurse prioritize for careful monitoring?
A) Cardiac symptoms
B) Agonist effectiveness
C) Toxicity of both drugs
D) Psychotic behavior
Answer: B
Rationale: The nurse should assess for an increased risk of agonist effectiveness
in the client. Increased risk of cardiac symptoms and increased risk of toxicity of
both drugs are the effects of the interaction of COMT inhibitors with MAOI
antidepressants and adrenergic drugs. Increased risk of psychotic behavior is the
effect of the interaction of cholinergic blocking drugs with haloperidol.
Question Format: Multiple Choice
Chapter: 27
Learning Objective: 2
Cognitive Level: Apply
Client Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 329, Dopamine Receptor Agonists
2. A nurse has administered entacapone to a 55-year-old client with Parkinson
disease. Which adverse reaction should the nurse prioritize?
A) Increased hand tremor
B) Constipation
C) Urinary retention
D) Dyskinesia
Answer: D
Rationale: The nurse should monitor for dyskinesia, which is an adverse reaction
of the COMT inhibitors, in the client. The other adverse reactions include
dizziness, hyperkinesia, nausea, anorexia, diarrhea, orthostatic hypotension,
sleep disorders, excessive dreaming, somnolence, and muscle cramps. A serious,
and possibly fatal, adverse reaction that can occur with the administration of
tolcapone, one of the COMT inhibitors, is liver failure. Increased hand tremor and
constipation are adverse effects associated with the use of dopaminergic drugs.
Urinary retention is an adverse reaction associated with the administration of
cholinergic blocking drugs.
Question Format: Multiple Choice
Chapter: 27
Learning Objective: 2
, Cognitive Level: Apply
Client Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 330, COMT Inhibitors
3. A nurse completed teaching a client with influenza A about the prescribed
amantadine. The nurse determines the session was successful when the client
correctly chooses which action to counter adverse reactions to the drug?
A) Instruct the client to take ice chips frequently.
B) Encourage the client to take small, frequent meals.
C) Instruct the client to avoid protein-rich foods.
D) Stop the use of the antiparkinsonism drug by the client.
Answer: A
Rationale: The nurse should instruct the client to suck on ice chips or hard candy
(if allowed). The nurse should also instruct the client to take frequent sips of water
throughout the day and between meals. The nurse encourages the client to have
small, frequent meals when the client experiences a GI disturbance and not when
the client reports dry mouth. The nurse does not need to instruct the client to
avoid protein-rich foods because this will not reduce the client's discomfort due to
dry mouth. The nurse should stop the use of the antiparkinsonism drug when the
client reports severe nausea or vomiting and not when the client is experiencing
dry mouth. If dry mouth is so severe that there is difficulty in swallowing or
speaking, or if loss of appetite and weight loss occur, the dosage of the
antiparkinsonism drug may be reduced but not stopped completely.
Question Format: Multiple Choice
Chapter: 27
Learning Objective: 5
Cognitive Level: Apply
Client Needs: Physiological Integrity: Basic Care and Comfort
Integrated Process: Teaching/Learning
Reference: p. 333, Malnutrition
4. A 70-year-old client with Parkinson disease is prescribed an anticholinergic drug.
Which finding on assessment should the nurse prioritize?
A) Confusion and disorientation
B) Choreiform movements
C) Suicidal tendencies
D) Psychotic episodes
Answer: A
, Rationale: The nurse should assess for confusion and disorientation when caring
for this elderly client receiving anticholinergic drug therapy. Individuals older than
60 years frequently develop increased sensitivity to anticholinergic drugs and
require careful monitoring. Lower doses may also be required in such cases.
Choreiform movements, suicidal tendencies, and psychotic episodes are serious
adverse reactions associated with the use of levodopa, which is a dopaminergic
drug.
Question Format: Multiple Choice
Chapter: 27
Learning Objective: 3
Cognitive Level: Apply
Client Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 331, Cholinergic Blocking Drugs (Anticholinergics)
5. A client has developed a hepatic injury related to the administration of tolcapone.
Which activity does the nurse anticipate will be added to the plan of care for this
client?
A) Monitor the client for signs of tactile hallucinations.
B) Monitor the client for signs of dystonic movements.
C) Perform regular blood tests of the client.
D) Perform serum transaminase level testing every day.
Answer: C
Rationale: A serious and potentially fatal adverse reaction to tolcapone is hepatic
injury. The nurse should, therefore, perform regular blood testing to monitor liver
function of the client as prescribed. The testing of serum transaminase levels may
be ordered at frequent intervals such as every 2 weeks for the first year and every
8 weeks thereafter. The nurse does not need to perform serum transaminase
level testing every day. The nurse should monitor for signs of dystonic
movements when caring for a client receiving carbidopa and levodopa, not
tolcapone. The nurse should monitor for signs of tactile hallucinations when caring
for an elderly client receiving tolcapone.
Question Format: Multiple Choice
Chapter: 27
Learning Objective: 3
Cognitive Level: Apply
Client Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 332, Ongoing Assessment
6. A 70-year-old client with Parkinson disease is receiving pramipexole. Which
potential adverse reaction should the nurse monitor the client for?
A) Blurred vision
B) Memory loss
C) Visual hallucinations
D) Muscular rigidity
PHARMACOLOGY 12TH EDITION By Susan M Ford
Chapter 27, Antiparkinson Drugs
1. The nurse is preparing to administer pramipexole to a client with Parkinson
disease. The nurse notes the client is also prescribed verapamil. Which potential
reaction should the nurse prioritize for careful monitoring?
A) Cardiac symptoms
B) Agonist effectiveness
C) Toxicity of both drugs
D) Psychotic behavior
Answer: B
Rationale: The nurse should assess for an increased risk of agonist effectiveness
in the client. Increased risk of cardiac symptoms and increased risk of toxicity of
both drugs are the effects of the interaction of COMT inhibitors with MAOI
antidepressants and adrenergic drugs. Increased risk of psychotic behavior is the
effect of the interaction of cholinergic blocking drugs with haloperidol.
Question Format: Multiple Choice
Chapter: 27
Learning Objective: 2
Cognitive Level: Apply
Client Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 329, Dopamine Receptor Agonists
2. A nurse has administered entacapone to a 55-year-old client with Parkinson
disease. Which adverse reaction should the nurse prioritize?
A) Increased hand tremor
B) Constipation
C) Urinary retention
D) Dyskinesia
Answer: D
Rationale: The nurse should monitor for dyskinesia, which is an adverse reaction
of the COMT inhibitors, in the client. The other adverse reactions include
dizziness, hyperkinesia, nausea, anorexia, diarrhea, orthostatic hypotension,
sleep disorders, excessive dreaming, somnolence, and muscle cramps. A serious,
and possibly fatal, adverse reaction that can occur with the administration of
tolcapone, one of the COMT inhibitors, is liver failure. Increased hand tremor and
constipation are adverse effects associated with the use of dopaminergic drugs.
Urinary retention is an adverse reaction associated with the administration of
cholinergic blocking drugs.
Question Format: Multiple Choice
Chapter: 27
Learning Objective: 2
, Cognitive Level: Apply
Client Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 330, COMT Inhibitors
3. A nurse completed teaching a client with influenza A about the prescribed
amantadine. The nurse determines the session was successful when the client
correctly chooses which action to counter adverse reactions to the drug?
A) Instruct the client to take ice chips frequently.
B) Encourage the client to take small, frequent meals.
C) Instruct the client to avoid protein-rich foods.
D) Stop the use of the antiparkinsonism drug by the client.
Answer: A
Rationale: The nurse should instruct the client to suck on ice chips or hard candy
(if allowed). The nurse should also instruct the client to take frequent sips of water
throughout the day and between meals. The nurse encourages the client to have
small, frequent meals when the client experiences a GI disturbance and not when
the client reports dry mouth. The nurse does not need to instruct the client to
avoid protein-rich foods because this will not reduce the client's discomfort due to
dry mouth. The nurse should stop the use of the antiparkinsonism drug when the
client reports severe nausea or vomiting and not when the client is experiencing
dry mouth. If dry mouth is so severe that there is difficulty in swallowing or
speaking, or if loss of appetite and weight loss occur, the dosage of the
antiparkinsonism drug may be reduced but not stopped completely.
Question Format: Multiple Choice
Chapter: 27
Learning Objective: 5
Cognitive Level: Apply
Client Needs: Physiological Integrity: Basic Care and Comfort
Integrated Process: Teaching/Learning
Reference: p. 333, Malnutrition
4. A 70-year-old client with Parkinson disease is prescribed an anticholinergic drug.
Which finding on assessment should the nurse prioritize?
A) Confusion and disorientation
B) Choreiform movements
C) Suicidal tendencies
D) Psychotic episodes
Answer: A
, Rationale: The nurse should assess for confusion and disorientation when caring
for this elderly client receiving anticholinergic drug therapy. Individuals older than
60 years frequently develop increased sensitivity to anticholinergic drugs and
require careful monitoring. Lower doses may also be required in such cases.
Choreiform movements, suicidal tendencies, and psychotic episodes are serious
adverse reactions associated with the use of levodopa, which is a dopaminergic
drug.
Question Format: Multiple Choice
Chapter: 27
Learning Objective: 3
Cognitive Level: Apply
Client Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 331, Cholinergic Blocking Drugs (Anticholinergics)
5. A client has developed a hepatic injury related to the administration of tolcapone.
Which activity does the nurse anticipate will be added to the plan of care for this
client?
A) Monitor the client for signs of tactile hallucinations.
B) Monitor the client for signs of dystonic movements.
C) Perform regular blood tests of the client.
D) Perform serum transaminase level testing every day.
Answer: C
Rationale: A serious and potentially fatal adverse reaction to tolcapone is hepatic
injury. The nurse should, therefore, perform regular blood testing to monitor liver
function of the client as prescribed. The testing of serum transaminase levels may
be ordered at frequent intervals such as every 2 weeks for the first year and every
8 weeks thereafter. The nurse does not need to perform serum transaminase
level testing every day. The nurse should monitor for signs of dystonic
movements when caring for a client receiving carbidopa and levodopa, not
tolcapone. The nurse should monitor for signs of tactile hallucinations when caring
for an elderly client receiving tolcapone.
Question Format: Multiple Choice
Chapter: 27
Learning Objective: 3
Cognitive Level: Apply
Client Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 332, Ongoing Assessment
6. A 70-year-old client with Parkinson disease is receiving pramipexole. Which
potential adverse reaction should the nurse monitor the client for?
A) Blurred vision
B) Memory loss
C) Visual hallucinations
D) Muscular rigidity
