Chapter 24: Care of Patients with Peripheral Nerve and Degenerative Diseases ||DeWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition

MULTIPLE CHOICE 1. The nurse is explaining Parkinson disease to the student nurse. Which statement indicates that the student nurse correctly understands the pathophysiology of the disease? a. “Regardless of the actual etiology, Parkinson disease is caused by depletion of dopamine and excess of acetylcholine.” b. “The pathophysiology of the disease is caused by the deterioration of the myelin sheath of the basal ganglia.” c. “Excess dopamine and deficient acetylcholine are the cause of Parkinson disease.” d. “When there is decreased dopamine uptake at receptors in brain cells, Parkinson disease results.” ANS: A The specific cause of Parkinson disease is unknown, but the basic pathophysiology is depletion of dopamine and excess ofacetylcholine. PTS:1 DIF: Cognitive Level: Comprehension REF: 553 OBJ:1 (theory) TOP: Parkinson Disease: Pathophysiology KEY: Nursing Process Step: Evaluation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. The nurse is assessing a patient with Parkinson disease. Which statement likely characterizes this patient’s tremors? a. Tremors occur constantly. b. Tremors decrease with voluntary movement. c. Tremors are absent when the body is at rest. d. Tremors are characterized by tonic/clonic muscle activity. ANS: B Tremors in Parkinson disease decrease with voluntary movement, are absent during sleep, and occur when the body is at rest. Parkinsonian muscle activity is that of “pill rolling.” Tonic/clonic movement is associated with seizures. PTS:1 DIF: Cognitive Level: Comprehension REF: 554 OBJ:1 (theory) TOP: Parkinson Disease: Signs KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. Which problem statement/nursing diagnosis is most appropriate for a person with Parkinson disease? a. Risk for falls related to unsteady gait. b. Ineffective airway clearance related to drooling. c. Risk for impaired skin integrity related to tremor. d. Nutrition: less than body requirements related to nausea. ANS: A Rigidity and impaired balance with the propulsive gait create a risk for falls. The tremor decreases with voluntary movement, making eating relatively trouble free. Drooling is not a threat for aspiration, and there is no characteristic nausea. PTS:1 DIF: Cognitive Level: Application REF: 557, Nursing Care Plan 24-1 OBJ:3 (theory) TOP: Parkinson Disease: Nursing Diagnoses KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential 4. To enhance more erect posture in the patient with Parkinson disease, the nurse should encourage the patient to practice which activity? a. Imagine stepping over an object. b. Sleep in the prone position. c. Walk with a marching step. d. Limit exercise to increase joint mobility.