Chapter 20: Drugs for Parkinsonism and Alzheimer Disease
McCuistion: Pharmacology: A Patient-Centered Nursing Process Approach, 11th
Edition
MULTIPLE CHOICE
1. An older patient exhibits a shuffling gait, lack of facial expression, and tremors at rest. The
nurse will expect the provider to order which medication for this patient?
a. Carbidopa-levodopa
b. Donepezil
c. Rivastigmine
d. Memantine
ANS: A
This patient is exhibiting signs of Parkinson disease and should be treated with a medication
indicated to treat Parkinson disease, such as carbidopa-levodopa. The other drugs are
indicated to treat Alzheimer disease.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Pathophysiology
2. A nursing student asks the nurse to differentiate the pathology of Alzheimer disease from that
of Parkinson disease. Which description is correct?
a. Alzheimer disease involves a possible excess of acetylcholine and neuritic p
b. Alzheimer disease is caused by decreased amounts of dopamine and degen
of cholinergic neurons.
c. Parkinson disease is characterized by an imbalance of dopamine and acetyl
d. Parkinson disease involves increased dopamine production and decreased
acetylcholine.
ANS: C
Parkinson disease (PD) is characterized by an imbalance of dopamine (DA) and acetylcholine
(ACh) caused by an unexplained degeneration of the dopaminergic neurons, allowing the
excitatory response of acetylcholine to exceed the inhibitory response of dopamine.
Alzheimer disease (AD) may result from decreased ACh, degeneration of cholinergic neurons,
and formation of neuritic plaques. Dopamine does not appear to play a role in Alzheimer
disease.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: N/A
MSC: NCLEX: Physiological Integrity: Pathophysiology
3. The spouse of a patient newly diagnosed with mild, unilateral symptoms of Parkinson disease
(PD) asks the nurse what, besides medication, can be done to manage the disease. The nurse
will do which of the following?
a. Counsel the spouse that parkinsonism is a normal part of the aging process
people.
b. Recommend exercise, nutritional counseling, and group support to help man
the disease.
c. Tell the spouse that the disease will not progress if mild symptoms are treat
early.
, d. Tell the spouse that medication therapy can be curative if drugs are started i
ANS: B
PD is a progressive disorder. Non-pharmacologic measures including exercise, nutritional
counseling, and group support can lessen symptoms and help patients and families cope with
the disorder. Although the aging process may contribute to the development of PD, it is not
necessarily a normal part of aging. Treatment may slow the progression but does not arrest or
cure the disease.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pathophysiology
4. A patient who has Parkinson disease is being treated with the anticholinergic medication
benztropine (Cogentin). The nurse will tell the patient that this drug will have which effect?
a. Helping the patient to walk faster
b. Improving mental function
c. Minimizing symptoms of bradykinesia
d. Improve tremors
ANS: D
Benztropine, an anticholinergic medication, is given to reduce rigidity and improve symptoms
of tremor. It does not improve gait, reduce bradykinesia, or improve mental function.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. The nurse is preparing to administer a first dose of benztropine (Cogentin) to a patient
diagnosed with parkinsonism. The nurse would notify the patient’s provider if the patient had
a history of which condition?
a. Asthma
b. Glaucoma
c. Hypertension
d. Irritable bowel disease
ANS: B
Patients with a history of glaucoma should not take anticholinergic medications, as the drug
can increase the intraocular pressure. Anticholinergics are not contraindicated in patients who
have asthma, hypertension, or irritable bowel disease.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. The nurse is caring for a patient who is receiving istradefylline for their Parkinson disease.
The patient asks the nurse why this medication was added. The nurse understands that this
medication was added to
a. help decrease dyskinesias.
b. to prevent the peripheral conversion of levodopa to dopamine.
c. to help with tremor.
d. to reduce “off” periods resulting from long-term treatment with levodopa.
McCuistion: Pharmacology: A Patient-Centered Nursing Process Approach, 11th
Edition
MULTIPLE CHOICE
1. An older patient exhibits a shuffling gait, lack of facial expression, and tremors at rest. The
nurse will expect the provider to order which medication for this patient?
a. Carbidopa-levodopa
b. Donepezil
c. Rivastigmine
d. Memantine
ANS: A
This patient is exhibiting signs of Parkinson disease and should be treated with a medication
indicated to treat Parkinson disease, such as carbidopa-levodopa. The other drugs are
indicated to treat Alzheimer disease.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Pathophysiology
2. A nursing student asks the nurse to differentiate the pathology of Alzheimer disease from that
of Parkinson disease. Which description is correct?
a. Alzheimer disease involves a possible excess of acetylcholine and neuritic p
b. Alzheimer disease is caused by decreased amounts of dopamine and degen
of cholinergic neurons.
c. Parkinson disease is characterized by an imbalance of dopamine and acetyl
d. Parkinson disease involves increased dopamine production and decreased
acetylcholine.
ANS: C
Parkinson disease (PD) is characterized by an imbalance of dopamine (DA) and acetylcholine
(ACh) caused by an unexplained degeneration of the dopaminergic neurons, allowing the
excitatory response of acetylcholine to exceed the inhibitory response of dopamine.
Alzheimer disease (AD) may result from decreased ACh, degeneration of cholinergic neurons,
and formation of neuritic plaques. Dopamine does not appear to play a role in Alzheimer
disease.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: N/A
MSC: NCLEX: Physiological Integrity: Pathophysiology
3. The spouse of a patient newly diagnosed with mild, unilateral symptoms of Parkinson disease
(PD) asks the nurse what, besides medication, can be done to manage the disease. The nurse
will do which of the following?
a. Counsel the spouse that parkinsonism is a normal part of the aging process
people.
b. Recommend exercise, nutritional counseling, and group support to help man
the disease.
c. Tell the spouse that the disease will not progress if mild symptoms are treat
early.
, d. Tell the spouse that medication therapy can be curative if drugs are started i
ANS: B
PD is a progressive disorder. Non-pharmacologic measures including exercise, nutritional
counseling, and group support can lessen symptoms and help patients and families cope with
the disorder. Although the aging process may contribute to the development of PD, it is not
necessarily a normal part of aging. Treatment may slow the progression but does not arrest or
cure the disease.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pathophysiology
4. A patient who has Parkinson disease is being treated with the anticholinergic medication
benztropine (Cogentin). The nurse will tell the patient that this drug will have which effect?
a. Helping the patient to walk faster
b. Improving mental function
c. Minimizing symptoms of bradykinesia
d. Improve tremors
ANS: D
Benztropine, an anticholinergic medication, is given to reduce rigidity and improve symptoms
of tremor. It does not improve gait, reduce bradykinesia, or improve mental function.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. The nurse is preparing to administer a first dose of benztropine (Cogentin) to a patient
diagnosed with parkinsonism. The nurse would notify the patient’s provider if the patient had
a history of which condition?
a. Asthma
b. Glaucoma
c. Hypertension
d. Irritable bowel disease
ANS: B
Patients with a history of glaucoma should not take anticholinergic medications, as the drug
can increase the intraocular pressure. Anticholinergics are not contraindicated in patients who
have asthma, hypertension, or irritable bowel disease.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. The nurse is caring for a patient who is receiving istradefylline for their Parkinson disease.
The patient asks the nurse why this medication was added. The nurse understands that this
medication was added to
a. help decrease dyskinesias.
b. to prevent the peripheral conversion of levodopa to dopamine.
c. to help with tremor.
d. to reduce “off” periods resulting from long-term treatment with levodopa.
