A 68-year-old diagnosed with Parkinson's disease is taking entacapone in addition to carbidopa/levodopa. Which of the following would be a priority nursing intervention?
Check the client's blood pressure twice a day to make sure it is not elevated.
Instruct the client to report brownish-orange urine to their health care provider immediately.
Explain to the client the entacapone should be separated from the carbidopa/levodopa by 2 hours.
Assess the client's ability to independently carry out their activities of daily living.
✓
Correct Answer
Assess the client's ability to independently carry out their activities of daily living.
The nurse is evaluating the therapeutic effectiveness of the drugs. The client being able to perform more activities of daily living indicates the drugs are working.
Question 2
The nurse is caring for a client who was recently diagnosed with PD. The provider wanted to begin the client on pramipexole, but the client has difficulty swallowing medications due to a previous stroke. What other medication in the same class would best meet the client's needs?
Rotigotine
✓
Bromocriptine
Ropinirole ER
Apomorphine
Correct Answer
Rotigotine
Because the client cannot swallow well, this drug is the best to meet their needs. It is available in a patch form and is administered transdermally.
Question 3
An 18-year-old is having surgery on their fractured hip after a football injury. During surgery, they develop a fever of 105°F and their muscles become rigid. Which of the following medications would the nurse expect to be administered?
Pregabalin
Gabapentin
Dantrolene
✓
Baclofen
Correct Answer
Dantrolene
This client is experiencing neuroleptic malignant syndrome.
Question 4
The nurse is caring for a client with the primary-progressive form of multiple sclerosis (PPMS). The nurse expects which of the following drugs to be included in the treatment plan?
Ocrelizumab
✓
Natalizumab
Siponimod
Alemtuzumab
Correct Answer
Ocrelizumab
This drug can be used to manage relapses in clinically isolated syndrome (CIS), primary progressive (PPMS), relapsing-remitting (RRMS), and secondary progressive (SPMS).
Question 5
A client is complaining of not being able to sleep for the past week. They mention starting a new medication at that time. Which medication could be the cause of their inability to sleep?
Pramipexole
Selegiline
✓
Entacapone
Benztropine
Correct Answer
Selegiline
Insomnia occurs with this drug because it metabolizes to methamphetamine and amphetamine, causing stimulation. If taken too late in the day, sleep could be disrupted.
Question 6
The nurse is caring for a client who is going to begin therapy with the immunomodulator teriflunomide. Which test is important to have done before the drug is started?
Hemoglobin A1C
Tuberculin skin test
✓
Serum creatinine
Liver function test
Correct Answer
Tuberculin skin test
This drug can exacerbate tuberculosis. If a tuberculin skin test and chest radiograph (x-ray) are positive, the client must be treated for TB before starting the prescribed drug.
Question 7
A nursing student is preparing a teaching plan for a client with PD who is being treated with carbidopa/ levodopa. Which of the following dietary recommendations is correct?
Daily required protein intake should be divided equally among three meals.
✓
Intake of green, leafy vegetables should be limited.
A high-fat diet will interfere with the absorption of carbidopa/levodopa.
High-fiber products will cause diarrhea.
Correct Answer
Daily required protein intake should be divided equally among three meals.
High-protein meals will interfere with levodopa absorption and entrance into the brain.
Question 8
The nurse is reviewing discharge instructions with a client with a new prescription for pregabalin. Which of the following points should be included in this discussion?
Improvement in suicidal ideation is common.
Weight loss is noted with prolonged use.
Altered impulse control can result at therapeutic doses.
✓
The drug is a first-line treatment for seizure disorders.
Correct Answer
Altered impulse control can result at therapeutic doses.
This drug causes euphoria, which can diminish impulse control.
Question 9
The nurse is preparing medications for assigned clients. The nurse calls the prescriber concerned about administering benztropine to one of the clients. What would be the reason for the concern?
74-year-old with symptomatic bradycardia
58-year-old with diarrhea
66-year-old with urinary incontinence
84-year-old with glaucoma
✓
Correct Answer
84-year-old with glaucoma
Benztropine is an anticholinergic. One of the adverse effects of this classification is the potential to increase intraocular pressure; therefore, it should be avoided in clients with glaucoma.
Question 10
Which class of drugs may reduce the therapeutic effects of levodopa if given concurrently?
Sympathomimetics
First-generation antipsychotics
✓
Tricyclic antidepressants
Selective serotonin reuptake inhibitors
Correct Answer
First-generation antipsychotics
These block dopamine receptors in the striatum, resulting in diminished therapeutic effects of levodopa and augmented Parkinsonian symptoms.