Med Surg Final Exam ATI Questions And Answers. A+ RATED.1. A nurse is caring for a client
who displays signs of stage III
Parkinson’s disease. Which of... [Show More] the
following actions should the nurse
include in the plan of care?
A. Recommend a community
B. Integrate a daily
C. Provide a walker for
D. Perform ADLs for the client.
2. A nurse is developing a plan of
care for the nutritional needs of a
client who has stage IV Parkinson’s
disease. Which actions should
the nurse include in the plan of
care? (Select all that apply.)
A. Provide three large
balanced meals daily.
B. Record diet and fluid
C. Document weight
every other week.
D. Place the client in Fowler’s
position to eat.
E. Offer nutritional supplements
3. A nurse is reinforcing teaching
with a client who has Parkinson’s
disease and has a new prescription
for bromocriptine. Which of the
following instructions should the
nurse include in the teaching?
A. Rise slowly when standing.
B. Expect urine to become
C. Avoid foods containing
D. Report any skin discoloration.
4. A nurse is assessing a client for
manifestations of Parkinson’s disease.
Which of the following are expected
findings? (Select all that apply.)
A. Decreased vision
B. Pill-rolling tremor of the fingers
C. Shuffling gait
E. Bilateral ankle edema
F. Lack of facial expression
5. A nurse is caring for a client who
has Parkinson’s disease and is
starting to display bradykinesia.
Which of the following is an
appropriate action by the nurse?
A. Teach the client to walk more
quickly when ambulating.
B. Complete passive
range-of-motion exercises daily.
C. Place the client on a
low-protein, low-calorie diet.
D. Give the client extra time
to perform activities.
44 CHAPTER 7 PARKINSON’S DISEASE CONTENT MASTERY SERIES
Application Exercises Key
1. A. The client/family should be involved in a community support group
at the onset of the disease process to enhance coping mechanisms.
B. The client should perform daily exercises with the onset of the disease
process to promote mobility and independence for as long as possible.
C. CORRECT: The client should use a walker for ambulation
in stage III of Parkinson’s disease because movement
slows down significantly and gait disturbances occur.
D. The client loses ability to perform ADLs during stage V
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,
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
for meals rather than in a supported Fowler’s position,
where the client’s head is elevated to 45 to 60°.
E. CORRECT: The nurse should offer nutritional supplements
between meals to maintain the client’s weight.
NCLEX® Connection: Basic Care and Comfort,
Nutrition and Oral Hydration
3. A. CORRECT: Orthostatic hypotension is a common adverse effect of
bromocriptine, a dopamine receptor agonist. Therefore, rising slowly
when standing up will decrease the risk of dizziness and lightheadedness.
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.
C. The client should avoid tyramine in the diet when taking
selegiline, a monoamine type B inhibitor. However, bromocriptine
does not interact with foods that contain tyramine.
D. Skin discoloration is an adverse effect of amantadine, an anti-viral
medication. However it is not an adverse effect of bromocriptine.
NCLEX® Connection: Pharmacological and Parenteral Therapies,
Adverse Efects/Contraindications/Side Efects/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 Specifc Assessments
Using the ATI Active Learning Template: System Disorder
ALTERATION IN HEALTH (DIAGNOSIS): Parkinson’s disease
is a debilitating condition that progresses to complete
dependent care. The disease involves a decrease in dopamine
production and an increase in secretion of acetylcholine, causing
resting tremor, slowed movement, and muscular rigidity.
● Aspiration due to pharyngeal muscle
involvement making swallowing difficult
● Orthostatic hypotension, slow movement, and muscle rigidity
● Change in speech pattern: slow, monotonous speech
● Altered emotional changes that can include depression and fear
● Add thickener to liquids to prevent aspiration.
● Consult with a dietitian about appropriate diet.
● Encourage periods of rest between activities.
● Allow adequate time to rise slowly from
a sitting to standing position.
● Encourage slower speech when expressing thoughts.
● Observe for signs of depression and dementia.
NCLEX® Connection: Physiological Adaptation,
PRACTICE Active Learning Scenario
A nurse is preparing a plan of care for a client who has
a new diagnosis of Parkinson’s disease. What should
the nurse include in the plan of care? Use the ATI Active
Learning Template: System Disorder to complete this item.
ALTERATION IN HEALTH (DIAGNOSIS):
Define Parkinson’s disease.
COMPLICATIONS: Identify four.
NURSING CARE: Describe six nursing actions.
RN ADULT MEDICAL SURGICAL NURSING CHAPTER 8 ALZHEIMER’S DISEASE 47
Appl [Show Less]