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A nursing student asks the nurse to differentiate the pathology of Alzheimer's disease from that of Parkinson's disease. Which description is correct?
- A. Parkinson's disease is characterized by an imbalance of dopamine and acetylcholine.
- B. Parkinson disease involves increased dopamine production and decreased acetylcholine.
- C. Alzheimer's disease is caused by decreased amount of dopamine and degeneration of cholinergic neurons.
- D. Alzheimer's disease involves a possible excess of acetylcholine and neuritic plaques.
Correct Answer: A
Rationale: The correct answer is A. In Parkinson's disease, there is a reduction in dopamine levels due to the degeneration of dopaminergic neurons in the substantia nigra of the brain. This imbalance leads to motor symptoms such as tremors and rigidity. In contrast, Alzheimer's disease is characterized by the accumulation of beta-amyloid plaques and neurofibrillary tangles, leading to neuronal cell death and cognitive decline. The incorrect choices can be eliminated as follows: B is incorrect because Parkinson's disease is associated with a decrease, not an increase, in dopamine levels. C is incorrect as Alzheimer's disease is not primarily characterized by decreased dopamine levels but rather by the accumulation of plaques and tangles. D is incorrect as Alzheimer's disease is not associated with an excess of acetylcholine but rather a decrease in its levels. Therefore, option A is the correct choice as it accurately describes the pathology of Parkinson's disease.
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A home care nurse administers oral morphine to the patient with cancer pain. When will the nurse expect the medication to reach peak activity?
- A. 45 minutes.
- B. 10 minutes.
- C. 30 minutes.
- D. 60 minutes.
Correct Answer: A
Rationale: The correct answer is A: 45 minutes. Oral morphine typically reaches peak activity within 30-60 minutes after administration due to its absorption rate. After ingestion, the medication passes through the stomach and intestines before entering the bloodstream, which takes time. Choice B (10 minutes) is too soon for peak activity. Choice C (30 minutes) is close but not the peak time frame. Choice D (60 minutes) is too late for peak activity.
A student asks the pharmacology instructor to explain the action of anticholinergic agents. What would be the instructor's best response?
- A. They compete with serotonin for muscarinic acetylcholine receptor sites.
- B. They increase norepinephrine at the neuromuscular junction.
- C. They block nicotinic receptors.
- D. They act to block the effects of the parasympathetic nervous system.
Correct Answer: D
Rationale: The correct answer is D: They act to block the effects of the parasympathetic nervous system. Anticholinergic agents inhibit the action of acetylcholine, the primary neurotransmitter of the parasympathetic nervous system. By blocking muscarinic acetylcholine receptors, these agents reduce parasympathetic stimulation, leading to effects such as decreased salivation, decreased GI motility, and pupil dilation.
Choice A is incorrect because anticholinergic agents do not compete with serotonin for receptor sites; they primarily target acetylcholine receptors. Choice B is incorrect as anticholinergic agents do not directly affect norepinephrine levels at the neuromuscular junction. Choice C is incorrect because anticholinergic agents primarily target muscarinic receptors, not nicotinic receptors.
The nurse is performing an admission assessment on a stable patient admitted after a motor vehicle accident. The patient reports having bad pain. What will the nurse do first?
- A. Attempt to determine what type of pain the patient has.
- B. Request an order for intravenous opioid analgesic.
- C. Administer acetaminophen (Tylenol).
- D. Ask the patient to rate the pain on a scale of 1-10.
Correct Answer: D
Rationale: The correct answer is D: Ask the patient to rate the pain on a scale of 1-10. This is the first step in assessing pain intensity, which helps determine the urgency and appropriate interventions needed. By having the patient rate the pain, the nurse can establish a baseline for pain management and monitor effectiveness of interventions.
Choice A is incorrect because determining the type of pain comes after assessing the intensity. Choice B is incorrect as requesting IV opioids without assessing pain intensity first may not be appropriate for a stable patient. Choice C is incorrect as administering acetaminophen should be based on the pain assessment.
The nurse is preparing to administer a medication from a multi-dose bottle. The label is torn and soiled, but the name of the medication is still readable. What is the nurse's priority action?
- A. Administer the medication if the name of the drug can be clearly read.
- B. Discard the entire bottle and contents and obtain a new bottle.
- C. Ask another nurse to verify the contents of the bottle.
- D. Find the drug information and make a new label for the bottle.
Correct Answer: B
Rationale: The correct answer is B: Discard the entire bottle and contents and obtain a new bottle. The nurse's priority is patient safety. A torn and soiled label increases the risk of administering the wrong medication, dosage, or route. Discarding the bottle ensures that the correct medication is given, preventing potential harm to the patient. Administering the medication with a damaged label poses a significant risk of medication error. Asking another nurse to verify or making a new label does not eliminate the risk associated with using a compromised bottle. Finding drug information for a new label may introduce inaccuracies. Prioritizing patient safety by obtaining a new bottle is the best course of action in this situation.
A nurse is providing patient teaching to a patient who has been experiencing unstable angina. What will the nurse's explanation of this condition include?
- A. A coronary vessel has become completely occluded and is unable to deliver blood to the heart.
- B. The pain is caused by a spasm of a blood vessel not just by the vessel narrowing.
- C. Your body response to a lack of oxygen in the heart muscle is pain.
- D. There is a serious narrowing of a coronary artery that is causing a reduction in oxygen to the heart.
Correct Answer: B,D
Rationale: The correct answers are B and D. For choice B, in unstable angina, the pain is often caused by a spasm of a blood vessel in addition to vessel narrowing, leading to reduced blood flow. This explanation is important for the patient to understand the multifactorial nature of their condition. For choice D, unstable angina is typically due to a serious narrowing of a coronary artery, resulting in reduced oxygen supply to the heart. This explanation helps the patient comprehend the underlying cause of their symptoms. Choices A and C are incorrect as they do not accurately describe unstable angina. Choice A suggests complete vessel occlusion, which is more characteristic of a heart attack. Choice C simplifies the cause of the pain to just a lack of oxygen, omitting the role of vessel narrowing and spasm.