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The nurse is aware that the characteristic gait of the person with Parkinson disease is a propulsive gait, which causes the patient to walk in which manner?
- A. stagger and need support of a walker.
- B. shuffle with arms flexed.
- C. fall over to one side when walking.
- D. take small steps balanced on the toes.
Correct Answer: B
Rationale: The propulsive gait causes the patient to shuffle with his arms flexed and with a loss of postural reflexes.
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The nurse explains to a patient and family that the triad of signs of Parkinson disease is: ___, rigidity, and bradykinesia.
Correct Answer: tremor
Rationale: Tremor, rigidity, and bradykinesia are the triad that make up the signs of Parkinson disease.
An 83-year-old patient has had a stroke. The patient is right handed and has a history of hypertension and 'little' strokes. The patient presents with right hemiplegia. To afford the patient the best visual field, the nurse will approach the patient in which manner?
- A. from the right side.
- B. from the left side.
- C. from the center.
- D. from either side.
Correct Answer: B
Rationale: Another perceptual problem is hemianopia, which is characterized by defective vision or blindness in half of the visual field. If the patient has hemianopia, which is common, the patient should be approached from the nonparalyzed side for care.
For which reason is a 'drug holiday' used in the treatment of Parkinson disease?
- A. Change all drugs.
- B. Allow the natural dopamine levels to rise.
- C. Restart drugs at a lower dosage with favorable results.
- D. Reduce the extrapyramidal symptoms.
Correct Answer: C
Rationale: A 'drug holiday' is a period when all drugs are withdrawn from the person with Parkinson disease. The drugs are then restarted at a lower dose with favorable results.
As the result of a stroke, a patient has difficulty discerning the position of his body without looking at it. In the nurse's documentation, which term would best describe the patient's inability to assess spatial position of his body?
- A. Agnosia
- B. Loss of proprioception
- C. Apraxia
- D. Sensation
Correct Answer: B
Rationale: Patients may experience a loss of proprioception with a stroke. This may include apraxia and agnosia (a total or partial loss of the ability to recognize familiar objects or people).
Which technique is necessary for safely feeding a patient with hemiplegia?
- A. Mixing liquids and solid foods together
- B. Taking the patient's dentures out to prevent choking
- C. Checking the affected side of mouth for food accumulation
- D. Offering small bites of food
- E. Elevating the patient to no more than 30 degrees
- F. Adding a thickening agent to liquids
Correct Answer: C,D,F
Rationale: Important nursing measures include avoiding foods that cause choking, checking the affected side of the mouth for accumulation of food and resultant poor hygiene, not mixing liquids and solid foods, and encouraging the patient to take small bites.