The nurse assessing the client diagnosed with Parkinson's disease (PD) would expect which of the following assessment findings?

Muscle rigidity and bradykinesia

Facial pain and ptosis

Diarrhea and nausea

Ecchymosis and petechiae

Answer and Explanation

The Correct Answer is A

A. Muscle rigidity and bradykinesia: Parkinson's disease (PD) is characterized by a combination of motor symptoms due to the degeneration of dopamine-producing neurons in the brain. The hallmark motor symptoms include muscle rigidity (stiffness of muscles, making movement difficult) and bradykinesia (slowness of movement). These symptoms are typically present early in the disease and can lead to difficulties with daily activities such as walking, speaking, and performing fine motor tasks. These two signs are primary indicators of Parkinson's disease.

B. Facial pain and ptosis: Facial pain and ptosis (drooping eyelids) are not typical symptoms of Parkinson's disease. PD can affect facial expression (resulting in a masked face), but it does not usually cause facial pain. Ptosis is more commonly seen in conditions like Horner's syndrome, myasthenia gravis, or as a side effect of medications, but it is not a hallmark symptom of Parkinson's disease.

C. Diarrhea and nausea: While gastrointestinal symptoms such as constipation can be seen in Parkinson's disease due to autonomic dysfunction and decreased gut motility, diarrhea and nausea are not typical primary symptoms. In fact, constipation is a more common issue in PD. Nausea could result from the use of medications like levodopa, but it is not a defining feature of the disease itself.

D. Ecchymosis and petechiae: Ecchymosis (bruising) and petechiae (small red or purple spots on the skin) are not characteristic of Parkinson's disease. These findings are more often associated with platelet disorders, bleeding disorders, or vascular conditions. While Parkinson's disease can involve complications like falls (which could lead to bruising), these are not direct symptoms of the disease itself. The primary symptoms involve motor and autonomic dysfunction.

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Correct Answer is A

Explanation

A. Sublingual nitroglycerin each day to prevent chest pain:
The statement about taking sublingual nitroglycerin daily is incorrect. Sublingual nitroglycerin is prescribed as needed for acute chest pain (angina) or for relieving chest discomfort associated with myocardial infarction (MI). It is not intended for daily use as a preventive measure. The client should be educated to use sublingual nitroglycerin only when experiencing chest pain, and if the pain persists or worsens, they should seek immediate medical help. Daily or routine use of nitroglycerin should be avoided unless specifically instructed by a healthcare provider. The client should also be educated about other preventive measures like long-acting nitrates if needed for chest pain prevention.

Explanation of other options:

B. Clopidogrel to prevent clots from forming:
This statement is correct. Clopidogrel (Plavix) is an antiplatelet medication commonly prescribed after a myocardial infarction to help prevent the formation of blood clots, which can reduce the risk of future cardiovascular events such as stroke or further heart attacks. It works by inhibiting platelets from clumping together, which is crucial in the post-MI period.

C. Atorvastatin at bedtime to reduce my cholesterol levels:
This statement is correct. Atorvastatin is a statin medication that is used to lower cholesterol levels, particularly LDL cholesterol (the "bad" cholesterol), which contributes to atherosclerosis and increases the risk of further heart problems. Statins are often prescribed after a myocardial infarction to help reduce the risk of future events. Taking atorvastatin at bedtime is also a common recommendation because cholesterol synthesis is higher during the night.

D. Metoprolol to decrease my heart's need for oxygen:
This statement is correct. Metoprolol is a beta-blocker that reduces the heart rate and blood pressure, which in turn lowers the heart's oxygen demand. After a myocardial infarction, beta-blockers like metoprolol are commonly prescribed to prevent further heart damage, reduce ischemia, and decrease the likelihood of arrhythmias. They help in the management of heart failure as well by improving the heart's efficiency.

A. Serum potassium of 5.2 mEq/L (normal 3.5 mEq/L-5.3 mEq/L.) B. T wave depression on electrocardiogram C. Heart rate of 90 beats per minute D. Blood pressure of 90/50

Correct Answer is D

Explanation

A. Serum potassium of 5.2 mEq/L: A potassium level of 5.2 mEq/L is slightly elevated but is still within a potentially acceptable range (normal is 3.5-5.3 mEq/L). While elevated potassium can be a concern, particularly in the context of an MI or with certain medications (like potassium-sparing diuretics), this level is not critically high. The nurse should monitor the potassium levels, but this is not an urgent finding requiring immediate reporting unless it increases further or is accompanied by significant symptoms (such as arrhythmias).

B. T wave depression on electrocardiogram (ECG): T wave depression can be a sign of ischemia or injury, which is common in the setting of an acute myocardial infarction. However, T wave changes are expected in this context and do not indicate an immediate emergency. The nurse should continue to monitor the ECG for any progression or worsening of ischemic changes but should prioritize concerns such as hypotension or worsening clinical status over this finding.

C. Heart rate of 90 beats per minute: A heart rate of 90 beats per minute is within normal limits (60-100 beats per minute), especially in the early stages of an MI. Nitroglycerin may cause a reflex tachycardia as a compensatory response to the decreased blood pressure, but a heart rate of 90 bpm is not an alarming finding. The nurse should continue to monitor the heart rate, but it is not the most pressing concern compared to hypotension. 4o mini

D. Blood pressure of 90/50: A blood pressure of 90/50 mmHg is significantly low and could indicate that the client is experiencing hypotension, which is a known side effect of nitroglycerin infusion. Nitroglycerin causes vasodilation, which can reduce blood pressure, especially in clients who are already at risk due to an acute myocardial infarction (MI). Low blood pressure can compromise perfusion to vital organs, including the heart, brain, and kidneys, and may lead to shock if not corrected promptly. This finding should be reported immediately to the healthcare provider, as it may require adjustment of the nitroglycerin dosage or discontinuation of the infusion.

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Arterial Blood Gases
pH	7.35-7.45
PaCO2	35-45mmHg
PaO2	80-100mmHg
HCO3-	22-26 mEq/L
O2 Saturation	>95%
Chemistry
BUN	8-21mg/dl
Creatinine	0.5-1.2mg/dl
Na	135-145 mEq/L
K	3.5-5.3 mEq/L
Cl	97-107 mEq/L
CO2	22-26 mEq/L
Ca	8.2-10.2 mg/dl
Glucose	65-99 mg/dl
Mg	1.7-2.2 mg/dl
PO4	2.5-4.5 mg/dl

The nurse assessing the client diagnosed with Parkinson's disease (PD) would expect which of the following assessment findings?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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