A client has idiopathic parkinsonism. Her physician prescribed benztropine mesylate (Cogentin) 1 mg po daily. The nurse explains to her that the pathophysiological defect is an imbalance between:

Estrogen and progesterone

An autosomal dominant genetic defect

Dopamine and acetylcholine

Atherosclerosis and lack of blood supply

Answer and Explanation

The Correct Answer is C

A. Estrogen and progesterone. These hormones regulate the reproductive system and do not play a direct role in Parkinsonism. While some studies suggest estrogen may have a neuroprotective effect, an imbalance between estrogen and progesterone is not the primary defect in Parkinson’s disease.
B. An autosomal dominant genetic defect. Parkinson’s disease can have a genetic component, but idiopathic Parkinsonism occurs without a clear genetic cause. Most cases are sporadic and result from dopamine depletion, rather than an inherited genetic mutation.
C. Dopamine and acetylcholine. Parkinsonism results from a deficiency of dopamine in the basal ganglia, leading to an imbalance between dopamine (inhibitory) and acetylcholine (excitatory). This imbalance causes motor symptoms such as tremors, rigidity, and bradykinesia. Benztropine (Cogentin) is an anticholinergic medication that helps reduce acetylcholine activity, restoring balance and improving symptoms.
D. Atherosclerosis and lack of blood supply. While vascular issues can contribute to stroke-related movement disorders, idiopathic Parkinsonism is caused by neurodegeneration, not blood flow problems. Atherosclerosis is not the primary cause of the dopamine-acetylcholine imbalance seen in Parkinsonism.

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Correct Answer is B

Explanation

A: "Provide a non-skid mat to alleviate plate movement." Using a non-skid mat can help prevent the plate from moving, but it does not address the specific issue of homonymous hemianopsia, which affects the client's visual field and ability to see food on one side.
B: "Remind the client to look for food on the left side of the tray." This strategy directly addresses the challenge posed by homonymous hemianopsia, which results in the loss of vision in half of the visual field. Reminding the client to scan the left side of the tray helps ensure that they can locate and eat their food more effectively.
C: "Encourage the use of the wide grip utensils." While using wide grip utensils may assist with grip and dexterity, it does not specifically address the visual field deficit caused by homonymous hemianopsia. This option does not improve the client’s ability to see the food they need to eat.
D: "Encourage the client to use his right hand when feeding himself." Using the right hand may not be beneficial for the client. If the client has right-sided stroke effects, using the right hand could be difficult due to weakness or hemiparesis. Promoting the use of the unaffected side is usually more effective in fostering independence in eating.

A. Poor impulse control B. Unable to discriminate words and letters C. Motor retardation D. Deficits in the right visual field

Correct Answer is A

Explanation

A. Poor impulse control. A stroke in the right cerebral hemisphere affects judgment, attention, and impulse control. Clients often display poor safety awareness, impulsivity, and difficulty recognizing deficits (anosognosia), increasing the risk of falls and injury.
B. Unable to discriminate words and letters. This symptom is associated with left hemisphere strokes, which affect language centers such as Broca’s and Wernicke’s areas. Clients with left-sided strokes may experience aphasia, difficulty reading, and problems with word recognition, which are not typical of right hemisphere strokes.
C. Motor retardation. Right hemisphere strokes typically cause left-sided hemiparesis or hemiplegia but do not necessarily result in motor retardation (slowness of movement). Instead, lack of awareness of deficits is more common, leading to neglect of the affected side.
D. Deficits in the right visual field. Right hemisphere strokes cause left visual field deficits (left homonymous hemianopia). Right visual field deficits occur with left hemisphere strokes. Clients may also experience left-sided neglect, where they fail to recognize or respond to stimuli on their affected side.

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A client has idiopathic parkinsonism. Her physician prescribed benztropine mesylate (Cogentin) 1 mg po daily. The nurse explains to her that the pathophysiological defect is an imbalance between:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who had a right-sided stroke and is exhibiting homonymous hemianopsia when eating. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

A nurse is caring for a client who had a stroke involving the right cerebral hemisphere. The nurse should monitor for which of the following findings?

Correct Answer is A

Explanation

A nurse is teaching about risk factors for developing a stroke with a group of older adult clients. Which of the following nonmodifiable risk factors should the nurse include?

A nurse is providing teaching to a client who has a new diagnosis of Parkinson's disease. On which of the following medications should the nurse prepare to instruct the client?

A nurse is assessing a client's cranial nerves as part of a neurological examination. Which of the following actions should the nurse take to assess cranial nerve III?

A nurse is teaching a client who has multiple sclerosis about factors that can worsen their manifestations. Which of the following factors should the nurse include in the teaching?

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