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. "The purpose of this device is to allow for neck movement during the healing process." The halo fixation device is designed to completely immobilize the cervical spine, preventing movement to allow for proper healing of spinal injuries. Neck movement is restricted, not encouraged, to avoid further spinal damage.
B. "The purpose of this device is to immobilize the cervical spine." The primary function of a halo fixation device is to stabilize the cervical spine following a spinal cord injury, vertebral fracture, or post-surgical procedure. It provides rigid external fixation to prevent movement that could worsen the injury. Clients must be educated about avoiding activities that may put stress on the device.
C. "Apply talcum powder under the vest to limit friction." Talcum powder should not be used because it can increase skin irritation and moisture buildup, leading to skin breakdown under the vest. Instead, clients should wear a cotton T-shirt under the vest and maintain proper skin hygiene to prevent pressure sores.
D. "Turn the screws on the device once each day." Family members or clients should never adjust the screws. The halo pins should only be adjusted by a healthcare provider, as improper handling can lead to misalignment, pressure injuries, or worsening spinal damage.

A. Massage the calves every shift. B. Place pillows under the client's knees when in bed. C. Perform passive range of motion exercises. D. Apply elastic compression stockings. E. Assess legs for redness.

Correct Answer is ["C","D","E"]

Explanation

A. Massage the calves every shift. Massaging the calves is contraindicated in clients at risk for pulmonary embolism (PE) because it can dislodge a deep vein thrombosis (DVT) and cause an embolism. Instead of massage, gentle movement and circulation-promoting interventions should be used.
B. Place pillows under the client's knees when in bed. Elevating the knees with pillows can impair circulation and increase the risk of venous stasis, leading to DVT formation. A better alternative is to keep the legs elevated slightly without knee flexion to promote venous return.
C. Perform passive range of motion exercises. Passive range of motion (ROM) exercises promote circulation and help prevent venous stasis, reducing the risk of DVT formation. Clients with quadriplegia are at high risk for immobility-related complications, including clots and muscle atrophy, making ROM exercises an essential intervention.
D. Apply elastic compression stockings. Compression stockings help prevent blood pooling in the lower extremities, reducing the risk of DVT and pulmonary embolism. They work by promoting venous return and preventing clot formation, making them a key preventative measure for immobile clients.
E. Assess legs for redness. Redness, swelling, and warmth in the legs can indicate the presence of a DVT, which can lead to PE. Early detection allows for prompt intervention with anticoagulation therapy, reducing the risk of embolism. Regular assessments are critical in clients with limited mobility.

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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 teaching the family of a client who is receiving treatment for a spinal cord injury with a halo fixation device. Which of the following statements should the nurse make?

Correct Answer is B

Explanation

A nurse is planning care for a client who has quadriplegia. Which of the following actions should the nurse take to prevent a pulmonary embolism (PE)? (Select all that apply.)

Correct Answer is ["C","D","E"]

Explanation

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