A client with Parkinson's disease complains of feeling dizzy upon standing. Which non-motor complication is suspected?
Tremor
Hypertension
Orthostatic hypotension
Bradykinesia
The Correct Answer is C
Rationale:
A. Tremor in Parkinson’s disease is a classic motor symptom, often presenting as a resting tremor in the hands, fingers, or jaw. It occurs independently of posture and does not typically cause lightheadedness, dizziness, or syncope upon standing. While tremor can interfere with fine motor tasks, it is not related to autonomic dysfunction or blood pressure changes.
B. High blood pressure generally does not cause dizziness upon standing. In fact, hypertension may coexist with Parkinson’s disease but is not responsible for orthostatic symptoms. Dizziness related to blood pressure in PD is usually caused by hypotension (low blood pressure), not elevated blood pressure. Focusing on hypertension would misdirect treatment efforts in this scenario.
C. Orthostatic hypotension (OH) is a non-motor complication of PD, resulting from autonomic nervous system dysfunction. When a patient stands, blood pressure fails to adjust appropriately, leading to decreased cerebral perfusion. Symptoms include dizziness, lightheadedness, blurred vision, or syncope, which can cause falls and impair functional independence. OH can be exacerbated by dopaminergic therapy, dehydration, prolonged bed rest, and age-related vascular changes.
D. Bradykinesia refers to slowness of voluntary movements and affects gait, speech, facial expression, and fine motor activities. It is a motor symptom, not an autonomic one, and does not directly cause dizziness or lightheadedness when changing positions. While bradykinesia may contribute to falls due to slow reactions, the primary cause of postural dizziness in this scenario is OH.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["125"]
Explanation
Step 1: Use the formula
Flow rate (mL/hr) = Total volume ÷ Time (hr)
Step 2: Insert known values
Flow rate = 1,000 ÷ 8
Flow rate = 125 mL/hr
Final Answer: 125 mL/hr
Correct Answer is ["A","B","D","E"]
Explanation
Rationale:
A. One of the hallmark early signs of MS is optic neuritis, which occurs when demyelination affects the optic nerve. This results in sudden or subacute vision loss in one eye, often accompanied by pain with eye movement. Visual symptoms may be transient or partially recover, but repeated episodes are common. Recognizing optic neuritis is important for early diagnosis and initiation of disease-modifying therapy.
B. MS commonly affects cranial nerves III, IV, and VI or their central pathways, leading to ocular motor dysfunction. This can cause: Diplopia (double vision) due to extraocular muscle weakness or impaired nerve conduction, Blurred vision from optic nerve involvement or demyelination in visual pathways, Nystagmus in some patients
These symptoms contribute to difficulty reading, driving, and performing fine visual tasks and often worsen with fatigue or heat (Uhthoff’s phenomenon).
C. Bradykinesia is a slowness of voluntary movement seen in Parkinson’s disease, not MS. While MS can cause motor weakness, spasticity, or coordination deficits, true bradykinesia is absent. Confusing the two may lead to misdiagnosis.
D. Fatigue is one of the most common and disabling symptoms of MS, affecting up to 80% of patients. It can be primary (from demyelination and CNS changes) or secondary (from sleep disturbance, depression, infection, or heat). Fatigue often: Worsens in the afternoon or after activity, Impairs ADLs, work performance, and quality of life and Requires energy conservation strategies, pacing, and sometimes pharmacologic management
E. Depression is common in MS due to a combination of: Neurochemical changes from CNS demyelination and psychological stress of living with a chronic, unpredictable disease
Depression can negatively impact adherence to medications, physical activity, and disease self-management. Screening and early treatment are essential.
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