A client with Parkinson's disease is started on Levodopa with Carbidopa (Sinemet). What should the nurse include in the patient teaching?

"Carbidopa crosses the blood-brain barrier where it is then converted to dopamine."

"It may take weeks to begin seeing the effects of this medication."

“You will remain on the same dosage of this medication for the rest of your life."

"Levodopa protects carbidopa, preventing carbidopa from being broken down before it reaches the brain."

Answer and Explanation

The Correct Answer is B

A.   Carbidopa itself does not cross the blood-brain barrier. Its primary role in Sinemet is to inhibit the peripheral breakdown of levodopa (the precursor of dopamine) into dopamine before it reaches the brain.
B.   It is true that it may take a few weeks to see the full effects of this medication, as the body needs time to adjust to it.
C.   Parkinson's disease is progressive, and as the disease advances, the dosage and frequency of levodopa with carbidopa may need to be adjusted to maintain symptom control. Over time, higher doses or additional medications may be required to manage symptoms effectively.
D.   Levodopa does not protect Carbidopa; rather, Carbidopa protects Levodopa from early conversion to dopamine outside the brain, which would make it less effective.

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Correct Answer is D

Explanation

A. This option describes a phenomenon seen in heparin-induced thrombocytopenia (HIT), not in immune thrombocytopenic purpura (ITP). In HIT, antibodies against the PF4-heparin complex can cause platelet activation and aggregation, leading to thrombocytopenia. However, this is not characteristic of ITP.
B. Abnormally long von Willebrand factor is seen in von Willebrand disease (VWD), not in ITP. VWD is a bleeding disorder caused by deficiency or dysfunction of von Willebrand factor, which plays a key role in platelet adhesion and aggregation. It is not typically associated with ITP.

C. ADAMTS13 deficiency is characteristic of thrombotic thrombocytopenic purpura (TTP), not ITP. TTP is a rare blood disorder where small blood clots form in blood vessels throughout the body, leading to thrombocytopenia (low platelet count) and other complications. It is distinct from ITP.
D. In immune thrombocytopenic purpura (ITP), the immune system mistakenly attacks and destroys platelets, leading to a low platelet count. Antibodies, particularly anti-platelet antibodies such as anti-GP IIb/IIIa or anti-GP Ib/IX, coat the surface of platelets. These antibody-coated platelets are recognized and destroyed by macrophages in the spleen and liver, contributing to thrombocytopenia.

A. Retropulsion B. Impaired handwriting C. Muscle soreness and pain D. Slow movements

Correct Answer is A

Explanation

A. Retropulsion is a classic manifestation of postural instability in Parkinson's disease. It refers to a tendency to lose balance and fall backward, especially when attempting to initiate walking or when challenged with external forces.
B. Impaired handwriting, also known as micrographia, is associated with bradykinesia (slowness of movement) in Parkinson's disease. It manifests as progressively smaller and more cramped handwriting.

C. Muscle soreness and pain can occur in Parkinson's disease, but they are not typically directly associated with postural instability. They may occur due to rigidity (muscle stiffness) or abnormal postures maintained over time.
D. Slow movements, or bradykinesia, are a hallmark feature of Parkinson's disease and are characterized by a gradual reduction in the speed and fluidity of voluntary movements. While related to motor symptoms in Parkinson's disease, slow movements are not specific to postural instability.

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A client with Parkinson's disease is started on Levodopa with Carbidopa (Sinemet). What should the nurse include in the patient teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a diagnosis of immune thrombocytopenic purpura (ITP). When reviewing the results of the client's peripheral blood smear, what would the nurse expect to find?

Correct Answer is D

Explanation

The classic manifestations associated with Parkinson's disease are tremor, rigidity, bradykinesia, and postural instability. The nurse understands that a finding related to postural instability includes which of the following?

Correct Answer is A

Explanation

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