A nurse is assessing a client on long-term Levodopa therapy. Which findings would the nurse identify as adverse effects of the medication? SELECT ALL THAT APPLY

Confusion

Depression

Increased appetite

Hallucinations

Sleep disturbances

Answer and Explanation

Correct Answer : A,B,D,E

Rationale:

A. Levodopa, especially with long-term use or higher doses, can cross the blood-brain barrier and affect neurotransmitter balance, leading to cognitive changes, including confusion and disorientation. This is a well-documented adverse effect in Parkinson’s patients.

B. Alterations in central dopamine levels due to Levodopa therapy can impact mood regulation, potentially resulting in depression or worsening pre-existing mood disorders. Monitoring mental health is essential during long-term therapy.

C. Levodopa does not typically increase appetite. Common side effects are neurological or psychiatric, and gastrointestinal effects may include nausea or vomiting, not increased appetite. This option is not associated with adverse effects of the medication.

D. Long-term or high-dose Levodopa can cause psychiatric effects, including hallucinations, vivid dreams, or paranoia, particularly in older adults. These adverse effects reflect excessive dopaminergic stimulation in the CNS.

E. Patients on Levodopa may experience insomnia, restless sleep, or sudden sleep attacks, particularly when dosing schedules are not optimized. Sleep disturbances are a recognized CNS-related adverse effect of chronic therapy.

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Correct Answer is A

Explanation

Rationale:

A. An unconscious client with severe hypoglycemia cannot swallow safely. Glucagon stimulates glycogen breakdown in the liver, rapidly increasing blood glucose. This is a life-saving intervention and the first priority in severe hypoglycemia when the patient is unresponsive.

B. Delaying treatment in a severely hypoglycemic, unconscious patient is extremely dangerous. Hypoglycemia at 40 mg/dL can lead to seizures, coma, brain damage, or death. Immediate action is required; rechecking without treatment does not address the urgent need for glucose.

C. Insulin lowers blood glucose by promoting cellular uptake of glucose. Administering insulin in a hypoglycemic patient would exacerbate the condition, potentially causing irreversible neurologic damage or death. This is the opposite of the needed intervention.

D. Oral carbohydrate is safe only for conscious patients able to swallow. In an unconscious patient, attempting to give juice poses a high risk of aspiration, which can lead to airway obstruction, aspiration pneumonia, and death.

A. The patient's tremors and rigidity have decreased B. The patient has increased blood pressure and heart rate C. The patient reports improved sleep and appetite D. The patient experiences improved speech clarity

Correct Answer is A

Explanation

Rationale:

A. Deep brain stimulation (DBS) targets specific brain areas, most commonly the subthalamic nucleus or globus pallidus, to modulate abnormal neuronal activity. The primary goal of DBS in Parkinson’s disease is to reduce motor symptoms such as tremors, rigidity, and bradykinesia when medications are insufficient or cause significant side effects. A noticeable reduction in these symptoms indicates effective treatment.

B. DBS primarily affects motor pathways, not autonomic regulation. While transient cardiovascular changes may occur during surgery, persistent hypertension or tachycardia is not a desired outcome and may indicate complications rather than therapeutic benefit.

C. Although improved comfort and activity may indirectly enhance sleep or appetite, these are secondary outcomes. DBS is not designed to treat non-motor symptoms such as sleep disturbances or appetite changes, so improvement in these areas does not confirm the primary efficacy of the therapy.

D. Speech issues in Parkinson’s disease, such as hypophonia or monotone speech, are less reliably improved by DBS. In some cases, DBS may even worsen speech due to stimulation parameters or target selection. Therefore, improved speech clarity is not a definitive indicator of treatment effectiveness.

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A nurse is assessing a client on long-term Levodopa therapy. Which findings would the nurse identify as adverse effects of the medication? SELECT ALL THAT APPLY

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client on insulin becomes unconscious with a blood glucose of 40 mg/dL. What is the priority intervention?

Correct Answer is A

Explanation

A nurse is caring for a client with Parkinson's disease who recently had deep brain stimulation. Which outcome indicates the treatment is effective?

Correct Answer is A

Explanation

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