A nurse is assessing a client who has Parkinson's disease (PD). Which of the following findings should the nurse expect? (Select all that apply.)

Choice A reason:

This is a correct answer. Resting tremor is a common symptom of PD, which occurs when the affected limb or body part shakes involuntarily at rest and stops with voluntary movement or sleep. Resting tremor usually affects one side of the body first and then progresses to both sides. It typically involves the hand, arm, leg, jaw, or tongue.

Choice B reason:

This is a correct answer. Muscle rigidity is another common symptom of PD, which occurs when there is increased resistance to passive movement of the joints due to sustained muscle contraction. Muscle rigidity can cause stiffness, pain, reduced range of motion, and difficulty initiating movement.

Choice C reason:

This is a correct answer. Bradykinesia is another common symptom of PD, which occurs when there is slowness or paucity of movement due to impaired initiation or execution of movement. Bradykinesia can affect various aspects of motor function, such as facial expression, speech, swallowing, gait, writing, dressing, and self-care.

Choice D reason:

This is a correct answer. Postural instability is another common symptom of PD, which occurs when there is impaired balance or coordination due to reduced postural reflexes or sensory feedback. Postural instability can cause falls, difficulty turning or changing direction, stooped posture, shuffling steps, or freezing episodes.

Choice E reason:

This is an incorrect answer. Nuchal rigidity is not a common symptom of PD, but rather a sign of meningitis or subarachnoid hemorrhage. Nuchal rigidity occurs when there is stiffness or pain in the neck when flexing or extending it due to inflammation or irritation of the meninges or subarachnoid space.

Choice A reason:

This is an incorrect answer. The caregiver does not need further teaching if they say that pramipexole will help reduce the symptoms of PD by stimulating dopamine receptors in the brain. Pramipexole is a dopamine agonist that works by mimicking the action of dopamine, which is a neurotransmitter that is deficient in PD and affects movement and cognition. Pramipexole can reduce tremors, rigidity, bradykinesia, and postural instability in clients who have PD.

Choice B reason:

This is an incorrect answer. The caregiver does not need further teaching if they say that pramipexole will help prevent the development of dyskinesia or involuntary movements in their loved one. Dyskinesia is a common side effect of levodopa-carbidopa, which is another medication used to treat PD. Pramipexole can delay or reduce the occurrence of dyskinesia by allowing lower doses of levodopa-carbidopa to be used.

Choice C reason:

This is an incorrect answer. The caregiver does not need further teaching if they say that pramipexole will help increase the duration and quality of sleep in their loved one. Sleep disturbances are common in clients who have PD, due to various factors such as nocturia, pain, restless legs syndrome, or anxiety. Pramipexole can improve sleep quality and quantity by reducing nighttime awakenings and increasing REM sleep.

Choice D reason:

This is a correct answer. The caregiver needs further teaching if they say that pramipexole will help improve the mood and motivation of their loved one. This is not the purpose or effect of pramipexole, but rather antidepressants or stimulants, which are medications used to treat depression or apathy, respectively. Depression or apathy are common neuropsychiatric symptoms of PD, which affect the levels of serotonin, norepinephrine, or dopamine in the brain.