The classic triad of Parkinson's disease signs include: (Select All That Apply)
Bradykinesia.
Resting tremor.
Memory loss.
Loss of sensation.
"Cogwheel" rigidity.
Correct Answer : A,B,E
Choice A rationale
Bradykinesia is a fundamental component of the Parkinson's triad and refers to the generalized slowness of movement. This occurs due to the depletion of dopamine in the substantia nigra, which disrupts the basal ganglia's ability to facilitate motor output. Patients experience difficulty initiating movements and a reduction in automatic motions, such as swinging the arms while walking. It significantly impacts daily activities and is essential for a clinical diagnosis of the neurodegenerative disease.
Choice B rationale
Resting tremor is a classic sign often described as a pill-rolling motion of the hands. It typically occurs when the limb is relaxed and disappears during purposeful movement or sleep. This tremor results from the rhythmic firing of neurons in the subthalamic nucleus and globus pallidus due to the loss of dopaminergic inhibition. While not all patients exhibit a tremor, it is one of the most recognizable and frequent symptoms included in the hallmark diagnostic triad.
Choice C rationale
Memory loss and cognitive decline can occur in Parkinson's disease, particularly in the later stages, but they are not part of the "classic triad" used for initial diagnosis. Dementia associated with Parkinson's is a separate clinical consideration from the primary motor symptoms. The triad focuses specifically on motor dysfunction resulting from basal ganglia pathology. Memory issues are more central to Alzheimer's disease or Lewy body dementia rather than being a defining primary motor sign.
Choice D rationale
Loss of sensation is not a characteristic feature of Parkinson's disease. Parkinson's is primarily a motor system disorder affecting the extrapyramidal tract. While some patients may report vague aches or pains, true sensory loss involving touch, temperature, or proprioception suggests a peripheral neuropathy or a lesion in the sensory cortex or spinal cord. Sensory pathways remain intact in Parkinson's, as the underlying pathology is concentrated in the dopamine-producing cells of the midbrain.
Choice E rationale
Cogwheel rigidity is the third component of the classic triad. It refers to a specific type of muscle stiffness where there is a jerky, lead-pipe resistance to passive limb movement. This "cogwheel" sensation is thought to be the combination of basic rigidity and an underlying tremor. It affects both agonist and antagonist muscles equally. This increased muscle tone contributes to the characteristic stooped posture and masked facies seen in individuals progressing through the stages of Parkinson's.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Straining during defecation, known as dyschezia, is a primary indicator of constipation. It suggests that the stool is hard, dry, or difficult to pass through the anal canal. This often results from excessive water absorption in the colon due to slow transit time. According to the Rome IV criteria, straining in more than 25 percent of bowel movements is a diagnostic feature of functional constipation, even if the frequency of movements seems somewhat regular.
Choice B rationale
Moving the bowels at least 7 times a week falls within the normal range for bowel frequency. The standard medical definition of normal bowel habits ranges from three times per day to three times per week. A frequency of once daily indicates regular transit and efficient waste elimination. Constipation is generally defined as having fewer than three bowel movements per week. Therefore, this statement suggests healthy colonic function rather than a state of constipation or delayed fecal transit.
Choice C rationale
Soft stools are generally considered a sign of healthy bowel function and adequate hydration. According to the Bristol Stool Form Scale, soft, sausage-shaped stools (Type 4) are the ideal consistency for easy passage. Constipation is characterized by stools that are hard, lumpy, or pebble-like (Types 1 and 2), which occur when fecal matter remains in the large intestine too long. Soft stools indicate that the transit time is appropriate and fiber intake is likely sufficient.
Choice D rationale
The feeling of complete evacuation indicates that the rectal ampulla has been successfully emptied and the defecation reflex is functioning correctly. In contrast, patients with constipation or pelvic floor dyssynergia often report a sensation of incomplete evacuation or anorectal obstruction. Successful and complete emptying is a sign of normal neuromuscular coordination between the colon, rectum, and anal sphincters. This statement confirms the absence of the obstructive symptoms typically associated with chronic constipation.
Correct Answer is C
Explanation
Choice A rationale
Infection of the endocardium describes endocarditis, which is an inflammatory process usually involving the heart valves and the inner lining of the heart chambers. This condition is typically caused by bacteria entering the bloodstream and colonizing damaged heart tissue. While serious, it is a different pathological process from a myocardial infarction, which is primarily a vascular event involving the coronary arteries rather than a primary infectious process of the heart lining.
Choice B rationale
A temporary deficit of oxygen that resolves with rest is the physiological definition of angina pectoris, specifically stable angina. In this state, the heart muscle experiences ischemia, which causes pain, but the cells do not suffer permanent damage or death because blood flow is restored quickly. Myocardial infarction is distinguished from this by the fact that the deprivation of oxygen is prolonged enough to cause irreversible tissue death and cellular necrosis.
Choice C rationale
Myocardial infarction occurs when a coronary artery is completely or nearly completely obstructed, often by a ruptured plaque followed by thrombus formation. This total blockage halts the delivery of oxygen and nutrients to the downstream cardiac tissue. Without blood flow, the myocytes undergo anaerobic metabolism, eventually leading to cell death and the loss of contractile function. This permanent structural damage is the defining characteristic of an infarction versus transient ischemia.
Choice D rationale
An increase in oxygen consumption by myocardial cells can trigger ischemia if the supply cannot keep up, but it does not describe the primary mechanism of an infarction. While high heart rates or hypertension increase demand, an infarction is defined by the failure of the supply line, usually due to a physical blockage. Increased demand is more often the precipitating factor for stable angina in a patient who already has narrowed, but not blocked, arteries.
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