The nurse assessing the client diagnosed with Parkinson's disease (PD) would expect which of the following assessment findings?

Muscle rigidity and bradykinesia

Facial pain and ptosis

Diarrhea and nausea

Ecchymosis and petechiae

Answer and Explanation

The Correct Answer is A

A. Muscle rigidity and bradykinesia: Parkinson's disease (PD) is characterized by a combination of motor symptoms due to the degeneration of dopamine-producing neurons in the brain. The hallmark motor symptoms include muscle rigidity (stiffness of muscles, making movement difficult) and bradykinesia (slowness of movement). These symptoms are typically present early in the disease and can lead to difficulties with daily activities such as walking, speaking, and performing fine motor tasks. These two signs are primary indicators of Parkinson's disease.

B. Facial pain and ptosis: Facial pain and ptosis (drooping eyelids) are not typical symptoms of Parkinson's disease. PD can affect facial expression (resulting in a masked face), but it does not usually cause facial pain. Ptosis is more commonly seen in conditions like Horner's syndrome, myasthenia gravis, or as a side effect of medications, but it is not a hallmark symptom of Parkinson's disease.

C. Diarrhea and nausea: While gastrointestinal symptoms such as constipation can be seen in Parkinson's disease due to autonomic dysfunction and decreased gut motility, diarrhea and nausea are not typical primary symptoms. In fact, constipation is a more common issue in PD. Nausea could result from the use of medications like levodopa, but it is not a defining feature of the disease itself.

D. Ecchymosis and petechiae: Ecchymosis (bruising) and petechiae (small red or purple spots on the skin) are not characteristic of Parkinson's disease. These findings are more often associated with platelet disorders, bleeding disorders, or vascular conditions. While Parkinson's disease can involve complications like falls (which could lead to bruising), these are not direct symptoms of the disease itself. The primary symptoms involve motor and autonomic dysfunction.

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Correct Answer is C

Explanation

A. Call for the rapid response team and request a portable chest X-ray: While calling for assistance and obtaining a chest X-ray is important for further assessment, the immediate priority is to secure the wound to prevent air from entering the pleural space. This action will help stabilize the patient until the rapid response team arrives and the X-ray can be performed.

B. Turn the suction drainage system off and auscultate breath sounds: Turning off the suction and auscultating breath sounds may be necessary after the wound is secured, but these actions should not take priority over sealing the chest tube site. The focus at this moment is to prevent a tension pneumothorax by sealing the dislodged chest tube site. Auscultation of breath sounds is useful afterward to assess for respiratory complications, but it is not the first action to take.

C. Apply a sterile dressing and tape on three sides: The first action when a chest tube becomes accidentally dislodged is to seal the opening to prevent air from entering the pleural space, which could lead to a pneumothorax (collapsed lung). Applying a sterile dressing and taping it on three sides helps create a temporary one-way valve effect, allowing air to escape from the pleural space but preventing further air from being drawn in. This intervention is crucial to stabilize the patient while awaiting further evaluation and intervention.

D. Notify the healthcare provider immediately: Notifying the healthcare provider is essential, but it is not the first action. The most important initial step is to seal the chest tube site to prevent further complications. After the dressing is applied, the nurse can then notify the healthcare provider and continue to monitor the patient.

A. and record vital signs every 4 hours. B. intake and output hourly. C. heart and lung sounds every shift. D. level of consciousness every shift.

Correct Answer is B

Explanation

A. and record vital signs every 4 hours:
While vital signs are important, monitoring every 4 hours may not be frequent enough in an intensive care setting, especially for a client requiring mechanical ventilation. Vital signs, including blood pressure, heart rate, respiratory rate, and oxygen saturation, should be monitored more frequently (at least every hour) to detect changes in the patient's condition, particularly since positive pressure ventilation can significantly affect circulatory status.

B. Intake and output hourly:
In acute respiratory distress syndrome (ARDS), the client may require mechanical ventilation to support breathing. Positive pressure ventilation, while essential for improving oxygenation, can increase intrathoracic pressure, which may impair venous return to the heart, decreasing cardiac output. As a result, it is critical to monitor the fluid balance closely, as fluid overload can worsen the patient's condition and contribute to pulmonary edema or other complications. Hourly assessment of intake and output (I&O) helps the nurse monitor renal function, fluid status, and cardiac output. Maintaining a proper balance of fluids is crucial in managing ARDS and its associated complications.

C. Heart and lung sounds every shift:
A shift assessment of heart and lung sounds is useful but is not frequent enough to detect early changes in a client with decreased cardiac output or other complications related to mechanical ventilation. More frequent monitoring of lung sounds and heart function may be necessary, particularly in clients at risk of ventilator-associated complications like ventilator-associated pneumonia (VAP), pulmonary edema, or arrhythmias.

D. Level of consciousness every shift:
Monitoring level of consciousness is important, especially in clients with ARDS and mechanical ventilation, as changes in consciousness can indicate worsening hypoxia or hypercapnia. However, this assessment is less directly related to the immediate concern of decreased cardiac output, which can be more effectively managed through continuous monitoring of fluid status and vital signs rather than consciousness alone. Though consciousness should be monitored regularly, I&O hourly would be more crucial in this context for managing cardiac output.

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The nurse assessing the client diagnosed with Parkinson's disease (PD) would expect which of the following assessment findings?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What is the first action the nurse should take with the accidental dislodgement of a chest tube?

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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