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The nurse is explaining early changes with Parkinson disease to the student nurse. Which statement by the nurse is correct regarding the pathophysiology of the disease?

There is total absence of dopamine at receptors in brain cells controlling motor movement, causing Parkinson symptoms to appear.

There is an excess of dopamine production and deficiency of acetylcholine production.

There is a decreased production of dopamine and excess of acetylcholine.

There is a deterioration of the myelin sheath of the basal ganglia and the person has tremors.

Answer and Explanation

The Correct Answer is C

Choice A reason: There is total absence of dopamine at receptors in brain cells controlling motor movement, causing Parkinson symptoms to appear, is not the correct statement. Parkinson disease is not caused by a complete lack of dopamine, but by a gradual loss of dopamine-producing neurons in the substantia nigra, a part of the brain that regulates movement. The symptoms of Parkinson disease, such as tremor, rigidity, and bradykinesia, appear when about 80% of the dopamine neurons are lost.

Choice B reason: There is an excess of dopamine production and deficiency of acetylcholine production, is not the correct statement. Parkinson disease is not caused by an excess of dopamine, but by a deficiency of dopamine. Dopamine is a neurotransmitter that helps to control movement, balance, and coordination. Acetylcholine is another neurotransmitter that works in opposition to dopamine. When dopamine is low, acetylcholine becomes dominant and causes abnormal muscle movements.

Choice C reason: There is a decreased production of dopamine and excess of acetylcholine, is the correct statement. Parkinson disease is caused by a decreased production of dopamine and excess of acetylcholine. This creates an imbalance in the neurotransmitters that regulate movement, leading to the characteristic symptoms of Parkinson disease, such as tremor, rigidity, and bradykinesia.

Choice D reason: There is a deterioration of the myelin sheath of the basal ganglia and the person has tremors, is not the correct statement. Parkinson disease is not caused by a deterioration of the myelin sheath, but by a degeneration of the dopamine neurons. Myelin is a fatty substance that covers the axons of the nerve cells and helps to transmit electrical impulses. The basal ganglia are a group of structures in the brain that are involved in movement, learning, and emotion. Tremors are one of the symptoms of Parkinson disease, but they are not the only or the most specific one.

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Correct Answer is C

Explanation

Choice A reason: This is incorrect. Polyphasia and nystagmus are not signs of neurological deterioration, but rather of speech and eye disorders. Polyphasia is the excessive use of words or speech, and nystagmus is the involuntary movement of the eyes.

Choice B reason: This is incorrect. Increased respiratory rate and depth are not signs of neurological deterioration, but rather of respiratory distress or hyperventilation. They may indicate a problem with the lungs or the blood gases, not the brain.

Choice C reason: This is correct. Decreased level of consciousness and difficulty arousing upon stimulation are signs of neurological deterioration, as they indicate a decrease in the brain's ability to function and respond to stimuli. They may be caused by increased intracranial pressure, bleeding, swelling, or infection in the brain.

Choice D reason: This is incorrect. Decreased pulse pressure and pupils slowly reactive and round to light are not signs of neurological deterioration, but rather of cardiovascular or autonomic dysfunction. They may indicate a problem with the heart or the blood pressure, not the brain.

A. Lethargy B. Slowed responses to verbal cues. C. Negative Babinski sign D. Altered speech. E. Decreased level of consciousness.

Correct Answer is ["A","B","D","E"]

Explanation

Choice A reason: Lethargy is a sign of increased intracranial pressure (ICP), as it indicates a decreased level of alertness and responsiveness due to brain compression¹².
Choice B reason: Slowed responses to verbal cues are a sign of increased ICP, as they indicate a decreased level of cognitive function and communication ability due to brain compression¹².
Choice C reason: Negative Babinski sign is not a sign of increased ICP, as it indicates a normal reflex response of the toes to stimulation of the sole of the foot³. A positive Babinski sign, where the big toe extends upward and the other toes fan out, is a sign of neurological damage, but not necessarily increased ICP³.
Choice D reason: Altered speech is a sign of increased ICP, as it indicates a decreased level of language function and articulation due to brain compression¹².
Choice E reason: Decreased level of consciousness is a sign of increased ICP, as it indicates a decreased level of awareness and arousal due to brain compression¹².

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The nurse is explaining early changes with Parkinson disease to the student nurse. Which statement by the nurse is correct regarding the pathophysiology of the disease?

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Explanation

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