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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 B

Explanation

Choice A reason: This is incorrect. Anticoagulant therapy may be necessary to prevent pulmonary thrombosis in patients with ischemic stroke, which is caused by a blood clot blocking a blood vessel in the brain. However, in patients with hemorrhagic stroke, which is caused by a ruptured blood vessel in the brain, anticoagulant therapy can worsen the bleeding and increase the risk of complications.

Choice B reason: This is correct. Anticoagulant therapy is contraindicated because it will cause additional bleeding in patients with hemorrhagic stroke. Anticoagulants are drugs that prevent blood from clotting or dissolve existing clots. They can increase the size of the hematoma and the pressure on the brain tissue, leading to more damage and disability.

Choice C reason: This is incorrect. Anticoagulant therapy is not inadvisable because it may mask signs and symptoms of neurologic changes in the brain. Anticoagulants do not affect the neurological assessment or the diagnosis of stroke. They can, however, interfere with the treatment and recovery of hemorrhagic stroke.

Choice D reason: This is incorrect. Anticoagulant therapy will not be started if necessary to enhance cerebral circulation in patients with hemorrhagic stroke. Anticoagulants do not improve the blood flow to the brain, but rather prevent or dissolve clots that may obstruct it. In patients with hemorrhagic stroke, the pro

A. Generalized muscle weakness and severe muscle spasms. B. Mental confusion and aggressive behaviors C. Dysarthria and decreased clarity of spoken words D. Impairment of respiratory muscles and cognition remains intact.

Correct Answer is D

Explanation

Choice A reason: This is incorrect. Generalized muscle weakness and severe muscle spasms are not late manifestations of amyotrophic lateral sclerosis, but rather early or intermediate symptoms. Amyotrophic lateral sclerosis is a progressive neurodegenerative disorder that affects the motor neurons that control voluntary muscles. The disease causes muscle weakness, stiffness, twitching, and cramps.

Choice B reason: This is incorrect. Mental confusion and aggressive behaviors are not common manifestations of amyotrophic lateral sclerosis, but rather signs of dementia or other psychiatric disorders. Amyotrophic lateral sclerosis does not usually affect the cognitive or emotional functions of the brain, except in some rare cases.

Choice C reason: This is incorrect. Dysarthria and decreased clarity of spoken words are not late manifestations of amyotrophic lateral sclerosis, but rather intermediate or advanced symptoms. Dysarthria is a speech disorder that results from the weakness or paralysis of the muscles involved in speech production. It causes slurred, slow, or distorted speech.

Choice D reason: This is correct. Impairment of respiratory muscles and cognition remains intact are common late manifestations of amyotrophic lateral sclerosis. As the disease progresses, the respiratory muscles become weak and unable to support breathing. This can lead to respiratory failure and death. However, the cognition of the patient usually remains intact until the end, as the disease does not affect the higher functions of the brain.

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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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Naxlex Comprehensive Predictor Exams

A family member of a patient diagnosed with a hemorrhagic stroke asks if the patient can receive anticoagulant therapy to improve their outcome. The nurse explains that anticoagulant therapy for the patient

Correct Answer is B

Explanation

The nurse is teaching the family about amyotrophic lateral sclerosis and progression of the disease. The nurse would include which common late manifestations?

Correct Answer is D

Explanation

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