When treating patients with medications for Parkinson’s disease, the nurse knows that the wearing-off phenomenon occurs for which reason?
There are rapid swings in the patient’s response to levodopa.
The patient cannot tolerate the medications at times.
The medications begin to lose effectiveness against Parkinson’s disease.
The patient’s liver is no longer able to metabolize the drug.
The Correct Answer is A
Choice A reason: The wearing-off phenomenon in Parkinson’s occurs when levodopa’s effect diminishes before the next dose, causing symptom fluctuations. This results from progressive dopamine neuron loss, reducing storage capacity, and shorter levodopa half-life, leading to rapid swings in motor control as plasma levels fluctuate.
Choice B reason: Intolerance to medications may cause side effects (e.g., nausea), but the wearing-off phenomenon is due to disease progression and levodopa’s pharmacokinetics, not patient tolerance. Symptoms return as drug levels drop, not because of inability to tolerate the dose.
Choice C reason: Medications like levodopa remain effective, but wearing-off occurs due to shorter duration of action as Parkinson’s progresses, not loss of drug efficacy. Neuron loss reduces dopamine storage, causing symptoms to re-emerge between doses, not a failure of the drug itself.
Choice D reason: The liver metabolizes levodopa minimally; carbidopa prevents peripheral breakdown. Wearing-off is due to central nervous system changes (loss of dopamine neurons), not liver dysfunction, which does not significantly alter levodopa’s pharmacokinetics in Parkinson’s disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Removing traction during repositioning disrupts the continuous pull needed to maintain bone alignment in fractures. This could lead to misalignment, delayed healing, or increased pain, as traction counteracts muscle spasms and stabilizes the fracture site.
Choice B reason: While skin assessment during a bed bath is important to detect pressure injuries, it is a general nursing responsibility, not specific to traction care. Traction-specific teaching focuses on maintaining the system’s integrity, such as ensuring proper weight function, over general hygiene tasks.
Choice C reason: Using alcohol wipes for pin care in skeletal traction is inappropriate, as it may not adequately prevent infection. Pin sites require sterile technique with solutions like chlorhexidine to minimize osteomyelitis risk, making this an incorrect teaching point.
Choice D reason: In traction, weights must hang freely to maintain consistent force for bone alignment and fracture stabilization. Obstructed weights reduce traction effectiveness, potentially causing misalignment, delayed healing, or increased pain, making this a critical teaching point for safe traction care.
Correct Answer is ["0.6"]
Explanation
Step 1 is: Convert pounds to kilograms 33 ÷ 2.2 = 15 Result = 15 kg
Step 2 is: Multiply weight by dosage 15 × 20 = 300 Result = 300 mg/day
Step 3 is: Divide total daily dose into 4 doses 300 ÷ 4 = 75 Result = 75 mg per dose
Step 4 is: (125 ÷ 1) = 125 mg/mL
Step 5 is: (75 ÷ 125) = 0.6 Result = 0.6 mL per dose
Final answer = 0.6 mL per dose
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