Which non-motor symptom would the nurse assess for in a client with Parkinson's disease who reports difficulty falling asleep and frequent nighttime awakenings?
Sleep disturbance
Anxiety disorder
Daytime sleepiness
Hallucinations
The Correct Answer is A
Rationale:
A. Difficulty falling asleep (sleep-onset insomnia) and frequent nighttime awakenings (sleep-maintenance insomnia) are common non-motor symptoms of Parkinson’s disease. Sleep disturbances may result from dopaminergic dysfunction, nocturia, restless legs, pain, or medication side effects, and can significantly affect quality of life, cognition, and daytime functioning. Assessing and addressing sleep hygiene, medication timing, and environmental factors is essential for managing this symptom.
B. Anxiety may coexist with sleep disturbances but is not the primary cause of difficulty falling asleep and frequent awakenings in this scenario. Anxiety typically presents as excessive worry, restlessness, or tension, rather than isolated nocturnal sleep disruption.
C. Excessive daytime sleepiness (EDS) is a related non-motor symptom, often secondary to poor nighttime sleep or as a side effect of dopaminergic medications. However, the client’s current complaint focuses on nocturnal insomnia, not daytime somnolence.
D. Hallucinations, such as visual or auditory perceptions without external stimuli, are non-motor symptoms of PD, often associated with advanced disease or medication side effects. They do not explain difficulty initiating or maintaining sleep.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Monitor for signs of hypoglycemia is incorrect because prednisone, a corticosteroid, typically causes hyperglycemia, not hypoglycemia. Corticosteroids increase blood glucose levels by stimulating gluconeogenesis, reducing peripheral glucose uptake, and promoting insulin resistance. Therefore, the client is at increased risk of high blood sugar, not low blood sugar.
B. Prednisone commonly causes significant hyperglycemia, especially in clients with type 2 diabetes mellitus. Because this client is already insulin-dependent, the priority intervention is to anticipate the need for increased insulin dosing and adjust the regimen accordingly. This prevents severe hyperglycemia, diabetic ketoacidosis (DKA), or hyperosmolar hyperglycemic state (HHS). Close monitoring of blood glucose levels and titration of insulin is essential.
C. The dose of prednisone is determined by the provider for asthma management. Increasing the dose without provider direction is unsafe and would worsen hyperglycemia and potential steroid-related complications.
D. Although corticosteroids can cause fluid retention, fluid restriction is not appropriate or safe unless the client has another condition requiring restriction (e.g., heart failure). Managing glucose levels is a much higher priority, and fluid restriction does not prevent steroid-induced hyperglycemia.
Correct Answer is ["11"]
Explanation
Step 1: Convert the patient’s weight to kilograms
Weight in kg = 231 ÷ 2.2 ≈ 105 kg
Step 2: Calculate the insulin dose in units per hour
Dose (units/hr) = 0.1 units/kg/hr × 105 kg = 10.5 units/hr
Step 3: Determine the concentration from the insulin label (typically, insulin is supplied as 100 units/100 mL for IV infusion unless otherwise specified; if we assume 1 unit/mL)
mL/hr = Units/hr ÷ Concentration (units/mL)
Assuming 1 unit/mL:
mL/hr = 10.5 ÷ 1 ≈ 11 mL/hr
Final Answer: 11 mL/hr
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