AIIMS BBSR SNO - 2019
Medical & Surgical Nursing
Easy
Which of the following is NOT a physical assessment finding in Parkinson's disease?
Appeared in: AIIMS BBSR SNO - 2019
Explanation
- Cognitive impairment is a common non-motor symptom in Parkinson's disease, affecting nearly all patients over the course of the illness.
- The presence of cognitive decline, ranging from mild issues to dementia, is a typical feature, not its absence.
- Therefore, stating that an 'absence of cognitive impairment' is a finding is incorrect; it is the opposite of what is commonly observed as the disease progresses.
Why Other Options Were Wrong
- Option B: Mask-like expression, or hypomimia, is a classic and common physical sign of Parkinson's disease, resulting from rigidity and bradykinesia of the facial muscles.
- Option C: Dysarthria, characterized by soft, monotonous, and rapid speech, is a frequent motor symptom affecting communication in individuals with Parkinson's disease.
- Option D: Pill-rolling tremor is one of the most well-known cardinal motor signs of Parkinson's disease. It is a resting tremor that often begins asymmetrically in one hand.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Clinical Manifestations of Parkinson's Disease to guide bedside assessment, documentation, and the next nursing action.
- Nurses must conduct holistic assessments for patients with Parkinson's, evaluating both motor and non-motor symptoms, as the latter significantly impact quality of life and safety.
- Cognitive decline can impair a patient's ability to adhere to complex medication schedules, manage finances, and recognize safety hazards, increasing the need for caregiver support and nursing interventions.
- What if? If a patient with early-stage Parkinson's disease presents with significant cognitive impairment from the outset, the nurse should consider that this might suggest an alternative diagnosis, such as Dementia with Lewy Bodies (DLB), and ensure the healthcare team investigates further.
How to Approach the Question
- First, identify the negative framing of the question ('NOT'). This means you are looking for the option that is inconsistent with the typical presentation of Parkinson's disease.
- Recall the classic signs and symptoms of Parkinson's disease. These include both motor and non-motor features.
- Evaluate each option: 'Mask-like expression,' 'Dysarthria,' and 'Pill-rolling tremors' are all well-known, classic motor findings.
- Consider the final option, 'Absence of cognitive impairment.' Think about whether cognitive function is typically spared in this disease.
- Conclude that since cognitive impairment is a very common non-motor symptom, its absence is not a characteristic finding. Therefore, this is the correct answer to the 'NOT' question.
Concept Tested & Keywords
- Concept Tested: Clinical Manifestations of Parkinson's Disease
- Stem keywords: Parkinson's disease, physical assessment finding
- Lead-in keywords: NOT
- Negative lead-in flag: The question asks to identify the option that is NOT a finding in Parkinson's disease.
Question ID
Q9RuLzNF-5RvO9r2ll3GtP
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 1844-1846, 1835-1837
E6 Medicine Davidson Principles Practice 24e p. 1133-1135
Practise the full AIIMS BBSR SNO - 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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