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CE Connection

Tremors: Learning to stop the shakes

Author Information
doi: 10.1097/01.NPR.0000375809.28406.e3
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INSTRUCTIONS Tremors: Learning to stop the shakes


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Tremors: Learning to stop the shakes

General Purpose: To provide NPs with an overview of assessment, diagnoses, and management of tremor. Learning Objectives: After reading the preceding article and taking the following test, the NP should be able to: 1. Discuss the pathophysiology, etiology, and various types of tremor. 2. Identify medications that can cause tremor. 3. Describe the NP's role in tremor identification, diagnosis, and management.

1. The most common cause of rest tremor is

a. Wilson disease.

b. multiple sclerosis.

c. Parkinson disease (PD).

d. Huntington chorea.

2. A tremor occurring with voluntary muscle contraction but without movement is a/an

a. postural tremor.

b. isometric tremor.

c. intention tremor.

d. task-specific tremor.

3. To assess for postural tremor, observe while the patient

a. pushes against a wall.

b. writes a short paragraph.

c. extends the arms in front of the body.

d. performs a finger-nose-finger maneuver.

4. A kinetic tremor can be caused by

a. hypoglycemia.

b. thyrotoxicosis.

c. heavy metal toxins.

d. posttraumatic stress disorder.

5. The use of amphotericin B can cause

a. rest tremor.

b. kinetic tremor.

c. postural tremor.

d. intention tremor.

6. Which drug can cause action tremor?

a. epinephrine

b. haloperidol

c. thalidomide

d. valproic acid

7. Intention tremor can occur with

a. tamoxifen use.

b. lithium toxicity.

c. co-trimoxazole use.

d. salmeterol use.

8. A slow, snake-like continuous movement of the arms and legs describes

a. a tic.

b. chorea.

c. athetosis.

d. akathisia.

9. A patient with dystonia will exhibit

a. rapid, irregular, jerky movements.

b. rapid, nonrhythmic facial movements.

c. sustained twisting muscle contractions.

d. explosive flail-like movements of the extremities.

10. Antipsychotic drugs can cause crawling feelings on the legs called

a. akathisia.

b. ballism.

c. dystonia.

d. myoclonus.

11. Which statement about essential tremor is accurate?

a. It occurs very rarely.

b. It mainly affects the hands.

c. It is usually asymmetrical.

d. It affects males more than females.

12. Infantile tremor may result from a

a. vitamin D deficiency.

b. cerebellar lesion.

c. vitamin B12 deficiency.

d. heterodegenerative disorder.

13. The frequency of PD tremor usually ranges from

a. 2 to 5 Hz.

b. 6 to 9 Hz.

c. 10 to 12 Hz.

d. 13 to 15 Hz.

14. Patients with multiple sclerosis experience

a. rest tremor.

b. postural tremor.

c. isometric tremor.

d. kinetic intention tremor.

15. Which statement about treatment for PD isnotaccurate?

a. Medications are used to slow progression of the disease.

b. Older patients have increased risk of levodopa complications.

c. Propanolol is a second-line medication.

d. Surgical options may be used late in the disease process.

16. Pharmacologic management of cerebellar tremor

a. includes levodopa.

b. includes antidepressants.

c. includes anticonvulsants.

d. has not yet been established.

17. The most determining factor in diagnosing tremor is

a. frequency.

b. location.

c. rhythmicity.

d. amplitude.

18. Serum ceruloplasmin and 24-hour urinary copper excretion tests are used to rule out

a. Wilson disease.

b. multiple sclerosis.

c. PD.

d. Huntington disease.

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