Which findings would the nurse expect when completing an admission physical for a client with a diagnosis of Parkinson disease?

• A. Muscle rigidity
• B. Blank facial expression
• C. Leaning toward the affected side
• D. Intention tremors with movement

Answer: (A)

Muscle rigidity is a hallmark of Parkinson disease and shows up on physical exam as an increased resistance to passive movement of the joints, often described as cogwheel or lead-pipe rigidity. This rigidity results from dopamine-related dysfunction in the basal ganglia, causing stiff, slowed, and inflexible muscles throughout the body. On admission assessment, this rigidity is a clear, objective sign that aligns with the motor pattern seen in PD.

A blank facial expression can occur in Parkinson disease due to reduced facial movements, but it’s not as definitive a finding on an exam as rigidity. Leaning toward the affected side suggests a stroke pattern with unilateral weakness, not the diffuse motor slowing and rigidity typical of PD. Intention tremors with movement point toward cerebellar disease, whereas Parkinson tremor is usually a resting tremor that decreases with purposeful movement. This resting, pipe-like rigidity is the most characteristic feature you’d expect to identify first in an admission exam for Parkinson disease.