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A client is prescribed donepezil for dementia. Review of the client's medication history reveals that the client uses NSAIDs for arthritis. The nurse would assess the client closely for which of the following?
- A. Decreased effectiveness of the NSAID
- B. Increased risk of NSAID toxicity
- C. Increased risk of GI bleeding
- D. Decrease GI absorption of the donepezil
Correct Answer: C
Rationale: NSAIDs in conjunction with donepezil increase the client's risk for GI bleeding. The effectiveness of the NSAID does not decrease, nor does the GI absorption of donepezil. There is no increase in the risk for NSAID toxicity.
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A client taking which of the following medications will see a decrease in effectiveness if rivastigmine (Exclon) is initiated?
- A. Benztropine (Cogentin)
- B. Quetiapine (Seroquel)
- C. Glycopyrrolate (Robinul)
- D. Theophylline (Theo-Dur)
- E. Tiotropium (Spiriva)
Correct Answer: A,C,E
Rationale: A client taking anticholinergic medications, like benztropine, glycopyrrolate, and tiotropium, will see a decrease in effectiveness if rivastigmine (Exelon) is initiated.
A client is prescribed memantine for the treatment of dementia of Alzheimer's disease. The nurse should assess the client for which of the following as a possible adverse reaction?
- A. Confusion
- B. Dyspepsia
- C. Muscle cramps
- D. Vomiting
Correct Answer: A
Rationale: When administering memantine to a client, a nurse should monitor the client for adverse reactions such as dizziness, headache, or confusion. Dyspepsia is an adverse reaction of rivastigmine; muscle cramps are an adverse reaction of donepezil; vomiting is an adverse reaction of rivastigmine and galantamine.
After teaching a group of nursing students about cholinesterase inhibitors, the instructor determines that additional teaching is needed when the students identify which drug as an example?
- A. Rivastigmine
- B. Donepezil
- C. Memantine
- D. Galantamine
Correct Answer: C
Rationale: Memantine is an example of an NMDA receptor antagonist. Rivastigmine, donepezil, and galantamine are cholinesterase inhibitors.
After administering rivastigmine to a client with AD, the nurse would continue to assess the client for which of the following adverse effects?
- A. Anorexia and nausea
- B. Cardiovascular dysfunction
- C. Diabetes mellitus
- D. Hypertension
Correct Answer: A
Rationale: The adverse effects associated with the administration of cholinesterase inhibitors include anorexia and nausea. Cardiovascular dysfunction, diabetes mellitus, and hypertension are not adverse effects associated with the administration of cholinesterase inhibitors.
A caregiver of a client diagnosed with AD asks the nurse about the cholinesterase inhibitor galantamine prescribed for the client. Which response by the nurse would be most appropriate?
- A. The drug will help to cure the memory problems the client is experiencing.
- B. Once the symptoms improve, the drug will most likely be stopped.
- C. These drugs help to slow the progression of the disease.
- D. This drug is primarily given to control the delirium the client is experiencing.
Correct Answer: C
Rationale: The progression of memory loss associated with dementia is treated with cholinesterase inhibitors. These drugs slow progression but do not cure dementia. These drugs are given to clients with mild to moderate dementia, but they do not treat any delirium that the clients may experience. Cholinesterase inhibitors are not frequently used in late-stage AD.