Nokea
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.
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The caregiver of a client diagnosed with AD asks the nurse about the prescribed therapy with rivastigmune and about how the drug works. The nurse would integrate knowledge of which action in the response to the caregiver?
- A. Increases the level of acetylcholine in the CNS
- B. Decreases the level of neurotoxins in the brain
- C. Increases the level of cholinesterase in the blood
- D. Increases the level of adenosine triphosphate in the blood
Correct Answer: A
Rationale: Administration of cholinesterase inhibitors results in an increase in the level of acetylcholine in the CNS. Administration of cholinesterase inhibitors does not decrease the neurotoxins in the brain or increase the level of adenosine triphosphate in the blood. Cholinesterase inhibitors inhibit and do not increase the level of cholinesterase in the blood.
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.
Which condition would require the nurse to cautiously monitor a client who is receiving donepezil?
- A. Hyperthyroidism
- B. Seizure disorder
- C. Renal disease
- D. Asthma
- E. GI bleeding
Correct Answer: B,C,D,E
Rationale: Cholinesterase inhibitors, like donepezil, are used cautiously in clients with renal or hepatic disease, bladder obstruction, seizure disorder, sick sinus syndrome, GI bleeding, history of ulcer disease, and asthma.
A review of a client's history reveals that the client takes ginkgo. Which of the following would the nurse assess for in the client as a common adverse reaction?
- A. Hyperglycemia
- B. Headache
- C. Hypotension
- D. Rash
- E. GI discomfort
Correct Answer: B,D,E
Rationale: The most common adverse reactions associated with ginkgo include mild GI discomfort, headache, and rash.
When reviewing the medical record of a client who is prescribed galantamine, which of the following, if found, would the nurse identify as a contraindication for the drug requiring the nurse to contact the primary health care provider?
- A. Hepatic disease.
- B. Renal disease.
- C. Pregnancy.
- D. Lactation
- E. Hyperthyroidism
Correct Answer: A,C,D
Rationale: Galantamine is contraindicated in clients who are pregnant, are lactating, or have hepatic disease.