Nokea
A client with AD is prescribed rivastigmine by the primary health care provider. The nurse would anticipate administering this drug by which route?
- A. Intravenously
- B. Intramuscularly
- C. Orally
- D. Subcutaneously
- E. Transdermally
Correct Answer: C,E
Rationale: The nurse should administer rivastigmine orally or transdermally to the client. Rivastigmine is not administered intravenously, intramuscularly, or subcutaneously.
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After teaching the caregiver of a client prescribed transdermal rivastigmine, the nurse determines that the teaching was successful when the caregiver states which of the following?
- A. I'll apply a new patch every other day.
- B. The patch should be placed on a hairless area.
- C. I'll make sure to put the patch where he can see it.
- D. I can use the same spot once or twice a week.
Correct Answer: B
Rationale: Rivastigmine patches are changed on a daily basis and rotated to a clean, dry, and hairless area. Because the patient is experiencing dementia, the site for application should be where the patient is not able to pick at or remove the patch. The upper or lower portions of the back are recommended for patch administration. Because the same site should not be used more than once every 2 weeks, the caregiver should be instructed to make a chart of the back and indicate where patches have been applied during the last 14 days.
A nurse is preparing to administer rivastigmine oral solution. The nurse decides to mix it in a small amount of which of the following?
- A. Water
- B. Coffee
- C. Soda
- D. Tea
- E. Fruit juice
Correct Answer: A,C,E
Rationale: A nurse administering rivastigmine (Exelon) oral solution can give the solution directly to the client or mix it in a small amount of water, cold fruit juice, or soda.
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.
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.
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.