Nokea
A group of nursing students are reviewing the stages of AD. They demonstrate understanding of the information when they identify which of the following as characteristic of preclinical AD?
- A. Client's changes in thinking are readily evident to family members.
- B. The client may exhibit moderate levels of anxiety.
- C. The ability to function is significantly limited.
- D. There are no cognitive changes noted.
Correct Answer: D
Rationale: Preclinical AD is characterized by no changes in cognitive or functional ability. With mild cognitive impairment, the changes in thinking are noticeable to the client and family members, and the person may experience mild to moderate anxiety. In dementia due to AD, memory, thinking, and behavior limit the person's ability to function.
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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.
A nurse is caring for a client receiving donepezil for treatment of Alzheimer's disease. Which of the following factors should the nurse monitor when assessing the client before administering the drug?
- A. Sexual habits
- B. Body weight
- C. Sleeping patterns
- D. Eating habits
Correct Answer: B
Rationale: The nurse should monitor body weight and the vital signs of the client during the initial assessment. The nurse need not monitor the sexual habits, sleeping patterns, or eating habits of the client when administering cholinesterase inhibitors.
A client asks the nurse about using the herb ginkgo to improve his memory and thinking. Which of the following would the nurse need to integrate into the response about this herb?
- A. There is scientific proof that this herb is effective.
- B. The effects may take at a minimum 4 weeks to occur.
- C. Mild GI discomfort and headache may occur with the herb.
- D. The herb needs to be taken at least four times a day to be effective.
- E. The herb if taken in large doses rarely leads to problems.
Correct Answer: B,C
Rationale: Conflicting research both supports and disputes ginkgo's ability to enhance memory. The effects of ginkgo may not be evident until after 4 to 24 weeks of treatment. The most common adverse reactions include mild GI discomfort, headache, and rash.
For a client who is receiving a cholinesterase inhibitor, which of the following can the nurse recommend to the client's caregiver to decrease the client's risk for injury?
- A. Observe frequent drug holidays.
- B. Encourage the use of assistive devices.
- C. Keep the bed in a low position.
- D. Use night lights.
- E. Decrease drug dose if mobility worsens.
Correct Answer: B,C,D
Rationale: To minimize the client's risk for injury, the nurse should encourage using assistive devices and keeping the bed in a low position, using night lights, and frequent monitoring by the caregiver.
A client is receiving donepezil. When reviewing the client's medication history, the nurse determines that the client is at increased risk for GI bleeding if the client is also taking which drug?
- A. Naproxen (Naprosyn)
- B. Oxycodone (OxyContin)
- C. Acetaminophen (Tylenol)
- D. Ibuprofen (Motrin)
- E. Meperidine (Demerol)
Correct Answer: A,D
Rationale: Use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen or ibuprofen, in combination with donepezil place the client at an increased risk for GI bleeding. Oxycodone, acetaminophen, and meperidine do not increase the client's risk.