Nokea
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.
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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.
The daughter of a client with AD who is receiving cholinesterase inhibitor therapy tells the nurse that her father has been getting more and more clumsy lately, saying, 'He's almost fallen several times and he often gets out of bed at night. That's when I'm most concerned that he will fall.' The daughter reports that his appetite is fair and that he takes his medication as prescribed. When developing the client's plan of care, the nurse would identify which nursing diagnosis as the priority?
- A. Imbalanced Nutrition: Less Than Body Requirements
- B. Risk for Injury
- C. Ineffective Self Health Management
- D. Deficient Knowledge: drug therapy
Correct Answer: B
Rationale: Based on the daughter's report, the client is at high risk for injury and this would be the priority. Imbalanced nutrition might be appropriate based on the daughter's report that her father's appetite is fair. However, additional information is needed to determine if this nursing diagnosis would be more of a priority than the risk for injury. The client is receiving his medication as prescribed, so ineffective self health management is not a concern. There is no evidence to suggest that there is a lack of knowledge about the drug therapy.
When describing the action of cholinesterase inhibitors to a class of nursing students, the instructor would include which of the following about their action?
- A. The drugs decrease the level of acetylcholine in the CNS.
- B. They inhibit the breakdown of acetylcholine.
- C. The drugs slow neural destruction.
- D. They stop neural breakdown.
- E. The drugs increase excitatory neurotransmitters in the CNS.
Correct Answer: B,C
Rationale: Cholinesterase inhibitors act to increase the level of acetylcholine in the CNS by inhibiting its breakdown and slowing neural destruction.
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.
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.