Nokea
A nurse is reviewing the action of memantine. The nurse understands that this drug addresses which of the following?
- A. Acetylcholine
- B. Glutamate
- C. Serotonin
- D. Dopamine
Correct Answer: B
Rationale: Memantine, an NMDA receptor antagonist, is thought to work by decreasing the excitability of neurotransmission caused by an excess of the amino acid glutamate in the CNS.
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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 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.
After teaching a group of nursing students about confusion and how it differs from dementia, the instructor determines that the teaching was successful when the students identify which of the following about delirium?
- A. The onset occurred suddenly.
- B. Memory is significantly impaired.
- C. Sensory impairment occurs.
- D. Environmental changes are needed for safety.
Correct Answer: A,C
Rationale: Delirium occurs suddenly, affects the senses, and is reversible when the cause is found. In contrast, dementia occurs slowly, affects memory and judgment, and is not reversible, often requiring a change in the environment to maintain safety.
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.
A client is prescribed donepezil. The nurse would assess the client for which of the following as a possible adverse reaction?
- A. Anorexia
- B. Dizziness
- C. Headache
- D. Constipation
- E. Bradycardia
Correct Answer: A,B,C
Rationale: The nurse would assess the client for generalized adverse reactions to cholinesterase inhibitors like donepezil, which would include anorexia, nausea, vomiting, diarrhea, dizziness, and headache.