Nokea
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.
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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 client is prescribed donepezil for dementia. Review of the client's medication history reveals that the client uses NSAIDs for arthritis. The nurse would assess the client closely for which of the following?
- A. Decreased effectiveness of the NSAID
- B. Increased risk of NSAID toxicity
- C. Increased risk of GI bleeding
- D. Decrease GI absorption of the donepezil
Correct Answer: C
Rationale: NSAIDs in conjunction with donepezil increase the client's risk for GI bleeding. The effectiveness of the NSAID does not decrease, nor does the GI absorption of donepezil. There is no increase in the risk for NSAID toxicity.
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.
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.
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.