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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.
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To assess a client's cognitive ability, the nurse uses the Mini-Mental Status Examination. Which areas would the nurse assess?
- A. Reading comprehension
- B. Calculation
- C. Orientation
- D. Recall
- E. Language
Correct Answer: B,C,D,E
Rationale: The Mini-Mental Status Examination assesses a client's abilities on items such as orientation, calculation, recall, and language.
A nurse should advise clients taking which medications to avoid the use of ginkgo?
- A. Selective serotonin reuptake inhibitors
- B. Monoamine oxidase inhibitors
- C. NSAIDs
- D. Nonsalicylates
- E. Anticholinergics
Correct Answer: A,B
Rationale: Ginkgo is contraindicated in clients taking SSRI or MAOI antidepressants, because of the risk of a toxic reaction. Cholinesterase inhibitors interact with anticholinergics. Ginkgo does not interact with NSAIDs or nonsalicylates.
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.
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 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.