Nokea
The caregiver of a client diagnosed with AD asks the nurse about the prescribed therapy with rivastigmune and about how the drug works. The nurse would integrate knowledge of which action in the response to the caregiver?
- A. Increases the level of acetylcholine in the CNS
- B. Decreases the level of neurotoxins in the brain
- C. Increases the level of cholinesterase in the blood
- D. Increases the level of adenosine triphosphate in the blood
Correct Answer: A
Rationale: Administration of cholinesterase inhibitors results in an increase in the level of acetylcholine in the CNS. Administration of cholinesterase inhibitors does not decrease the neurotoxins in the brain or increase the level of adenosine triphosphate in the blood. Cholinesterase inhibitors inhibit and do not increase the level of cholinesterase in the blood.
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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.
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.
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.
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.