Nokea
The nurse is caring for a client in the mild cognitive impairment stage of Alzheimer disease. When reviewing the client's medication regimen, which medication does the nurse identify as having a neuroprotective property?
- A. Namenda
- B. Vitamin B2
- C. Celebrex
- D. Neurontin
Correct Answer: A
Rationale: The neuroprotective drugs are the newest medications on the market. The newest drug, Namenda, contains memantine, which is a neuroprotective. The other medications are not Alzheimer medications that diminish dementia.
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Which of the following is an outcome of the drug memantine (Namenda) in clients with advanced stages of Alzheimer disease?
- A. Less depression
- B. Increased brain excitability
- C. Lessens symptoms
- D. Decreased brain excitability
Correct Answer: C
Rationale: Clients in advanced stages of Alzheimer disease have fewer symptoms when taking memantine than others who were given a placebo.
The client asks the nurse if there is a diagnostic test that confirms the diagnosis of Alzheimer disease. Which response by the nurse identifies how the diagnosis is confirmed?
- A. Alzheimer disease is confirmed by validating mental decline and ruling out other diseases.
- B. Alzheimer disease is confirmed by the presence of biomarkers found in the blood.
- C. Alzheimer disease is evident on an MRI that highlights tangles in the brain.
- D. Alzheimer disease is diagnosed when acetylcholine is found in spinal fluid.
Correct Answer: A
Rationale: Much research is being done to determine a diagnostic test confirming Alzheimer disease. The nurse is most correct to confirm that Alzheimer disease is currently validated by noting mental decline and ruling out all other disease processes. Upon autopsy, neurofibrillary tangles are noted. There currently is not a test using biomarkers for Alzheimer disease. An MRI is used to exclude other disease processes and is not specific for Alzheimer disease. Acetylcholine may result in cognitive deficits but is not found in the spinal fluid.
A client is taking a traditional antipsychotic medication and is exhibiting grimacing and lip smacking. The nurse would document this side effect as which of the following?
- A. Akinesia
- B. Akathisia
- C. Tardive dyskinesia
- D. Dystonia
Correct Answer: C
Rationale: Tardive dyskinesia occurs when the client makes involuntary muscle movements, usually in the face, such as tongue thrusting, lip smacking, or blinking. Akinesia is pseudo parkinsonism. Akathisia is the inability to sit still. Dystonia is a sudden severe muscle spasm, usually in the neck, tongue, or eyes.
The nurse is caring for a client who has experienced readmission to the behavioral health unit for an exacerbation of schizophrenia. Which assessment question asked by the nurse identifies a possible cause for the return?
- A. Do you take a generic form of your medications?
- B. When was your last dose of medication?
- C. Are you having any side effects of the medication?
- D. Can you afford to purchase your medication?
Correct Answer: B
Rationale: The nurse is correct to identify that noncompliance with drug therapy is the leading cause of the return of disease symptoms and the need for short-term hospitalization. Asking when the client's last dose of medication was opens communication for when the medication was last administered. If it was not at the prescribed time, the conversation allows the nurse to probe why. Taking a generic medication does not change the effectiveness. Asking if the client can afford the medication or if the medication causes side effects does not directly address the question of noncompliance.
A family brings a parent to the physician's office to discuss the parent's decline in cognitive status. The family states that the parent is forgetful and needs reminders to be able to live alone. Following assessment, which stage of Alzheimer disease does the nurse anticipate?
- A. Preclinical
- B. Post clinical
- C. Mild cognitive impairment
- D. Alzheimer dementia
Correct Answer: C
Rationale: The nurse is most correct to anticipate that the client will be diagnosed at the mild cognitive impairment stage of Alzheimer disease. At this stage, the client has noticeable memory problems, however, the memory loss is not serious enough to interfere with independent living.