Nokea
The nurse is relating medication classifications for Alzheimer type dementia to the pathophysiology of the disease process. Which neurotransmitter do most the medications on the market currently impact?
- A. Dopamine
- B. Acetylcholine
- C. Norepinephrine
- D. Epinephrine
Correct Answer: B
Rationale: Current drugs approved for treatment of dementia of the Alzheimer type include cholinesterase inhibitors, which increase acetylcholine by inhibiting cholinesterase, the enzyme that degrades it. When these drugs, tacrine (Cognex), donepezil (Aricept), or rivastigmine (Exelon), are administered in the early to middle stages of Alzheimer disease, some clients improve. Only memantine (Namenda) has a different mechanism of action.
You may also like to solve these questions
Which of the following nursing diagnoses would be of highest priority for a client diagnosed with advanced Alzheimer disease?
- A. Chronic Confusion
- B. Memory Impairment
- C. Impaired Verbal Communication
- D. Aspiration Risk
Correct Answer: D
Rationale: When identifying a priority, select the diagnosis that could be the most harmful. The nurse is most correct to select Aspiration Risk as the highest priority. Aspiration can potentially cause pneumonia. Memory Impairment and Chronic Confusion are manageable with appropriate supervision. Impaired Verbal Communication is an obstacle in expressing thoughts and feelings.
The nurse is instructing the parents of a 21-year-old with schizophrenia who hears voices. Which response by the parent to the child validates that the parent understands the discharge teaching?
- A. The parent states 'Does the person speaking have a name?'
- B. The parent states 'The person speaking to you is bad, but you are good.'
- C. The parent states 'The voice is not real. We have talked about this before.'
- D. The parent states 'I do not hear the voices, but what are they telling you?'
Correct Answer: D
Rationale: The parent is most correct to state not hearing the voices but then asking the client to share what the voices are saying. By identifying the content of the hallucinations, the parent can determine the safety of the client or if others are in jeopardy. Also, the parent is correct to call the auditory hallucinations by the term 'the voices.'
The nurse is observing the interaction between a parent and child with schizophrenia. The child states, 'The man visiting me said you went on vacation without me.' The parent replies 'There is no man, you are just making that up.' When interacting with the parent privately, which reply from the parent would the nurse suggest?
- A. I am not on vacation. I am here with you.
- B. How can I go on vacation. I do not have any money.
- C. Stop saying that. You know better. No one told you that.
- D. Just forget about that and let's talk about something else.
Correct Answer: A
Rationale: The nurse is correct to suggest not arguing with the client. This can escalate the situation. The nurse should suggest not validating the delusional belief and focus the discussion to the 'here and now.'
The nurse is caring for a client diagnosed with delirium. What does the nurse know to be true of delirium?
- A. It is incurable.
- B. It is a sudden, transient state.
- C. It has a gradual onset.
- D. It is considered permanent.
Correct Answer: B
Rationale: Delirium is a sudden, transient state of confusion. The period of confusion depends on the cause of the delirium. Treating the underlying medical condition usually restores mental function.
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.