Nokea
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.
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A caregiver of a client diagnosed with AD asks the nurse about the cholinesterase inhibitor galantamine prescribed for the client. Which response by the nurse would be most appropriate?
- A. The drug will help to cure the memory problems the client is experiencing.
- B. Once the symptoms improve, the drug will most likely be stopped.
- C. These drugs help to slow the progression of the disease.
- D. This drug is primarily given to control the delirium the client is experiencing.
Correct Answer: C
Rationale: The progression of memory loss associated with dementia is treated with cholinesterase inhibitors. These drugs slow progression but do not cure dementia. These drugs are given to clients with mild to moderate dementia, but they do not treat any delirium that the clients may experience. Cholinesterase inhibitors are not frequently used in late-stage AD.
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.
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 with AD receiving a cholinesterase inhibitor has a nursing diagnosis of Imbalanced Nutrition: Less Than Body Requirements. Which of the following would be most appropriate?
- A. Provide nutritious meals three times a day.
- B. Give foods that have the same consistency.
- C. Encourage careful chewing.
- D. Encourage visitors during mealtime.
Correct Answer: C
Rationale: The nurse should encourage chewing action when feeding. The nurse need not provide nutritious meals three times a day; instead, frequent small nutritious meals would be more beneficial. Offering foods of different consistency and flavor is important in case the patient can handle one form better than another. The nurse should not encourage visitors during mealtime; mealtime should be simple and calm.
A client is receiving donepezil. When reviewing the client's medication history, the nurse determines that the client is at increased risk for GI bleeding if the client is also taking which drug?
- A. Naproxen (Naprosyn)
- B. Oxycodone (OxyContin)
- C. Acetaminophen (Tylenol)
- D. Ibuprofen (Motrin)
- E. Meperidine (Demerol)
Correct Answer: A,D
Rationale: Use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen or ibuprofen, in combination with donepezil place the client at an increased risk for GI bleeding. Oxycodone, acetaminophen, and meperidine do not increase the client's risk.