Nokea
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.
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A client taking which of the following medications will see a decrease in effectiveness if rivastigmine (Exclon) is initiated?
- A. Benztropine (Cogentin)
- B. Quetiapine (Seroquel)
- C. Glycopyrrolate (Robinul)
- D. Theophylline (Theo-Dur)
- E. Tiotropium (Spiriva)
Correct Answer: A,C,E
Rationale: A client taking anticholinergic medications, like benztropine, glycopyrrolate, and tiotropium, will see a decrease in effectiveness if rivastigmine (Exelon) is initiated.
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.
The daughter of a client with AD who is receiving cholinesterase inhibitor therapy tells the nurse that her father has been getting more and more clumsy lately, saying, 'He's almost fallen several times and he often gets out of bed at night. That's when I'm most concerned that he will fall.' The daughter reports that his appetite is fair and that he takes his medication as prescribed. When developing the client's plan of care, the nurse would identify which nursing diagnosis as the priority?
- A. Imbalanced Nutrition: Less Than Body Requirements
- B. Risk for Injury
- C. Ineffective Self Health Management
- D. Deficient Knowledge: drug therapy
Correct Answer: B
Rationale: Based on the daughter's report, the client is at high risk for injury and this would be the priority. Imbalanced nutrition might be appropriate based on the daughter's report that her father's appetite is fair. However, additional information is needed to determine if this nursing diagnosis would be more of a priority than the risk for injury. The client is receiving his medication as prescribed, so ineffective self health management is not a concern. There is no evidence to suggest that there is a lack of knowledge about the drug therapy.
A client asks the nurse about using the herb ginkgo to improve his memory and thinking. Which of the following would the nurse need to integrate into the response about this herb?
- A. There is scientific proof that this herb is effective.
- B. The effects may take at a minimum 4 weeks to occur.
- C. Mild GI discomfort and headache may occur with the herb.
- D. The herb needs to be taken at least four times a day to be effective.
- E. The herb if taken in large doses rarely leads to problems.
Correct Answer: B,C
Rationale: Conflicting research both supports and disputes ginkgo's ability to enhance memory. The effects of ginkgo may not be evident until after 4 to 24 weeks of treatment. The most common adverse reactions include mild GI discomfort, headache, and rash.
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.